“Stop Bashing The CDC”: Government Is The Enemy Until You Need A Friend
After a rough start dealing with America’s first Ebola cases, the Centers for Disease Control and Prevention appear to be getting the problem under control. This doesn’t mean that there won’t be more incidents; a health care worker was diagnosed with the virus in New York yesterday after returning from West Africa. But the CDC now seems better able to control secondary infections, particularly among health care workers, who are at the greatest risk.
As the 21-day incubation period lapses without new infections in Texas, dozens of people are being cleared from the watch list. But Ebola lingers as a reminder of how easily safety organizations can weaken and what we must do to keep them effective.
“Government is the enemy until you need a friend,” said former Secretary of Defense William Cohen. Government organizations like the CDC, the Army Corps of Engineers, the Federal Emergency Management Agency and the Federal Aviation Administration exist mostly to be our friends when we need protection from harm.
Unfortunately safety organizations like these don’t get much love in between disasters. They get attacked by those who covet their budget. They get attacked by those who hate government in general. They get attacked by corporations that don’t want to spend the money to comply with regulation. And they face political pressure to paper over potential problems that could embarrass some elected official. It’s hard to retain talent under conditions like that.
When we don’t take care of our safety organizations and don’t listen to them, they atrophy. Then disasters happen, and whoever is on watch ducks the blame. The person on watch always uses words like “Nobody could have foreseen …” For example: “Nobody could have foreseen” that the Army Corps’ levees in New Orleans would crumble during Hurricane Katrina. “Nobody could have foreseen” that terrorists might hijack an airplane and fly it into a building on 9/11. “Nobody could have foreseen” that dismantling Glass-Steagall Act protections would lead banks to gamble with taxpayer-guaranteed deposits. Not true. In most cases, agency staff anticipated the problem and tried to warn their bosses, but the boss didn’t pay attention because it was politically inconvenient or too expensive.
Frankly it’s a wonder that our safety agencies work as well as they do. The CDC is a case in point; they got many things right after their original poor response:
- They quickly acknowledged that procedures were not working.
- They didn’t circle the wagons. They listened to international medical organizations that had more experience in handling Ebola in the field.
- They rapidly rolled out new procedures and equipment for protecting staff and training people in the proper use of the equipment.
- Without succumbing to hysteria and political pressure, they updated travel regulations to ve rify the health of travelers from Africa while allowing essential aid workers to move unimpeded.
CDC did not do what so many agencies and private sector entities do in similar situations: Deny the problem, conceal data, refuse to change and retaliate against critics. The CDC responded and recovered more quickly than most. For example, they responded even more quickly than the U.S. Army did in giving our troops adequate protection against improvised explosive devices in Iraq.
Whatever the mistakes of government safety organizations, private sector safety organizations – the ones that exist inside corporations – are often much, much worse. Halliburton Co. and their contractors undercut internal safety processes in the prelude to the Deepwater Horizon disaster, and four years later, they’re still fighting over who’s to blame. American International Group Inc.’s internal risk-management processes failed dismally in the subprime mortgage crisis, and rather than accept responsibility, they’re still arguing over the terms of the taxpayer bailout that saved them from bankruptcy.
Fast recovery is perhaps the best we can realistically ask of any safety organization, public or private, which faces infrequent, catastrophic risks. If we want these organizations to do the job, we need to treat them right. We need to give them the budget they need to conduct drills and stay sharp. We need to give them professional leadership and not put political appointees in charge. And we need to drop the hypocrisy of treating them as the enemy in between those rare but inevitable moments when we need them to save us. Far from failing, the CDC performed well under the circumstances. We won’t always be so lucky.
By: David Brodwin, Economic Intelligence, U. S, News and World Report, October 24, 2014
“Rand Paul’s Recklessness Spins Out Of Control”: To Assume Paul Has More Credibility Than Legitimate Medical Experts Is A Mistake
A couple of weeks ago, Sen. Rand Paul (R-Ky.) started making appearances on far-right radio, questioning Ebola assessments from the actual experts, blaming “political correctness,” and raising threats that seemed plainly at odds with the facts.
Soon after, Dr. Anthony Fauci, who directs the Allergy and Infectious Diseases Institutes at NIH, appeared on CBS and was presented with the Republican senator’s assessment. “I don’t think that there’s data to tell us that that’s a correct statement, with all due respect,” the doctor said.
