Obama May Name ‘Czar’ to Oversee Ebola Response

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Jeff Hulbert of Annapolis, Md., protesting Thursday by the White House against flights from West Africa, was a tourist attraction. Credit Mladen Antonov/Agence France-Presse — Getty Images

DALLAS — President Obama raised the possibility on Thursday that he might appoint an “Ebola czar” to manage the government’s response to the deadly virus as anxiety grew over the air travel of an infected nurse.

Schools closed in two states, hospitals and airlines kept employees home from work, and Americans debated how much they should worry about a disease that has captured national attention but has so far infected only three people here.

A federal official said that the Centers for Disease Control and Prevention had broadened its search for contacts of Amber Joy Vinson, the second nurse infected with Ebola at Texas Health Presbyterian Hospital here, after interviewing family members who gave a different version of events from Ms. Vinson’s. The nurse had said she had a slight fever before boarding a flight from Cleveland to Dallas on Monday. But family members said she had appeared remote and unwell during her trip to Ohio over the weekend.

The C.D.C. said it was now tracking down passengers on Frontier Airlines Flight 1142 from Dallas to Cleveland, which Ms. Vinson took last Friday. It had already been tracing passengers on her Monday flight.

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In Oakland, Calif., the Registered Nurses Response Network protested what it said was a lack of cooperation and preparedness for future Ebola cases nationwide. Credit Nate Pesce

Ms. Vinson’s case raised flags for investigators because the day after she arrived home in Dallas, she reported substantial symptoms. Health experts say those would be unlikely to develop in just one day.

Seven people in Ohio were voluntarily quarantined because they had contact with Ms. Vinson during her trip, health officials said on Thursday. Crew members from Ms. Vinson’s flight were put on a three-week paid leave. And anxieties mounted among parents and students who received notices that their local schools were being closed for cleanings.

“It’s put a lot more fear into people,” said Michelle Eisenberg, a mother who lives in the Solon school district in Ohio, where two schools were closed on Thursday. “They’re saying there’s no risk, but no one knows for sure.”

Mr. Obama spoke Thursday night after meeting with several top aides working on the Ebola issue. The president praised their work but said they were also responsible for other tasks, including national security matters and other health care concerns.

“It may be appropriate for me to appoint an additional person, not because they haven’t been doing an outstanding job, really working hard on this issue, but they are also responsible for a whole bunch of other stuff,” Mr. Obama told reporters.

He added that appointing an Ebola chief would make sense “just to make sure that we are crossing all the t’s and dotting all the i’s going forward.” He declined to say when he might do so.

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Mayor of Ohio Town on Ebola Precautions

Mayor of Ohio Town on Ebola Precautions

Mayor David Kline of Tallmadge, Ohio, where the second Dallas nurse to contract Ebola spent the weekend, talks about safety precautions.

Publish Date October 16, 2014.

Earlier in the day, lawmakers on Capitol Hill pummeled federal health officials for their response to the public-health emergency that erupted after a Liberian man, Thomas Eric Duncan, tested positive for Ebola last month. Ms. Vinson and another infected nurse, Nina Pham, were among nearly 100 workers at the Dallas hospital who cared for Mr. Duncan b

On Thursday, to ease the burden on Presbyterian, Ms. Pham was transferred at the hospital’s request to a specialized unit at the National Institutes of Health in Maryland. Ms. Vinson was flown on Wednesday to Emory University Hospital in Atlanta, which has successfully treated two other American Ebola patients.

Health officials said that Presbyterian was being strained in its effort to monitor dozens of health care workers who might have been exposed to the virus. Dr. Thomas R. Frieden, director of the C.D.C., told members of Congress that the agency “felt it would be more prudent to focus on caring for any patients who come in with symptoms.”

Another line of questioning dealt with why Ms. Vinson had been allowed to fly even after she called the C.D.C. from the Cleveland airport on Monday and told officials she had a slight fever. It was not known then that she had contracted the virus.

“Were you part of those conversations?” Representative Tim Murphy, Republican of Pennsylvania, asked Dr. Frieden.

“No, I was not,” Dr. Frieden responded.

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Dr. Thomas R. Frieden, the C.D.C. director, at a congressional hearing on Thursday. Credit Jabin Botsford/The New York Times

The hearing thrust the Ebola virus and the government’s halting management of it into the realm of politics in the midst of a national election season.

“Errors in judgment have been made,” Mr. Murphy said. “We have been told, ‘Virtually any hospital in the country that can do isolation can do isolation for Ebola.’ The events in Dallas have proven otherwise.”

Public-health experts said the school closings were panicked overreactions to a virus that is spread only through close contact with someone who is already sick and showing signs like fever, or with infected bodily fluids.

Across the country, interviews with nearly four dozen parents, air travelers, health care workers and others showed an often-nuanced response to a disease that has saturated television news, social media and conversations. While some expressed concerns, others said they had little fear that Ebola would become a nationwide outbreak, and even less about their own health.

In Fort Worth, Russell Page, the father of a 5-year-old kindergartner at Lake Pointe Elementary, said he was more worried about people overreacting, hoarding supplies and “doing dumb things.” But after school officials ordered janitors to do a high-grade overnight cleaning because the father of a student had been on a flight with Ms. Vinson, Mr. Page decided to keep his child home.

