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Governors Upstage White House as Ebola Coordinator Out of Sight

Tuesday, 28 October 2014 07:13 AM

A week before midterm elections, governors are upstaging the White House on dealing with Ebola, and President Barack Obama’s Ebola coordinator, Ron Klain, is staying out of public view.

The result is a national response to the risk of Ebola that has looked anything but coordinated.

Governors Chris Christie, a New Jersey Republican, and Andrew Cuomo, a New York Democrat, seized the national stage with orders to quarantine health workers returning from regions of Africa where Ebola is epidemic.

Over the weekend, the dominant image of the U.S. Ebola response was a confrontation between Christie and a nurse, who complained on social media of being held against her will in a tent at a New Jersey hospital, initially without access to a shower, flushable toilet, reading material or a television. The comedy show “Saturday Night Live” parodied Obama defending his Ebola response as less hapless than other recent crises.

Governors Rick Scott, a Florida Republican, and Pat Quinn, an Illinois Democrat, both in close re-election contests, soon followed the example set by Christie and Cuomo with their own actions, furthering a patchwork of diverging state-by-state policies on quarantines.

Obama administration officials succeeded in getting the state quarantine orders somewhat relaxed, saying they would hurt efforts to combat Ebola at its source. That message was undercut when a Pentagon spokesman revealed that U.S. Army personnel returning after performing logistics work in the outbreak region are being held in isolation for 21 days.

Election Drama

The drama is unfolding as Democrats struggle to hold their Senate majority in the Nov. 4 election. Obama’s job approval is sagging and polls show the public already in an uneasy mood over the state of the economic recovery and a re-emerging threat of terrorism from the Middle East.

“This is an election where there is an enormous amount of anxiety among voters, in particular among what I would call the super-shifters, the persuadables that are still out there,” said Chris Lehane, a Democratic strategist. “Both parties have had a hard time closing the deal with them.”

The Centers for Disease Control and Prevention released new, stricter guidelines yesterday for handling doctors and nurses who have treated patients in the outbreak region in an attempt to bring some consistency to the national response.

State Authority

It doesn’t go as far as requiring a quarantine, and the Obama administration said it can’t compel state and local officials to follow the CDC guidance.

“These kinds of policies should be driven by science, and the best scientific advice that is available,” White House Press Secretary Josh Earnest said yesterday, adding that “state and local officials have broad authority to impose quarantine policies in their own states and localities.”

Earnest refused to say whether New York and New Jersey officials notified the White House before mandating 21-day quarantines on doctors and nurses when they return from treating patients in the outbreak region. He also declined to say whether Klain participated in discussions with state officials.

Klain primarily will work in a “behind the scenes role,” Earnest said. “He’s responsible for coordinating the whole-of- government approach that the president has suggested is necessary.”

Quiet Encouragement

An Obama administration official, who asked for anonymity to discuss private conversations, said the White House quietly encouraged officials in New York and New Jersey to relax the quarantines initially imposed Oct. 24.

The official said that approach succeeded because the states removed the harder edges of the orders. Cuomo will allow health workers to serve out their quarantines in their homes and Christie permitted the nurse held in isolation over the weekend to leave the state to go to her home in Maine.

The White House has focused its efforts on building capacity to treat more people in the event of more cases, addressing national issues such as travel restrictions, speeding help to cities with Ebola cases, galvanizing an international strategy to fight the disease at its source and accelerating development of vaccines and new treatments, the official said.

Lehane said a calm, deliberate response often isn’t rewarded by the public when Americans fear a potential health crisis.

More Communication

“The lesson is you want to over-communicate, over-respond, overreact, overcompensate,” Lehane said. “It’s much better to be in a position, frankly, where you have a nurse complaining about how she’s being treated than to be in a position of why did you let someone with Ebola roam around the streets of New York.”

The quarantine orders were sparked by the case of an American doctor, who had treated patients in West Africa and was diagnosed last week with Ebola following his return to New York City. Before he developed symptoms, he was out and about in the city, eating at a restaurant and going bowling.

Two other states with international airports where additional health screenings are being done, Georgia and Virginia, haven’t take similar steps. Virginia Governor Terry McAuliffe said quarantines of individuals will be ordered only if needed. Georgia also is the host state for the CDC.

CDC Director Thomas Frieden issued guidelines recommending most health care workers returning from West Africa be actively monitored for symptoms of Ebola by local health-care authorities without a quarantine.

CDC Guidelines

Frieden said health care works at the highest risk, such as those who suffered a needle stick while caring for an Ebola patient or who tended to a patient without protective gear, should be voluntarily isolated at home and intensely monitored until the disease’s 21-day incubation period lapsed.

Frieden said treating “heroic” health care works like “pariahs” would make them less likely to go to the outbreak region to help stop the disease and ultimately increase the risk to the U.S.

Christie, a potential candidate for the Republican presidential nomination in 2016, said he doesn’t plan to rescind the mandatory quarantine order.

“We need to protect the public safety of the folks in the most densely populated area in the country, and that’s what we’re going to do,” he said in Florida on Oct. 26.

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A week before midterm elections, governors are upstaging the White House on dealing with Ebola, and President Barack Obama's Ebola coordinator, Ron Klain, is staying out of public view. The result is a national response to the risk of Ebola that has looked anything but...
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Tuesday, 28 October 2014 07:13 AM
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