Ebola response leads to grilling of health officials

Senior health officials defended the government’s response to Ebola at a tense hearing Thursday on Capitol Hill, as lawmakers accused them of underestimating the danger posed by the deadly disease and flubbing procedures to contain its spread in the United States, and shortly before President Barack Obama suggested he might appoint an Ebola czar to coordinate the nation’s response.

“With no vaccine or cure we are facing down a disease for which there is no room for error,” said Rep. Tim Murphy, R-Pa., who chaired Thursday’s hearing. “We cannot afford to look back at this point in history and say we could have done more. Errors in judgment have been made, and it is our immediate responsibility today to learn from those errors, correct them rapidly and move forward effectively.”

Thomas Frieden, director of the Centers for Disease Control and Prevention, told Murphy and other lawmakers that his agency is working 24-7 to protect Americans, but “there are no shortcuts in the control of Ebola.”

He added, “To protect the United States we have to stop it at the source” in West Africa.

Obama issued an executive order on Thursday allowing the deployment of National Guard and Reserve forces to West Africa to help combat the Ebola outbreak. He also met with top advisers and defended his team’s response to the disease.

“The truth is, is that up until this point, the individuals here have been running point and doing an outstanding job in dealing with what is a very complicated and fluid situation,” Obama told reporters in the Oval Office following the two-hour meeting.

“It may be appropriate for me to appoint an additional person,” he added. He said that would “make sure we’re crossing all the t’s and dotting all the i’s going forward.”

Frieden testified Thursday along with other federal and state officials before a hearing of the House Energy and Commerce Subcommittee on Oversight and Investigation.

Frieden acknowledged that lawmakers have “a lot of understandable concerns about the cases in Dallas,” including about how health care workers at Texas Health Presbyterian Hospital Dallas initially misdiagnosed the first patient, Thomas Duncan, and how two nurses who treated Duncan became infected despite following safety protocols.

The CDC is working to identify and learn lessons from those three cases, he said.

But Frieden had trouble answering some specific questions from lawmakers, who grilled him on what protective gear the nurses wore and why one of them, Amber Vinson, was allowed to board an airplane from Dallas to Cleveland.

Murphy asked Frieden whether he could confirm reports that Vinson had called the CDC to report a slight fever before getting on the plane.

“My understanding is that she did contact CDC and we discussed with her her reported symptoms as well as her plan to fly,” Frieden replied.

“Were you part of the conversation?” Murphy asked.

“No, I was not,” Frieden said. Pressed for details, Frieden said he hadn’t seen a transcript of the call, so he couldn’t say exactly what his agency had advised or what symptoms Vinson had described.

Rep. Renee Ellmers, R-N.C., asked Frieden how the nurses got infected if they were wearing protective gear. She asked if it is possible that the Ebola virus has mutated.

“What we have seen is very little change in the virus,” Frieden said. “We don’t think it’s spreading in any different way. We are confident this is not airborne.”

Rep. Bill Johnson, R-Ohio, told Frieden he’s concerned that “we don’t know what we don’t know” about Ebola.

“Under questioning today, I’ve heard you say multiple times: ‘I don’t know the details of that, I don’t know,’ ” Johnson said. “And I’m sure the American people want to know that somebody knows the details.”

Republicans on the committee also pressed Frieden to explain why the government hasn’t imposed a travel ban from the countries in West Africa affected by the Ebola outbreak: Guinea, Liberia and Sierra Leone.

“If other countries are doing this … why cannot we move to a similar ban for folks who may or may not have a fever?” asked Rep. Fred Upton, R-Mich. “It seems to me that this is not a fail-safe system that has been put in place here.”

Frieden said a travel ban isn’t practical — travelers intent on entering the U.S. would simply do so through different countries. That would be more risky to the U.S. public because under the current system, he said, travelers from West Africa provide contact information so U.S. authorities can find them while they’re in the country.

“Right now we know who is coming in,” he said. “If we try to eliminate travel, the possibility is that people will travel overland or from other places. … We won’t be able to check them for fever.”

Upton interrupted, impatient.

“Do we not have a record of where they’ve been before, i.e. passports?” he asked.

“Borders are porous,” Frieden said.

“I just don’t understand,” Upton complained. “We can’t look at one’s travel history to say no, you’re not coming here? … We should not be allowing people in, period.”

Frieden took the brunt of Thursday’s grilling by lawmakers, but a Texas health official also came under fire for missteps and misinformation by Texas Health Presbyterian Hospital Dallas, the facility where Duncan was treated and where both infected nurses worked.

Daniel Varga, the chief clinical officer and senior executive vice president of Texas Health Resources, the company that owns the hospital, apologized for not correctly diagnosing Duncan and for providing inaccurate information about his case.

“Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes,” said Varga, who testified via video link from Texas. “We are deeply sorry.”

Varga admitted under questioning from Rep. Diana DeGette, D-Colo., that the hospital did not provide its staff with training on Ebola precautions after receiving a health advisory from the CDC in late July.

“Was there any actual person-to-person training at Texas Presbyterian at that time?” DeGette asked Varga.

Varga said the advisory was given to the emergency department.

“Was there actual training?” DeGette pressed.

“No,” Varga said.

In hearing testimony, Varga said Pham and Vinson were both intensive care unit nurses.

He said Pham first came into contact with Duncan when he was transferred from the emergency room to the intensive care unit. Pham was wearing protective equipment in all her contacts with Duncan, Varga said.

In later testimony, Varga said Pham was in full-body protective gear during interactions with Duncan, while the hospital’s emergency room staff wore partial-body protective gear that left some portion of skin exposed.

At Kent State University in Ohio, where Vinson earned degrees in 2006 and 2008 and where three of her relatives are employees, the university doesn’t want Vinson’s family members on campus.

“Out of an abundance of caution, we’re asking the patient’s family members to remain off campus for the next 21 days and self-monitor per CDC protocol,” said a statement by Dr. Angela DeJulius, director of University Health Services at Kent State.

“It’s important to note that the patient was not on the Kent State campus,” Kent State President Beverly Warren said in a statement. “She stayed with her family at their home in Summit County and did not step foot on our campus.”

In Ohio, several schools in the Akron area were closed Thursday after a student’s parent said she met with Vinson during her trip to Ohio. In Dallas, several elementary schools were closed because of students who were on the plane with Vincent. The Texas schools are being disinfected.