The Cable

Obama’s Ebola Czar Immediately Panned for Lacking Public-Health Experience

In an effort to placate Congress and reassure the American public that the Ebola virus would not spread across the country, President Barack Obama appointed Ron Klain, a political operative with no apparent public-health experience, to oversee the government’s response. The appointment comes a day after Obama administration officials were hammered for their response to ...

Andrew H. Walker / Getty Images News
Andrew H. Walker / Getty Images News

In an effort to placate Congress and reassure the American public that the Ebola virus would not spread across the country, President Barack Obama appointed Ron Klain, a political operative with no apparent public-health experience, to oversee the government’s response.

The appointment comes a day after Obama administration officials were hammered for their response to the disease’s appearance on U.S. soil. Earlier this week, reports emerged that Amber Vinson, a 29-year-old nurse who had treated Thomas Eric Duncan, the first Ebola victim in the country, flew between Dallas and Cleveland despite reporting a fever to the Centers for Disease Control and Prevention before boarding. Vinson was later diagnosed with Ebola, prompting an intensifying CDC effort to track down the other passengers on the flight and test them for the virus.

It comes as the spot for America’s top doctor sits empty. The appointment of Vivek Murthy, who was nominated last November to be surgeon general, is stalled in the Senate.

It’s also a curious choice, given that Klain has no apparent experience dealing with public health. In Washington, he’s best known for serving as chief of staff to Vice Presidents Al Gore and Joe Biden. If he’s known outside of Washington, it’s for actor Kevin Spacey’s portrayal of him in the film Recount, which detailed the bitter and convoluted 2000 presidential recount in Florida between Gore and George W. Bush.

David Dausey, a Yale-trained epidemiologist who works on controlling pandemics, and who is dean of the School of Health Professions and Public Health at Mercyhurst University, said that it’s a mistake to appoint someone lacking public-health experience.

"You need somebody that understands the disease and how it spreads. If this person doesn’t have that background or knowledge, it would be problematic," Dausey told FP. "You can’t be a czar for a disease if you don’t understand how the disease spreads."

Dausey dismissed the appointment as another empty gesture by the White House.

"There’s a lot of symbolic stuff going on with the Obama administration," he said. "Forget the symbolism. Get people on the ground."

Republicans also criticized Obama’s choice. On Twitter, Rep. Tim Murphy (R-Pa.) wrote, "New #EbolaOutbreak Czar w/o HC background or infectious disease experience? Don’t need another WH political spokesman." Reps. Steve King (R-Iowa) and Blake Farenthold (R-Texas) also tweeted their disapproval.

Klain is the 45th "czar" appointment attributed to Obama since he took office in 2009. Experience in the relevant fields is no guarantee of success, however. Despite a storied diplomatic record, Richard Holbrooke was largely viewed as ineffective as the czar for Afghanistan and Pakistan from 2009 to 2010. On the other hand, Steven Rattner, an American financier who Obama named auto czar in 2009, has led a successful turnaround of the American auto industry.

Public-health czars appointed by Obama have a mixed record. Nancy-Ann DeParle, Obama’s czar for health care reform, had no public-health expertise but shepherded the Affordable Care Act from inception into law. Obama’s AIDS czar, Douglas Brooks, has a limited record since being appointed in March.

It’s not unusual for presidents to appoint political allies to lead their responses to crises. The late Sargent Shriver, husband of Eunice Kennedy Shriver, President John F. Kennedy’s sister, served as President Lyndon Johnson’s poverty czar after Kennedy appointed him as the Peace Corp’s founding director.

Others have had less success. Ira Magaziner, a friend of President Bill Clinton’s who was appointed in 1993 to guide Hillary Rodham Clinton’s health care reform task force, failed. Magaziner still works for Clinton, serving in a leadership role at his foundation.

Fears that the deadly disease could be spreading in the United States have sparked growing unease. Some schools in Texas and Ohio were closed on Thursday and some on Friday and many airline travelers have been spotted wearing sanitary masks. Transportation stocks continued to tumble over fears that Ebola could disrupt air travel. There was even an Ebola scare at the Pentagon on Friday.

Lawmakers, fully aware of the public’s panic, took the Obama administration to task Thursday, slamming CDC chief Thomas Frieden and other government officials for the White House’s inability to confine the disease to a hospital in Texas.

"The trust and credibility of the administration and government are waning," Murphy said. He added that the federal government should "do everything in our power to keep the American people safe from the Ebola outbreak in West Africa" and suggested a ban on travelers from the region.

That echoed a statement made by House Speaker John Boehner (R-Ohio) on Wednesday, who said, "A temporary ban on travel to the United States from countries afflicted with the virus is something that the president should absolutely consider, along with any other appropriate actions as doubts about the security of our air travel systems grow." On Thursday, Rep. Dennis Ross (R-Fla.) released the Contain Ebola and Stop the Epidemic Act, which would institute a travel ban, and called on Boehner to bring the House back into session to consider it.

When asked for comment, Boenher’s office referred FP to Wednesday’s statement. Senate Majority Leader Harry Reid (D-Nev.) did not immediately return a request for comment. The White House claims that the travel ban is unnecessary.

According to epidemiologists, perspective is just what the American public needs. Eden Wells, a prominent epidemiologist at the University of Michigan School of Public Health, said the likelihood of an outbreak like the one in West Africa, which has claimed approximately 4,000 lives, was low, but added "fear is definitely understandable…. It’s OK to have it. We have to address it with good information. Ebola is in our public consciousness and is a very scary disease. Right now, people are feeling uncertain because the situation is evolving so rapidly."

Even if the outbreak is contained, though, the notion that this disease, or any disease, could be completely eradicated is false.

"Ebola is not going to go away. There’s always going to be some kind of diseases that Mother Nature creates" that we can’t fight, she said.

Doctors around the world are working on more effective treatment for the disease, including the possibility of a vaccine. Eden said Ebola would never be as common as the flu bug, but compared it to another tropical disease: yellow fever.

Mosquitos spread yellow fever, which has symptoms that could be described as an extreme version of the flu that eventually shuts down organs and can lead to death. About 30,000 people die of the disease each year.

In the 1950s, a yellow fever vaccine was developed. Now, before traveling to regions where the fever is common, travelers can inoculate themselves from the disease.

"People are aware that Ebola needs a vaccine and other treatments as well. If we can get those in place, [Ebola] might not be a common cold, but it might not be as scary," Wells said. "Wouldn’t it be wonderful, if you knew you were traveling to a country [where Ebola exists] and [could] simply get a vaccine?"

Click each photo to meet the previous "czars" appointed to public health and notable positions recently:

Graphic by Emma Carew Grovum

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