The Ebola Stand

The Ebola Stand

The threat is containable if government is still remotely competent.

From the Wall Street Journal

Ebola is said to be manageable as long as a country has a sturdy health-care system and reasonably functional governance. So now that the virus has arrived in America, there’s absolutely no cause for alarm—or is there?

The U.S. is surely better prepared to contain an epidemic than Liberia, Guinea and Sierra Leone, where infections are now doubling every three weeks and health systems and trust in authority are disintegrating. President Obama has dispatched the U.S. military to prevent the region from becoming a disease reservoir that could spread around the world.

But the U.S. public may be right to wonder if the official no-danger-at-home blandishments conceal a more troubling reality. The Liberian national diagnosed with Ebola in Dallas was an avoidable, if so far minor, crisis. Thomas Duncan travelled from Monrovia to Brussels to Dulles to Dallas-Fort Worth in late September, though he showed no symptoms until four days after he arrived in Texas. And until he showed symptoms, he could not give Ebola to other passengers.

But African airports are supposed to screen travelers before departure not merely for signs of illness with a handheld temperature monitor but also for those who have had close contact with contagious people. Mr. Duncan eluded this audit despite living in an Ebola-stricken apartment building and carrying a dying woman to a hospital. The U.S. should elevate surveillance of flight manifests and international boarding.

After four days in Dallas, Mr. Duncan presented at Texas Health Presbyterian Hospital with a fever and was discharged with antibiotics despite telling a nurse that he was visiting from West Africa. Some 48 hours later he was readmitted having exposed as many as 100 others, including five kids from four public schools. Mr. Duncan is now in intensive care and may have violated U.S. and Liberian laws by lying at the airport and hospital.

Since August, the Centers for Disease Control and Prevention (CDC) has been urging hospitals and other providers to follow specific diagnostic and management protocols for potential Ebola cases. But these instructions are only as good as the doctors and hospitals carrying them out. It is less than reassuring that Health Presbyterian claims Mr. Duncan’s travel and other early warning signs weren’t transmitted to physicians due to a “workflow” glitch in its electronic medical records.

Ebola is easy to kill if caregivers wash their hands. Then again, 99,000 Americans die every year from hospital-acquired infections, most of which are preventable via hand-washing, gloves and surface sanitation. Contra naturam medicine is a marvel, but human failure is eternal and will intensify in a panic.

Nor does it inspire confidence that the head of infectious diseases for the CDC is resorting to that promiscuous federal excuse—budget cuts. Anthony Fauci recently told Congress that sequestration “has, both in an acute and in a chronic insidious way, eroded our ability to respond in the way that I and my colleagues would like to see us be able to respond to these emerging threats.”

Well, the CDC budget has increased only modestly in real terms since being doubled in 2003, and no doubt prevention and basic research is taxpayer money well spent. But can modern government prioritize among obligations, or do anything besides cut checks? National security is the core reason the state exists, which includes avoiding a replay of medieval plagues, or for that matter the influenza ravages of 1918, 1957 and 1968.

Scott Gottlieb and Tevi Troy argue nearby that classic containment methods are deficient for an epidemic at this scale and the world may soon need a new therapy or vaccine. So of course Washington has spent the year excoriating the pharmaceutical industry for supposedly excessive drug prices for innovations like the Hepatitis C cure Sovaldi.

The political class—and the public—may need to begin preparing for the maybe-not-so-remote contingency of a world-wide pandemic, whether from Ebola or some future microbe. Federal quarantines, mass detentions and forced treatments against the will of patients are more possible than most realize. The Bush Administration spelled out in 2005 regulations how the government would respond to such a crisis. Mr. Obama withdrew them five years later to repudiate his predecessor, only to later substitute ambiguous and ad hoc executive orders to keep the same powers.

Ebola is stoppable and there’s little reason to think that the world’s leading disease experts at the CDC aren’t ready to combat its spread—except these days government competence is all too often exposed as a fragile veneer. When an elite corps like the Secret Service can’t remember to lock the White House’s front door and alleged health technocrats can’t build a working ObamaCare website for less than $2 billion, a sense of low-level worry about Ebola seems more than reasonable.