At the risk of putting too fine a point on this, it’s no longer clear just how much respect Rand Paul is due. My msnbc colleague Benjy Sarlin reported yesterday from New Hampshire, where the senator appeared eager to move the public conversation backwards.
Rand Paul had a message for students at Plymouth State University who had gathered for a pizza party with the Kentucky senator on Thursday: Ebola is coming for us all and the government is hiding the truth about the deadly disease. […]
“This thing is incredibly contagious,” Paul said. “People are getting it, fully gowned, masked, and must be getting a very tiny inoculum and they’re still getting it. And then you lose more confidence because they’re telling you stuff that may not be exactly valid and they’re downplaying it so much that it doesn’t appear that they’re really being honest about it.”
On CNN, Paul added, “If someone has Ebola at a cocktail party they’re contagious and you can catch it from them. [The administration] should be honest about that…. You start to wonder about a basic level of competence.”
Yes, if there’s one person who has standing to whine about “a basic level of competence,” it’s the often confused junior senator from Kentucky – the one who’s deliberately contradicting medical experts, confusing the public at a difficult time.
To reiterate a point from our previous coverage, because Rand Paul has a medical background, some may be more inclined to take his concerns seriously on matters of science and public health.
With this in mind, let’s not forget that the senator, prior to starting a career in public office four years ago, was a self-accredited ophthalmologist before making the leap to Capitol Hill.
To assume Paul knows what he’s talking about, and that he has more credibility that legitimate medical experts, is a mistake.
Stepping back, though, there’s a larger context to consider, especially as the senator prepares for a national campaign. When the pressure is high and conditions get tense, the public can learn a lot about a potential leader. Do they maintain grace under fire or do they start to crack? Can they remain calm and responsible in the face of fear or do they run wild-eyed in misguided directions? Do they maintain their composure and keep a level head or do they encourage panic and anxiety?
The past couple of weeks have told us something important about Rand Paul, but none of what we’re learning casts the senator in a positive light.
By: Steve Benen, The Maddow Blog, October 17, 2014
“The Politics Of Fear Comes With Fine Print”: If You’re Afraid Of Anything, Vote GOP, But Don’t Expect Us To Actually Do Anything
After a couple of Republican congressional candidates literally included ISIS propaganda excerpts in their anti-Democratic attack ads, the message of this year’s elections came into sharper focus. The GOP has effectively given up on running against “Obamacare” and unemployment – choosing instead to tell Americans there’s a monster under their beds and only Republicans can save them.
Last night in North Carolina, for example, Sen. Kay Hagan (D) debated her far-right challenger, state House Speaker Thom Tillis (R), who focused the bulk of his attention on Islamic State terrorists and the Ebola virus.
Does Tillis have any background in national security? No. Has he presented new ideas on keeping the public safe? No. Does he have any expertise in infectious diseases? Of course not. Are there any instances in which Hagan has made a misstep on these issues? Not even one.
But Tillis gets the sense North Carolinians are feeling anxiety, and the Republican hopes he can exploit that angst for personal gain.
As Jeremy Peters reported, there’s a lot of this going around.
With four weeks to go, the election has taken a dark turn as conservatives use warnings about Islamic State militants, the Ebola virus and terrorist acts to send a message: The world is a scary place, and the Democrats can’t protect you.
Take a new Republican ad aimed at Representative Ann Kirkpatrick of Arizona that warns of terrorists streaming across the Mexican border. “Evil forces around the world want to harm Americans every day,” it says. “Their entry into our country? Through Arizona’s backyard.”
Another one, against Senator Mark Udall in Colorado, plays a clip in which he says the Islamic State does not pose an imminent threat. “Really?” the announcer asks. “Can we take that chance?” An ad in another Arizona House race features the footage of the journalist James Foley right before his beheading.
There’s no denying the political potency of fear. Those who feel terrified are more easily manipulated, more likely to ignore reason, and more likely to show poor judgment. Those who otherwise have nothing worthwhile to offer the public often turn to demagoguery because it can be an effective substitute for substance.
But there’s one important flaw in the Politics of Fear, or at least the Republicans’ reliance on it.
The GOP pitch relates to government in a fairly obvious and direct way: your government, the argument goes, whatever its intentions, simply isn’t capable, competent, or prepared enough to keep you safe. Your family should therefore feel a sense of panic … and vote Republican.
