Friday, October 17, 2014

CHARLES: Ebola, more vital facts untold


FILE - This undated file image made available by the Centers for Disease Control (CDC) shows the Ebola virus. In a second, smaller Ebola outbreak, at least 69 people, including eight health workers, are believed to have been infected according ... more >

By Robert Charles (Bio- - Thursday, October 16, 2014

The Obama White House and CDC have done it again.

With countless unknowns surrounding the recent discovery, transmission, infection rates, and potentially exponential growth of Ebola in the United States in the months ahead, trust is vital. Every American is dependent on information being disseminated by the Federal Government as this crisis unfolds. Information has to be accurate, both as to what we know and do not know. There cannot be material omissions. Yet, this White House continues to blithely assert knowledge they do not have, and to hold back facts that the public should know.

Examples pile up in both categories. In the first category, statements of knowledge and confidence without basis, we learned today that the White House really does not know how the nurses in Texas contracted Ebola, despite being protected by hazmat suits. We learned that the disease is supposed to be transmissible only person-to-person and by an exchange of bodily fluids, and yet there are studies indicating it may be transmitted by dogs, and that contact can be minimal.

Likewise, we learned that flights will continue to the U.S. from West Africa, even though we are not checking 100 percent of the passengers arriving from these countries; we are checking 94 percent of the hundreds daily entering the U.S. We learned that even at the five U.S. airports checking for Ebola infections by fever readings, there is no agreed fever level that warrants pulling someone aside. We learned that there is no protocol for what to do with the person pulled aside, other than call a hospital.

Nor is there a protocol to stop the passengers leaving the airport who were in contact with the potentially infected person. There are no quarantine facilities, no negative pressure or “clean rooms,” for passengers arriving who may be infected. There is no way, apparently, to check manifests from Europe to see if any passengers arriving from Europe have come recently from an infected country. And under the current policy, if a person wants to enter the US from these unregulated flights, direct or indirect, they can pop two aspirin before landing and banish their fever. They are now among us.

All these facts, and many more surfaced in the congressional hearings today, seem to make current presidential protestations of “complete confidence” in a flawed process with vast unknowns, seem more than a little hollow. Who can be confidence or can presume knowledge when so many unknowns – including the old unknown unknowns – plague the Federal repository of knowledge.

Instead, be honest. Be aggressive with the crisis, protecting Americans first, last and always. And stop telling the American public that this is like other crises, since it is not.

This set of events requires not just vigilance, deterrence, and luck. It requires flawless execution of a thoughtful, defensible and realistic set of protocols, intensive and immediate nationwide training, proper deployment of quarantine zones, equipment and so-called “clean rooms” (even if temporary and later decontaminated) at both airports and major hospitals. Happy talk will not get you through this one, Mr. President. Needed is a higher level of nationwide engagement, complete competence, and total transparency.

This brings me to that second category, the set of facts known and not being communicated. If trust is everything in a crisis, giving the American public reasons to trust in a President who has given us pause prior to this should be a White House priority.

Every fact that could help average Americans believe more in their Federal Government should be shared. But that is not happening. The reverse is happening.

Thus, for example, the White House – President Obama – did a long press conference on Wednesday of this week, but never revealed that one of the nurses infected was not – as presumed – remaining in Texas. Nor was she headed for Atlanta, but was instead quietly headed for a “level four containment” medical facility in suburban Washington, DC. She was placed in a “level four containment” area at the National Institutes of Health.

If he knew this on Wednesday, during the press conference, why keep this material fact from the American people? Even if the move was medic ally necessary, why was this kept secret? Again, the trust thing. People have a right to know about this crisis, both as and before it happens – not afterwards.

Here is another secret. According to well-placed sources tied to various parts of the medical community, the nation – our entire nation – has only four “level four containment” medical facilities, that is, highly secure hospitals of the Emory sort in Atlanta and the NIH sort in Washington DC.

The news is starker still. Between the four, I am told that there is a capacity of only 18 beds. For a population of 350 million Americans? Let us hope that no more than 18 cases emerge, then. Is this good preparation? No, not if that level of containment is needed for stopping the Ebola epidemic from rooting in the United States, and not if that level of isolation is needed to keep these patients both well treated and non-infectious to medical staff.

The four are apparently located in disparate places, and are each highly unique – thus, the placement of the two Ebola cases, so far known, at two of these four locations. The four are at Emory, NIH, Nebraska and Montana. That is it. So, please tell the American people Mr. President, that the options are limited, and that you are therefore doing something about this, now.

What are we doing to prepare for a wider set of needs? Are there temporary facilities with high level isolation units being created? And on the contact front, are each of the potentially infected persons on various flights, including those on which infected persons have flown, being physically isolated, tracked before they can infect others, and is there a universal or mass contact list being created to track each in detail?

If so, tell us. If not, tell us. Either way, do it.

In short, average Americans should not have to be hunting and pecking for real data, for the material facts surrounding this bona fides emerging Ebola crisis. Their President should be leading, helping them understand the facts, not backing and filling or blaming others, not sending his head of CDC to the Hill to spread unfounded confidence based on no more than happy talk.

Now is a time for complete engagement, honesty, and a restoration of trust. As I have written before, on other less urgent topics, if not now, when? Is this not reason enough to leave politics at the curb, get beyond the dodge and weave practice, and get in front of this emerging set of critical events.

Mr. President, you have the wheel. Now, turn into the wind. Help us all with this restoration of trust, or a meaningful attempt. We will try to turn with you into the wind. America must meet this Ebola crisis head on, unified. You must lead, based on a realistic assessment of what lies ahead. Unity depends on common trust. Trust depends on transparency, which means sharing all material facts with the public. There is no time like the present. Back to you, Mr. President.

Robert Charles is a former Assistant Secretary of State who served under Colin Powell and is now a private consultant in Washington DC.