Friday, October 17, 2014

Obama's Ebola czar is a federal insider with no medical background


WASHINGTON — President Barack Obama on Friday named a former longtime top aide to coordinate the government’s efforts to combat Ebola, a veteran insider with experience in navigating the government bureaucracy but also a man with no medical background.


Ron Klain, a former chief of staff to two vice presidents, Joe Biden and Al Gore, is well-known in Washington as a manager who has overseen large federal government operations including implementing the stimulus to aid economic recovery, and has relationships with members of Congress and administration officials.


“He is a brilliant strategist and is known for his ability to manage large, complex operations,” said Sen. Chris Coons, D-Del., chairman of the Senate Foreign Relations Subcommittee on African Affairs.


But Klain’s lack of medical expertise also drew complaints.


“I think it’s a pretty pathetic gesture to appoint a non-medical person to be in charge of this response, which has already been dangerously futile,” said Richard Amerling, president of the Association of American Physicians and Surgeons and associate clinical professor at Icahn School of Medicine at Mount Sinai Hospital in New York.


“This guy knows nothing about Ebola,” said Robert Murphy, director of the Center for Global Health and a professor of medical and biomedical engineering at Northwestern University. “He’s probably a smart insider political guy. He has no credibility in the field of public health and he has no credibility in Africa, where the Ebola crisis began. . . . I really think that this is a very inappropriate choice.”


Obama changed course and decided to name a single government coordinator — often called a czar — amid growing criticism of the government since a man traveling from Liberia to Texas, Thomas Eric Duncan, became sick and later died at Texas Health Presbyterian Hospital Dallas and two nurses, Nina Pham and Amber Vinson, were infected.


On Friday, the State Department announced that a hospital employee who may have had contact with Duncan’s clinical specimens is on a cruise ship in the Caribbean. The employee has been self-monitoring, including daily temperature checks, and remained isolated in a cabin.


Obama has been criticized for his domestic response to Ebola, specifically because hospitals and health care workers lacked preparation for Ebola and because he has failed to call for a travel or visa ban from West Africa.


“Given the mounting failings in the Obama administration’s response to the Ebola outbreak, it is right that the president has sought to task a single individual to coordinate its response,” said Rep. Ed Royce, R-Calif., chairman of the House Foreign Affairs Committee. “But I have to ask why the president didn’t pick an individual with a noteworthy infectious disease or public health background.”


White House press secretary Josh Earnest repeatedly defended the decision at his daily briefing.


“What we were looking for is not an Ebola expert, but rather an implementation expert,” he said. “And that’s exactly what Ron Klain is. He is somebody who has extensive experience in the federal government. He’s somebody that has extensive management experience when it comes to the private sector.”


The White House had resisted calls for a point-person on Ebola, but on Friday it announced that Klain would serve as Ebola response coordinator, charged with coordinating inter-agency plans to detect, isolate and treat patients without distracting from efforts to stop the virus at its source in West Africa.


Presidents have appointed dozens of so-called czars through the years as they look to calm the public on a variety of vexing issues, from AIDS to illegal drugs.


Klain will report directly to White House Homeland Security Adviser Lisa Monaco and National Security Adviser Susan Rice. He is expected to serve in that role for several months, Earnest said. He said he did not know if Klain would be paid.


Obama told reporters late Thursday that existing administration officials had been doing well, but he opened the door to a single overseer.


“It’s not that they haven’t been doing an outstanding job really working hard on this issue, but they also are responsible for a whole bunch of other stuff,” Obama told reporters after meeting with senior aides on Ebola. “It may make sense for us to have one person, in part just so that after this initial surge of activity we can have a more regular process just to make sure that we’re crossing all the T’s and dotting all the I’s going forward.”


Earnest said that Obama offered Klain the job Friday morning. Klain is president of Case Holdings and general counsel of Revolution, an investment group. In addition to his work in government, he was Gore’s top legal adviser in the Florida recount of the 2000 presidential election.


Paul Jarris, executive director of the Association of State and Territorial Health Officials, said he did not know Klain but was not concerned by his lack of medical background. He said the administration already has a number of medical experts, including those at the Centers for Disease Control and Prevention and the National Institutes of Health, and what is needed is a strong manager.


“There is real potential for this position to help,” he said.


Katrina Crist, CEO at the Association for Professionals in Infection Control and Epidemiology, said the position “will free up medical and research experts to provide clinical guidance, protocols and training to ensure that America’s hospitals and health facilities are best prepared to identify, isolate and treat potential patients.”


Earlier this week, Sen. Bill Nelson, D-Fla., had suggested Obama appoint someone with a medical background, such as former Surgeon General Richard Carmona. But on Friday, Nelson sidestepped a question about whether he was disappointed Klain lacks a medical background.


“I’m glad the president recognizes the need for having a point person take charge,” he said. “The situation in Dallas has convinced me that we don’t have any time to waste.”


Tony Pugh of the Washington Bureau contributed.


©2014 McClatchy Washington Bureau. Distributed by McClatchy-Tribune Information Services.



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