Cooler heads might notice the flaw in the logic. An American in a constant state of fear about terrorism, diseases, the state of the Secret Service, migrant children, and creeping Sharia, might think twice about supporting the party that believes in slashing budgets, gutting the public sector, and generally avoiding governing whenever possible.
In other words, the Republican tack is burdened by an awkward contradiction: what Americans need is a strong, vibrant public sector prepared for every emergency, which is why Americans should vote for a party that wants to weaken and dismantle the public sector as quickly as possible.
Think of it this way: If Republicans could magically take control every federal office today, what exactly would they do differently than the Obama administration in, say, addressing Ebola? Privatize the CDC, cut taxes, and offer vouchers for protective gear? What would they do differently about ISIS? Continue the airstrikes President Obama launched back in early August – the ones Republicans don’t even feel like holding an authorization vote on?
The entire strategy is void of meaning and purpose if Republicans are pushing fear for the sake of fear – there’s still no agenda, no vision, no plans, and no ideas to serve as a foundation.
“If you’re afraid – of pretty much anything – vote GOP,” the message goes. “Just don’t expect us to actually do anything if we win.”
By: Steve Benen, The Maddow Blog, October 10, 2014
“Ebola Was Already Here”: How The United States Contains Deadly Hemorrhagic Fevers
The Centers for Disease Control and Prevention announced Tuesday the first diagnosis of Ebola in a person in the United States. The man was admitted to a hospital in Dallas after traveling from West Africa. In August, infectious disease specialist Tara C. Smith wrote about how the United States stops the spread of diseases that are similar to Ebola. The original article is below.
It’s odd to see otherwise pretty rational folks getting nervous about the news that the American Ebola patients are being flown back to the United States for treatment. “What if Ebola gets out?” “What if it infects the doctors/pilots/nurses taking care of them?” “I don’t want Ebola in the United States!”
Friends, I have news for you: Ebola is already in the United States.
Ebola is a virus with no vaccine or cure. Any scientist who wants to work with the live virus needs to have biosafety level 4 facilities (the highest, most secure labs in existence, abbreviated BSL-4) available to them. We have a number of those here in the United States, and people are working with many of the Ebola types here. Have you heard of any Ebola outbreaks occurring here in the United States? Nope. These scientists are highly trained and very careful, just like people treating these Ebola patients and working out all the logistics of their arrival and transport.
Second, you might not know that we’ve already experienced patients coming into the United States with deadly hemorrhagic fever infections. We’ve had more than one case of imported Lassa fever, another African hemorrhagic fever virus with a fairly high fatality rate in humans (though not rising to the level of Ebola outbreaks). One occurred in Pennsylvania, another in New York just this past April, a previous one in New Jersey a decade ago. All told, there have been at least seven cases of Lassa fever imported into the United States—and those are just the ones we know about, people who were sick enough to be hospitalized, and whose symptoms and travel history alerted doctors to take samples and contact the Centers for Disease Control and Prevention. It’s not surprising this would show up occasionally in the United States, as Lassa causes up to 300,000 infections per year in Africa.
How many secondary cases occurred from those importations? None. Like Ebola, Lassa is spread from human to human via contact with blood and other body fluids. It’s not readily transmissible or easily airborne, so the risk to others in U.S. hospitals (or on public transportation or other similar places) is quite low.
OK, you may say, but Lassa is an arenavirus, and Ebola is a filovirus—so am I comparing apples to oranges? How about, then, an imported case of Ebola’s cousin virus, Marburg? One of those was diagnosed in Colorado in 2008, in a woman who had traveled to Uganda and apparently was sickened by the virus there. Even though she wasn’t diagnosed until a full year after the infection (and then only because she requested that she be tested for Marburg antibodies after seeing a report of another Marburg death in a tourist who’d visited the same places she had in Uganda), no secondary cases were seen in that importation either.
And of course, who could forget the identification of a new strain of Ebola virus within the United States. Though the Reston virus is not harmful to humans, it certainly was concerning when it was discovered in a group of imported monkeys. So this will be far from our first tango with Ebola in this country.
