As President Barack Obama named a trusted political adviser Friday to oversee the fight against Ebola, the trail of Americans who may have come into contact with the virus stretched across much of the country and beyond.
And after the admitted mistakes by the U.S Centers for Disease Control and Prevention and the Dallas hospital that treated the country’s first Ebola victim, the World Health Organization conceded that it failed to contain the Ebola epidemic at its roots, in West Africa.
“Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall,” the United Nations health agency said in a draft internal document obtained by The Associated Press. The health organization said incompetence and a politicized bureaucracy compounded ineffective efforts to contain the disease, in a region where borders mean little.
“A perfect storm was brewing, ready to burst open in full force,” the document said.
In response to the crisis, Obama named Ron Klain, a former chief of staff to Vice President Joe Biden, as the point man in the Ebola fight.
The disease first appeared in the U.S. in late September in the emergency room of Texas Health Presbyterian Hospital Dallas, in a recent arrival from Liberia. Two nurses at the hospital were subsequently infected, leaving hundreds of people who had even the slightest contact with any of the three confirmed victims wondering whether they’ll get sick, too.
The list of contacts now includes 48 people who were around Thomas Eric Duncan before the Liberian was admitted to Presbyterian and more than 70 health care workers who had contact with him in the hospital.
Dallas County Judge Clay Jenkins’ staff said all the Presbyterian health care workers monitored for their exposure to the Ebola virus have voluntarily signed agreements to avoid public transit and public places.
One of those first 48 people who came in contact with Duncan is no longer at risk of illness from Ebola, Dallas Mayor Mike Rawlings said.
The man, who had visited the apartment where Duncan was staying before he was hospitalized, has shown no symptoms of the virus for 21 days and is no longer under quarantine.
“This was the first contact they could trace,” Rawlings said.
Since Duncan was hospitalized Sept. 28, fears of exposure have spread beyond Dallas.
Concerns have been raised for hundreds of air travelers who were on a Frontier Airlines flight with one of the sick nurses, Amber Joy Vinson, or traveled in the same plane on later flights before it was pulled from service.
Vinson, 29, traveled to Ohio to visit relatives last weekend. Before her return flight, she noticed she had a slight fever — 99.5 — and called the CDC to see whether she should fly. Because she had no other symptoms, and her temperature was below the Ebola threshold, she was told she could.
Another Presbyterian employee, a lab supervisor who may have had contact with a lab specimen from Duncan, remained aboard a cruise ship after Belize and Mexico denied her permission to disembark. The other passengers left the ship in Belize.
Vinson was diagnosed with Ebola on Tuesday and was flown to Emory University Hospital in Atlanta, which has cared for three patients who contracted the disease while doing mission work in Africa.
Last weekend, 26-year-old Nina Pham, another Presbyterian nurse, was diagnosed with Ebola. Like Vinson, she had been one of Duncan’s caregivers before he died Oct. 8. Pham was moved Thursday to a National Institutes of Health clinic in Bethesda, Md.
Obama’s choice of Klain as Ebola czar drew sharp criticism from Texas congressional leaders. Rep. Michael McCaul, the Austin Republican who chairs the House Homeland Security Committee, said that the Obama administration took “an important and necessary step” by designating someone to spearhead the fight against Ebola, but that the wrong person was chosen. Previous administrations, he said, chose people with solid scientific or medical backgrounds to serve, for example, as special advisers on biodefense policy.
Klain, he said, “may have the ear of the White House and experience from the campaign trail,” but “I am concerned he doesn’t have significant relationships in the medical community that are imperative during this current biological emergency.”
Texas Sen. Ted Cruz, also a Republican, was more blunt.
“We don’t need another so-called ‘czar,’” he said in a statement. “We need presidential leadership. This is a public health crisis, and the answer isn’t another White House political operative. The answer is a commander-in-chief who stands up and leads, banning flights from Ebola-afflicted nations and acting decisively to secure our southern border.”
Another White House staffer, Adrian Saenz, will serve as the federal coordinator with officials in Texas, where he was state director for Obama’s 2008 presidential campaign.
There is no evidence that Ebola has entered the United States through Mexico. And health experts have said that banning all travel to and from West Africa would be counterproductive in the fight against Ebola. Cutting that part of the world off from American and European sources of medical help, they say, would only cause the epidemic there to intensify.
House Energy and Commerce Chairman Fred Upton, a Michigan Republican, agreed with McCaul that the person leading the fight against Ebola needs a medical background.
“What has been missing from this administration’s response to Ebola is not a new figurehead,” he said. “What we need is a strategy to get ahead of this and restore the public’s faith that they are safe.”
Seven Republicans on the Senate Judiciary Committee, including Cruz and fellow Texan John Cornyn, wrote to the president on Friday urging him to cut off visas for travelers from Liberia, Sierra Leone and Guinea.
According to the State Department, from March 1 to Sept. 27 the United States issued 3,135 visas to Liberians, including Duncan; 1,472 to Sierra Leoneans; and 1,791 to Guineans.
In Texas, Gov. Rick Perry asked the president to consider placing health care workers and others who have been in close contact with Ebola patients on a no-fly list.
The Ebola crisis has cost Dallas County alone more than $1 million, and the meter is still running. But Perry said it would be premature to seek federal disaster relief.
“There is an appropriate time to look at costs associated with this,” the governor said. “This is not that time.”
Dr. Robert Haley, director of epidemiology at UT Southwestern Medical Center at Dallas, told an audience at a health care conference at Methodist Dallas Medical Center that locally, the only Ebola “epidemic” is an epidemic of fear.
“We have children being kept home from school, we have children being stigmatized because their parents may have had contact with someone who has Ebola, we have planes being decontaminated, we have guys in hazmat suits cleaning apartments of people who have had no symptoms whatsoever,” Haley said.
Staff writers Christy Hoppe, David Flick and Matthew Watkins contributed to this report.
tgillman@dallasnews.com; myoung@dallasnews.com
