The Ebola Crisis: Learning the Difference Between 99.5 and 100.4

October 16, 2014

The Ebola Crisis: Learning the Difference Between 99.5 and 100.4

Every crisis has its defining moment when an action, statement, picture or video seals its fate in the minds of Americans.

Who can forget President Bush’s praise for his FEMA chief – “Brownie, you’re doing a heckuva job” – in the midst of the Katrina disaster.

Then there was BP’s former CEO, Tony Hayward who earnestly said “I’d like my life back” as oil from one of his company’s wells was gushing into the Gulf of Mexico.

Sometimes the moment earns a company or organization huge praise and turns around a potential crisis such as when Johnson & Johnson quickly pulled all Tylenol medication off the market after some bottles were found to be tainted, replacing them within days with a tamper proof package.  More recently, NBA Commissioner Adam Silver lanced the potential damage from the crisis created by LA Clippers former owner Donald Sterling’s racist comments with a strong, decisive and action-filled press conference.

When the history of the current U.S. handling of the Ebola crisis is written, the CDC’s apparent decision not to stop Nurse Amber Vinson from flying home to Dallas, after she reported an elevated 99.5 fever which fell below the CDC’s Ebola threshold of 100.4, may be such a defining moment.

Why?  Because in any large scale crisis, the people in charge have to manage both the technical elements of the crisis – in this case, containing Ebola – as well as the confidence and trust of the American people.  The CDC made the wrong call on Ms. Vinson’s air travel because it applied strict public health protocols to a decision that should have been made by also applying the standards required to maintain public trust and confidence – standards that would have dictated a no fly decision.

To be clear, I think most Americans have great trust in the CDC on infectious disease issues and view it as one of the world’s leading health care institutions.  But the CDC’s mistaken call on Ms. Vinson’s flight, and its slow recognition of the fact that hospitals like Texas Health Presbyterian have not adequately trained their staffs in CDC Ebola protocols, make clear its limitations.  

To manage the Ebola crisis effectively, the CDC’s voice must be supplemented by national leaders who have their fingers on the pulse of Americans, and recognize when public trust, not just a public exposure temperature threshold, is on the line, as it was in the decision regarding Ms. Vinson’s air travel.  We need leaders who understand that when it comes to American hospitals treating Ebola patients, trust alone is not sufficient; we need to verify that they can and will implement the CDC protocols without fail as Emory appears to have done.  

More complex, but equally important, the current Ebola crisis clearly requires a multi-faceted approach that involves public health, international relations, coordination with state and local governments, screening of travelers, education and training, communications with the American people and much more.  The Obama Administration may be doing the proper work on most of these fronts, but if there is one glaring shortcoming in its CDC-centric communications, it is that they are not doing a very good job of communicating the full scope and magnitude of the effort underway.  As a result, the Administration is allowing the Ebola response to be defined by mistakes in protocols and temperature threshold decisions – and that is losing ground on which to manage this crisis with the American people.


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