America’s Ebola Mess

October 17th, 2014

When confronted with what appears to be a disaster in the making, it’s oftentimes instructive to take a step back and look at the big picture and the overall lessons we might learn.

Such is the case with Ebola and the daily health crises unfolding as a result of a desperately ill Liberian national, Thomas Eric Duncan, appearing in an unprepared Dallas emergency room.

First, let’s all pause and take a moment to be thankful for one thing and that is that Ebola currently is widely believed to be difficult to catch.  That’s borne out to date by the fact that none of the four people living in very close quarters with Duncan in a Dallas apartment yet show any signs of the disease. Instead, nurses who had the very unpleasant task of dealing with Duncan’s bodily fluids are infected.

Face it—the way the government has botched this whole matter, if this disease was easy to get, we’d all be dead, dying, or hiding in fear somewhere right now.

I don’t want to suggest that we’re 100% certain about anything.  For example, the NBC photographer stricken with the disease still isn’t sure how he contracted it.  There are many unanswered questions when it comes to Ebola.

What does seem certain is that our current regulatory framework combined with political sensibilities unique to our generation is making a difficult situation much worse.

For starters, we must ask why the Dallas hospital was so woefully unprepared to deal with this situation. I’ve talked to a number of friends in the medical profession since all this transpired and they’ve told me that Ebola training and information in their hospitals typically amounts to a voluntary Brown Bag discussion or a handout thumbtacked on the break room wall directing them to read the CDC website. As one doctor at a prestigious U.S. hospital told me, he and his colleagues spend more time taking mandatory sexual harassment in the workplace courses than even casually discussing what to do if an Ebola case walks into the ER.

That’s stunning.  I practiced environmental law for many years, and I can’t imagine a breach of hazardous materials at a site where the only recourse for remediation is getting on the Internet because no one has ever walked through exactly what to do.

We should also recognize that regulatory environments tend to breed a lack of common sense.  As an attorney, I spent my career reading endless regulations which in theory are supposed to answer every question related to a particular issue after great debate and study.  Unfortunately, in that environment, brain paralysis sets in where the idea of substituting common sense for what’s written in a regulation or guidance document is regarded as practically criminal.  Indeed, in some settings, it probably is a crime.

This explains why when an individual on behalf of infected nurse, Amber Vinson, called the CDC to ask if she should board a plane with a 99.5 fever, the “authority” on the other end (after looking up the CDC guidance document on the Internet) said that she was fine to go because the guidance specified a fever of 100.4 before forbidding travel.

And guess what?  If someone ends up sick from Ms. Vinson’s Frontier Airlines flight, this will likely prompt further study before several layers of bureaucracy determines that the wording on the Internet site should change.

This isn’t the first time in our history that we’ve had to deal with dangerous infectious disease.  As a matter fact, until the recent past, all of human history struggled with this problem.

Because we’ve been so blessed lately, we are now a society that can’t contemplate the idea of quarantines, but they’ve been used throughout our history to combat communicable diseases.  In fact, historically, it wasn’t uncommon for ships to remain at sea for up to twenty days before docking in order to assure that ill passengers didn’t enter the country.

Translating that approach to today would mean, for example, holding all travelers from West Africa in quarantine at the airport for twenty-one days before permitting them to enter the United States.  That would be a bureaucratic expensive nightmare to administer, but it would appear to be the only reasonable solution if we’re not going to ban such travel altogether.  Otherwise, we’re going to repeat this scenario where cities spend resources chasing down acquaintances and decontaminating apartments, schools, and wherever else a sick person may have visited.  Why that approach is preferable is something the CDC still hasn’t successfully explained.

Unless we adjust our approach and thinking to a crisis such as the one we’re currently experiencing we’ll simply find ourselves playing out this drama over and over again in the future with Ebola or any other number of communicable diseases.

Ultimately, our society can’t afford this approach.  Eventually, much more than our health will be affected.  That’s why the government needs to get its act together immediately.

A successful democracy depends upon the trust and confidence of the people and competence is necessary to warrant that trust.



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