On Wednesday, October 15, President Obama “ordered the U.S. Centers for Disease Control and Prevention to create a ‘SWAT team’ to be ready to deploy anywhere in the country to help local healthcare systems respond to any Ebola cases.” This according to the Los Angeles Times article headlined Obama tells CDC he wants Ebola “SWAT team” ready to go anywhere.
Then on Sunday, October 19, the Defense Department announced it “…will create a 30-person team of medical experts that could quickly leap into a region if new Ebola cases emerge in the United States, providing support for civilian doctors who lack proficiency in fighting the deadly virus.” This was reported in the Washington Post article headlined Pentagon plans Ebola domestic response team of medical experts to aid doctors.
Why does President Obama think it is necessary to reinvent the concept of a tactical response team? If he had competent cabinet members, he would know that it was done long ago in response to both nuclear and biological emergencies. He already has all the tools and teams he needs.
Such an emergency tactical response team concept to respond to potentially catastrophic nuclear emergencies was formed in the early 1970’s. It was then called the Nuclear Emergency Search Team (NEST), however its name is now the Nuclear Emergency Support Team. The NEST teams were experts from the various disciplines relevant to detecting and responding to nuclear emergencies of any cause or origin. Their equipment was already assembled in aircraft cargo containers that could be loaded on various commercial and military aircraft for short-notice deployment.
It’s not as if the US government is only now becoming aware of the dangers of biological agents. Since 1969 the US Army Medical Research Institute of Infectious Diseases (USAMRIID) has been the designated Department of Defense component to deal with them. It is at Ft. Detrick, MD, and is also home to the U.S. Army Medical Research and Materiel Command and the National Cancer Institute.
In fact:
If USAMRIID is called to assist with a disease outbreak investigation or a threat to public health, our Diagnostic Systems Division and Emergency Operations Center (EOC) will surge to meet the demand. As part of the nation’s Laboratory Response Network, USAMRIID would collaborate with CDC to rapidly characterize suspected pathogens. Our EOC can consult the right subject matter experts for the most challenging cases. Whether the request comes from a Combatant Command or another Federal agency, USAMRIID stands ready to assist in any biological contingency.
So why, we wonder, is President Obama only now supposedly forming a tactical response team to deal with future incidents of Ebola in the US? It’s not as if he needed to reinvent the concept.
Details, Details. There are only so many hours in a day. (Although I do find that if it is a particularly hectic day and a person jumps on a plane on the east coast and flies to the west coast that, by the time the person arrives at the west coast, he/she has an extra three hours during the day to work) He already uses a golf cart to speed up his game. He already attends 40% of his daily national security briefings. What more can he reasonably be expected to do?
Comment by up river — October 21, 2014 @ 5:25 am
Well, for starters he might start personally receiving the President’s Daily Brief from real, live briefers instead of from the President’s Daily Tweets (limited to 140 characters). The people from the intel community who deliver the PDB come prepared to discuss the matters in the PDB, answer questions, and get answers for him.
Comment by Bill — October 21, 2014 @ 6:20 am
Jeeeze, what is the point of this post?
So what is wrong with creating a response to this unique situation?
The other agencies you mention are different. In fact the one you quote, USAMRIID, is fine and dandy but as you read one notice that:
“Diagnostic Systems Division and Emergency Operations Center (EOC) will surge to meet the demand. As part of the nation’s Laboratory Response Network, USAMRIID would collaborate with CDC to rapidly characterize suspected pathogens. Our EOC can consult the right subject matter experts for the most challenging cases.”
That sure sounds like delay to me and delay is not a good thing. Why not have a team ready that is specific to this particular situation that are connected and in the know already? It says “consult the right subject matter experts” would that be the team that is currently being assembled?
Comment by Eric — October 21, 2014 @ 9:07 am
Eric,
There is nothing wrong with creating a response to this unique situation, but the response need not be built from the ground up. It certainly did not require appointing one of Crazy Uncle Joe’s political hacks as an Ebola czar. This is not the first biomedical response in recent history.
