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CDC's Katrina critique is secret
By ALISON YOUNG
Atlanta Journal-Constitution
November 7, 2006
The Centers for Disease Control and Prevention has critiqued its response to Hurricane Katrina and says it's taking actions to ensure that the agency is better prepared in the future.
But the Atlanta-based CDC is keeping secret the report analyzing its performance, and is talking only generally about the problems it identified, saying they are being addressed with better plans, communication and training.
CDC Director Julie Gerberding in the past has cited the agency's response to Katrina as an example of success, and proof that the CDC's ability hasn't been hurt by an exodus since 2004 of high-ranking staff — or by the strategic reorganization she's done of the agency.
"Our performance was excellent, but it was not perfect. And we will always work hard to find every area where we can improve," CDC spokesman Tom Skinner, speaking for Gerberding, said Monday.
Dr. Richard Besser, who coordinated the CDC's response to the catastrophic hurricane on the Gulf Coast in 2005, agreed.
"I think that CDC's response to Hurricane Katrina was really one of its shining moments," said Besser, director of the agency's Coordinating Office for Terrorism Preparedness and Emergency Response.
Pressed further in an interview Friday, he said: "There were a number of critical issues that were identified in Katrina."
Room for improvement
The CDC dispatched 700 staffers to help prevent disease and care for those who were displaced, and has received praise from local officials for playing a critical role in vaccinating residents and monitoring for disease outbreaks.
But behind the scenes, the CDC ran into problems commanding and controlling its response, the agency acknowledged in a document posted on its Web site, www.cdc.gov, Friday after receiving questions from The Atlanta Journal-Constitution.
While the CDC was in charge of only a small portion of the federal response to Katrina, its performance is, in the agency's words, a "gauge" of its ability to coordinate logistics in a major public health crisis. CDC officials said they are taking a wide range of actions as a result of lessons learned from Katrina to better prepare the agency for a crisis, such as a flu pandemic.
At the time Katrina hit, the CDC acknowledges it was not fully prepared to use federal command structures and standard operating procedures required by the National Response Plan, the nation's blueprint for disaster response.
"At the time, (standard operating procedures) either did not exist, were in draft form, or were in conflict with those of other response organizations," said the CDC Web site article, titled "CDC Learns From Katrina, Plans for Pandemic."
The CDC article also said: "A clear, publicized Incident Action Plan (IAP) was not implemented, which led to confusion among our responders ... Incident action plans are now the norm for CDC's emergency response."
In internal e-mails obtained by the AJC, that confusion was evident even weeks after Hurricane Katrina made landfall near New Orleans on Aug. 29, 2005.
A Sept. 19, 2005, e-mail circulated among senior agency staff reported that, among CDC staff dispatched to the disaster area, "travel orders are missing or wrong, assignments are vague, the equipment issued from the (Director's Emergency Operations Center) doesn't work, especially the laptops, and epidemiologists are filling in to do clerical work because there is really nothing for them to do and they were not expected when they arrived."
In a Sept. 10, 2005, e-mail to dozens of CDC employees involved in the Katrina response, Dr. Douglas Hamilton described communication problems stemming from the CDC Director's Emergency Operations Center, a command center known as DEOC.
"We've all seen in the last week how problems with communication" within the operations center and between it and the field teams "and the rest of the world have created difficulties," wrote Hamilton, who directed the disease detectives in the CDC's Epidemic Intelligence Service.
Hamilton's e-mail also relayed an anecdote about a CDC employee dispatched to Mississippi who was called by the Director's Emergency Operations Center and asked: "Who is your team leader?" He added, "But enough DEOC bashing (it's wayyy too easy)."
Hamilton and Linda Neff, the sender of the Sept. 19, 2005, e-mail, said in response to questions that they were proud of the CDC's Katrina response.
"While there might have been a few glitches," said Neff, a science officer in Besser's office, she considered Katrina "one of the most successful responses in CDC's repertoire."
The CDC has repeatedly refused since August to release a copy of its Katrina after-action report, which could put these e-mails in a broader context.
In denying an AJC request under the Freedom of Information Act, the CDC said the Katrina report is only a "draft" and that making it public would "interfere with the agency's deliberative process."
Taking action
Yet the CDC last spring developed a "corrective action plan" from the report, and Besser said Friday the agency has already implemented 80 to 90 percent of those corrections. The AJC continues to seek release of the report and has filed an appeal.
Gerberding, in the CDC article, said the "CDC did not flinch" when faced with Katrina's aftermath. "CDC also did not flinch when it was time to learn the lessons this historic national disaster could teach it to prepare for one still on the horizon – pandemic influenza."
Last month, Gerberding said the federal government is debating whether after-action reports should be made public. Through Skinner, she said Monday that she's still waiting for that decision to be made.
Michael Greenberger, director of the Center for Health and Homeland Security at the University of Maryland, said the CDC has largely escaped scrutiny of its Katrina response because it played a small role and because problems at other agencies — notably the Federal Emergency Management Agency — dwarfed anything that may have gone wrong at the CDC.
He questioned, therefore, why the CDC is keeping its Katrina after-action report secret.
"The White House after-action report was made public; the congressional after-action reports were made public," he said.
To be sure, CDC staff is credited with doing important work in the wake of Katrina – monitoring for disease outbreaks and environmental contamination, helping to immunize more than 100,000 people, shoring up local public health staffs and other activities, said state health officials in Mississippi and Louisiana.
"They did a lot of things for us," said Dr. Jimmy Guidry, Louisiana's state health officer.
Besser said that not having a consistent incident command structure is what led to the confusion in the coordination of some of the CDC's response.
"It was new and it was new to folks here at CDC," said Besser, who was assigned to lead the CDC's Katrina response on his first day as emergency preparedness director. "We were learning as we were going in terms of the incident management system."
Besser and CDC officials said the agency has already taken many actions to correct problems identified in its Katrina after-action report, but stressed that nothing in it should detract from the agency's view that its employees did an outstanding job.
The agency now uses the standardized federal command structure for responding to a disaster and has created a plan for conducting a wide range of disaster response exercises.
The agency also learned that more than half of the staff who volunteered to help during Katrina had never been deployed before, so it's creating a Web-based training program for future incidents.
"We're far better prepared than we were," Besser said.
"One of the lessons from Katrina is people need to practice," Besser said.
Senator Tom Coburn's activity on the Subcommittee on Federal Financial Management, Government Information, and International Security
340 Dirksen Senate Office Building Washington, DC 20510
Phone: 202-224-2254 Fax: 202-228-3796
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