Health Care

Ebola czar faces first big test

Confusion over how to handle healthcare workers returning to the United States from Ebola hot zones is becoming the first serious test for Ron Klain, the man President Obama asked to coordinate the federal response to the virus.

A longtime Democratic operative hailed by the White House for his management and government experience, Klain saw his first weekend on the job consumed by controversy over the decision by state officials to quarantine doctors and nurses who had traveled to West Africa to fight Ebola.

{mosads}The apparently unilateral decisions by New York Gov. Andrew Cuomo (D) and New Jersey Gov. Chris Christie (R) to implement mandatory 21-day quarantines prompted new questions about how effectively the Obama administration was consulting with local officials on Ebola.

It also intensified the focus on Klain, who was brought into the administration largely to combat perceptions that the government’s response to the crisis was ad hoc and poorly coordinated.

At the White House on Monday, spokesman Josh Earnest was confronted with questions about Klain.

“He’s supposed to be the Ebola response coordinator,” one reporter asked him. “It seems that you have a need for some coordinating here.”

“What has changed since he started his job?” asked another. “Because it appears as though this week there’s more confusion than there was last week, given what we’re seeing in New York and New Jersey, and more differences between how the states are dealing with it.”

Earnest sidestepped questions about whether Klain needed to do more to coordinate with state governments to prevent panic and confusion over Ebola practices.

“I don’t think it fuels panic because I think people understand the facts,” the White House spokesman said, emphasizing the “vanishingly low” risk of contracting the disease.

He dismissed questions about Klain’s effectiveness, pointing out that Klain had less than a week on the job.

And Earnest said his tenure had already seen “a significant number of announcements related to the whole-of-government approach that the president has ordered to dealing with the Ebola situation.”

Confusion also surrounded the federal government’s handling of people returning from West Africa when the Army ordered a 21-day quarantine for soldiers returning from the three countries ravaged by the virus: Sierra Leone, Guinea and Liberia. That decision was made despite soldiers explicitly not assisting in medical treatment in the region.

But the policy was not extended to members of the other branches of the military, and the administration suggested it might be reversed, with Earnest saying Pentagon “policy has not been settled and implemented yet.”

The government on Monday afternoon announced new guidelines from the Centers of Disease Control and Prevention for the treatment of returning healthcare workers.

The federal government said it was recommending “voluntary at-home isolation” and monitoring for health workers who treated Ebola patients. 

But the new standards did little to clarify the patchwork of rules emerging from state and local officials, who appear to be largely freelancing their own isolation and quarantine rules with minimal input from or deference to the Obama administration. 

In New Jersey, Christie defiantly said that despite the discharge of the first aid worker to be quarantined under his new policies, he was not changing his approach.

“I’m telling you guys this is going to become a national policy eventually. Eventually the CDC will come around,” Christie said.

And the White House conceded on Monday there was little they could do to force governors and mayors to comply with their preferred outcome.

“In some ways you can sort of take this up with James Madison, right?” Earnest said. “We have a federal system in this country in which states are given significant authority for governing their constituents.”

Left unanswered was why the governors — one a Democrat, and the other a blue-state Republican whose reelection bid was cemented by his willingness to work with President Obama in the aftermath of Hurricane Sandy — either did not speak to the White House ahead of their announcement, or ignored the administration’s advice.

Officials steadfastly refused to describe the nature of calls between the White House and the leaders of New York and New Jersey before or after the announcement — including any communication with Klain.