You may recall the Ebola incident at the Reston (Virginia) Primate Quarantine Unit in 1989 and also the mysterious deaths in Philadelphia in 1976 from the bacterial (Legionella pneumophila) infection that came to be known as Legionnaire’s Disease.
My post was to point out that the biological tactical response team the President directed to be created had already been created and used. Its framework is proven and tested. Necessarily, operational parts of it will have to be altered to respond to various strains of Ebola. The next strain is likely to be very different from this one and require a modified response.
Comment by Bill — October 21, 2014 @ 9:45 am
Oh please, legionnaire’s desease? That’s your example?
While serious it isn’t tranferable from person to person.
The response team in place is for new unknown situations that start have from scratch. Regardless of a differing strain of ebola it still stands to reason that the team arranged to address the current strain would still be the best and most ready to respond and identify the routing should a varying strain show up.
Comment by Eric — October 21, 2014 @ 10:12 am
Eric,
1. Legionnaire’s disease is a good example, because in the summer of 1976 it was a mystery disease that affected 182 members of the Pennsylvania American Legion who had attended the Legion’s state convention at the Bellevue-Stratford Hotel in Pennsylvania. It killed 29 of those who attended. What is known about it now was not known then, and that includes how it was transmitted. Once Dr. Joseph McDade and others at CDC identified the causal bacterium, diagnosis and treatment quickly followed. It killed fewer people then because of the coordinated response that treated it exactly for what it was at the time: A mystery disease. Had it not been for Dr. Joseph McDade’s persistence and for the comprehensive reference laboratories at the CDC, more would likely have died.
2. Since 2000 there have been 16 documented cases or outbreaks of Ebola worldwide(see Outbreaks Chronology: Ebola Virus Disease). Typically, the number of people affected are fewer than 425 and most often in single and double digits. In some of them, there have been no human victims, only animals. The current outbreak has affected approximately 4,655 people, nearly all of them so far in west Africa. Ebola is not new.
The leaders may need to be changed, but the team in place is fully capable of changing and executing the tactics needed to address it.
Comment by Bill — October 21, 2014 @ 11:31 am
That’s all well and good but this isn’t a mystery disease anymore, why not have a special task force specific to the threat?
Comment by Eric — October 21, 2014 @ 12:21 pm
Eric,
I don’t object to the concept of a task force specific to the threat. I strongly object to the President and his SecDef using the word “create” as if the concept of the task force was something they created. It isn’t. People far smarter and more professionally qualified than them created the concept of chem-bio-nuke task forces years ago. The task force infrastructure has been in place and evolving for decades, and unless the political hacks (like the Ebola czar, the Secretary of Health and Human Services, and the director of CDC) decide to tinker with it and mess it up, it will handle the situation.
After the current Ebola threat subsides, the public health and medical communities need to take a very close look at the performance of the CDC. CDC’s untimely and confused guidance to the country’s medical community deserves very close scrutiny, because that needs correction.
Comment by Bill — October 21, 2014 @ 1:05 pm
OK so let me get this straight, so if he used say the words, “We are going to organize, gather, put together, assemble,beget, generate, twine, etc etc, you would be ok with it, talk about symantics.
Is there something wrong with putting together a special team for a special purpose considering the curcomstances?
If not then what would you call doing that?
LOL, like if you were to say, Honey, I lost my job so, now I am going to create a new budget plan for us.
She then would say, Oh really, your going to create a new budget plan, like the concept of a budget plan was something you “created?”
Just seems silly to me that you would choose to make something out of nothing for this president when there is so much more to choose from.
Comment by Eric — October 21, 2014 @ 4:35 pm
Eric,
The framework for the teams that the President would like people to believe he directed to be “created” has, in fact, existed for decades. Teams have been quickly assembled and deployed to fit the particulars of each emergency. I gave you examples of two.