“Everybody is concerned and wondering how it will affect their children,” Mr. Page said. “The district is doing the best they can. It’s new territory for everyone involved.”

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Sparta Elementary School in Belton, Tex., was one of a number of schools in Texas and Ohio closed because students or faculty had flown with an Ebola patient. Credit Ilana Panich-Linsman for The New York Times

David James, a recruiter in Louisville, Ky., said he had gotten a call from his 91-year-old godmother urging him not to board a flight for a vacation in Argentina. Mr. James, like others, was anxious, though not nearly enough to cancel his travel plans. His confidence seemed to be reflected so far by a lack of cancellations of airline bookings.

People said they were taking small precautions — fewer handshakes, more hand-washing — but not altering their lives to avoid a disease they stand almost no chance of contracting. Sean Riley, a teacher in Los Angeles, said he was paying attention to students with flulike symptoms. In Boston, Katie Couto, a student at Suffolk University, said she was carrying hand sanitizer everywhere and increasing her vitamin intake, hoping it would strengthen her immune system.

Still, she added, “I don’t lose sleep over this.”

Michael Nunn, 66, a retired social worker in Traverse City, Mich., said the news of Ms. Vinson’s travels had prompted him to avoid planes for a while. He plans to drive the more than 2,000 miles to Los Angeles for Christmas instead of flying.

And in New York, where a possible case — later determined not to be Ebola — at Yale University in Connecticut added some unease to the day, a package-delivery messenger named David Evans said that on a worry scale of 1 to 10, “I’m about an eight and a half right now.” He said that he handled packages from unknown locations, and that he had no way to know who had touched them or where their contents originated.

As the revelations about Ms. Vinson’s travels raised anxieties, at least six schools in Texas and Ohio said they were shutting their doors because students or staff members had been on Ms. Vinson’s flight, or had flown on the same plane after she had. In Akron, Ohio, the Resnik Community Learning Center was closed for cleaning until Monday because a student’s parent had spent time with Ms. Vinson, school officials said.

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When Did Ebola Arrive and Spread at a Dallas Hospital?

Timelines of the three people in Dallas who have been diagnosed with Ebola. Full Q. and A. »

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High risk period when

Pham and Vinson

were treating Duncan.

Thomas Eric Duncan

Fri.

Sat.

Nina Pham

Sept. 19

20

Amber Joy Vinson

Leaves

Liberia.

Arrives

in Dallas.

Sun.

Mon.

Tue.

Wed.

Thu.

21

22

23

24

25

26

27

Develops

symptoms.

Visits

hospital.

28

29

30

Oct. 1

2

3

4

Returns

to hospital.

Ebola test

confirmed.

5

6

7

8

9

10

11

Flies to

Cleveland.

Ebola test

confirmed.

Dies.

12

13

14

15

Flies back

to Dallas.

Ebola test

confirmed.

“This is panic,” said Dr. Paul A. Offit, chief of the infectious diseases division and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “This reminds me of the early days of AIDS, when people were afraid to walk into a grocery store and pick up a piece of fruit because they didn’t know who’d touched it. This doesn’t follow the epidemiology of the disease. This isn’t flu or smallpox. It’s not spread by droplet transmission. As long as nobody kissed the person on the plane, they’re safe.”

Thomas W. Skinner, a spokesman for the C.D.C., said that there was no known medical reason for closings, and that the agency had not advised any school to shut its doors.

Nevertheless, officials who closed facilities or asked workers to stay off the job said they were trying to calm public fears, not inflame them. In statement after statement, they said Thursday that they were acting “out of an abundance of caution.”

In Dallas, in response to the fears stirred by Ms. Vinson’s air travel, county officials asked the more than 70 health care workers at Texas Health Presbyterian Hospital being monitored for Ebola symptoms to voluntarily avoid public places and transportation during the virus’s 21-day maximum incubation period. State and county officials have drawn up written agreements that appear to effectively limit the workers to staying home.

Until Ms. Pham fell ill and officials stepped up efforts to watch health care workers, Ms. Vinson and others at Presbyterian had been under a self-monitoring regimen. Ms. Vinson had been checking her temperature twice a day, but there had been no restrictions on her travel.

Public-health experts have criticized the C.D.C. for not putting all of the hospital workers who had contact with Mr. Duncan under intensive monitoring, as opposed to the more loosely followed self-monitoring regimen.

Even as federal health officials widened their efforts to find travelers who had been on Ms. Vinson’s flights, one of those passengers, Byron Watters, said he had initially been frustrated in his efforts to reach local and federal officials. He said he had called a C.D.C. hotline repeatedly but had been unable to find answers about what to do, and had then called Dallas officials.

“They said I’m not supposed to call that number and to call the C.D.C. I call the C.D.C., and I can’t get someone on the phone,” Mr. Watters said. “When I do get someone on the phone, I get disconnected.”

He said that a friend had eventually helped him reach C.D.C. officials, and that they had told him he was at low risk for exposure. Still, he said he and his wife, Tiffany Bramwell-Watters, planned to stay home for 21 days.

“I don’t think there’s anything,” Ms. Bramwell-Watters said, “but we just wanted to make sure that we took the correct precautions and measures.”


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