Ebola is a terrible disease. It kills many of the people that it infects. It can spread fairly rapidly when precautions are not carefully adhered to: when cultural practices such as ritual washing of bodies are continued despite warnings, or when needles are reused because of a lack of medical supplies, or when gloves and other protective gear are not available, or when patients are sharing beds because they are brought to hospitals lacking even such basics as enough beds or clean bedding for patients. But if all you know of Ebola is from The Hot Zone or Outbreak, well, that’s not really what Ebola looks like. I interviewed colleagues from Doctors without Borders a few years back on their experiences with an Ebola outbreak, and they noted:
As for the disease, it is not as bloody and dramatic as in the movies or books. The patients mostly look sick and weak. If there is blood, it is not a lot, usually in the vomit or diarrhea, occasionally from the gums or nose. The transmission is rather ordinary, just contact with infected body fluids. It does not occur because of mere proximity or via an airborne route (as in Outbreak if I recall correctly). The outbreak control organizations in the movies have no problem implementing their solutions once these have been found. In reality, we know what needs to be done, the problem is getting it to happen. This is why community relations are such an issue, where they are not such a problem in the movies.
So, sure, be concerned. But be rational as well. Yes, we know all too well that our public health agencies can fuck up. I’m not saying there is zero chance of something going wrong. But it is low. As an infectious disease specialist (and one with an extreme interest in Ebola), I’m way more concerned about influenza or measles or many other “ordinary” viruses than I am about Ebola. Ebola is exotic and its symptoms can be terrifying, but also much easier to contain by people who know their stuff.
“The Dangers To Everyone”: A Gun-Carrying GOP Congressman Is Outraged A Man With A Concealed Gun Got Near Obama
Stipulating that none of the Secret Service lapses, revealed in the press over the past week, should’ve happened in the first place, the only one that strikes me as truly inexplicable is the revelation that USSS allowed an armed felon into an elevator with President Obama at the Centers for Disease Control, and that they didn’t know he was armed.
The two other big stories aren’t as terrifying, at least to me. Inexcusable, maybe, but explicable. In the case of the fence jumper, I get why people on a security detail might let their guard down when the people they’re charged with protecting are off site. And the inconvenient truth is that the Secret Service can’t stop every determined person with a sniper rifle from taking shots at the White House from a number of different locations in the city. Maybe they bungled the response, but the rifle shots themselves were probably not preventable.
The armed felon in the elevator represents a different level of failure. There appears to be widespread recognition of this fact in both the media and in Congress. That’s good, and important, but it’d be nicer still if elected gun enthusiasts thought through the logical implications of their completely warranted outrage.
Consider the following exchange from a Tuesday oversight hearing on Capitol Hill.
Rep. Jason Chaffetz (R-Utah), who heads a House subcommittee that oversees the Secret Service, first heard of the breakdown from a whistleblower. The Washington Post confirmed details of the event with other people familiar with the agency’s review.
“You have a convicted felon within arm’s reach of the president, and they never did a background check,” Chaffetz said. “Words aren’t strong enough for the outrage I feel for the safety of the president and his family. “
Chaffetz added: “His life was in danger. This country would be a different world today if he had pulled out his gun.”
This is all true, but it could use a little further unpacking. Chaffetz isn’t a gun grabber. He’s spoken openly about the fact that he carries a concealed weapon when he’s in his Utah district. He cosponsors legislation that would erode state concealed carry restrictions by requiring those states to honor concealed carry permits from other states, including states with weaker permitting processes. (This would presumably apply to Washington, D.C., now, too.) And yet Chaffetz also joins the overwhelming consensus that Obama shouldn’t have been on an elevator with a person carrying a concealed weapon because he fully grasps that people carrying concealed weapons can be incredibly dangerous.
Chaffetz is appalled that USSS allowed a person to carry a concealed handgun around the president without conducting a background check, but supports legislation to make it significantly easier for people—many of whom come into lawful possession of firearms without undergoing background checks—to carry concealed weapons around you and me.
This isn’t to give USSS a pass. They should’ve been aware of every armed person on the premises in advance of the visit, and followed protocol to keep them or their guns away from the president. But the man on the elevator was a security contractor at CDC. His employer issued him that gun. His felony convictions only underscore the dangers—to everyone, not just the president—of combining easy access to firearms with lax carry laws. But that’s more or less the beau ideal for the gun lobby, gun enthusiasts, many Democrats, and the entire Republican party.
By: Brian Beutler, The New Republic, October 1, 2014
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