In this instance, HHS and CDC failed to make timely use of the response framework that has been available for decades.
Here’s a silly parallel, but maybe you’ll be able to understand it. The White House catches fire, but instead of calling the existing tried and tested fire department, the President decides he needs to create a new fire department. Instead of relying on the emergency response teams already in place and instead of relying on their adaptability to fight a fire at the White House rather than a single-family home, the President decides to create a fire department to be staffed and trained to fight the current fire, the one at the White House.
Comment by Bill — October 21, 2014 @ 5:10 pm
Oh ok, kind of like creating an “identity theft task force”, that uses already existing federal entities or better yet how about creating an Energy Task Force” Oh hey now that one has a nice ring to it we could complise it of Secretaries of State, Treasury, Interior, Agriculture, Commerce, Transportation and Energy, as well as other cabinet and senior administration-level officials while of course, they already exist or existed I don’t recall anything about THOSE being such an issue as we have here.
Oh wait that was a different guy, however I didn’t have an issue with him “creating” something from something to address a dire need.
Look you can B and moan all you like it’s your blog, I’m just pointing out this particuolar post and rant just looks petty.
Honestly and with all due respect I like my parallel better.
Comment by Eric — October 21, 2014 @ 6:22 pm
After a couple of disastrous years the existing fire dept I worked for and the existing LA county fire dept in conjunction with the existing US forest service got together and created the Incident Command System, this system was created by taking ideas and other existing command and control systems and putting them together in one plan workable for just about every type of incident by all fire dept.
Over the years, this plan has been adopted by every fire dept. in Calif and eventually most of the country. While putting this existing plan into action, from time to time different entities have had to create subsections to this existing plan because either the work wasn’t getting done or not done effectively.
If the fire dept called to put out a white house fire can’t get the job done then you better create a dept that can and quickly. I know that my dept created specialized teams that when needed had the authority to cut through any red tape either create a new plan or get to existing plan back on track.
No Bill I don’t think it is so much of what was done that is stuck in your craw, as it is who did it.
Comment by Mike Teague — October 22, 2014 @ 9:02 am
Mike Teague,
Your example of what you did in California is irrelevant to the issue raised about the President purporting to need to “create” that which was already in existence. The framework of the specialized teams he wants to take credit for creating already existed. Of course there will need to be some flexibility in activation and deployment, because every incident will be factually different. But one doesn’t need to redesign a car when it’s time to upgrade the tires.
Referring to my admittedly simplistic and silly example, you said, “If the fire dept called to put out a white house fire can’t get the job done then you better create a dept that can and quickly.” He could not create a White House fire department quickly enough to put out the fire. That’s the point. You would call the existing fire department (DCFD) because if the necessary coordination had been done properly ahead of the emergency, their response would have been adequate even if the President believed it would not be. The same is true of the Ebola response in the US. The coordination for those kinds of events was begun decades ago and modified as necessary. If CDC failed to do its job in coordinating ahead of time with the other agencies and local responders, then the CDC needs to be fixed. That most certainly does not take some political hack Ebola czar or the reinvention of already existing responders. The President has to answer the question directly: Why were the response measures that have been developed over decades not used when it became readily apparent that the outbreak in Africa was not limited to one village or even one country? Has the work begun decades ago on the responses to chem-bio-nuke incidents in the US been neglected to the extent that the President really does need to “create” new teams? If so, how was that neglect allowed to occur?
Comment by Bill — October 22, 2014 @ 11:18 am
Mike! A most excellent reply especially the ending.
Both sides of the isle do this exact same thing and that’s why the obvious good never gets accomplished anymore.
“I realized that if I wanted to get anywhere in doing some good, I had to put politics aside. From then on, I always shied away from politics and managed to do good without interference. In addition, I found help where I least expected it.”
Saint Jonh Bosco, 1848
Comment by Eric — October 22, 2014 @ 11:19 am