Science C.D.C. Director Becomes Face of Nation’s Worry and Flawed Response By SABRINA TAVERNISEOCT. 15, 2014 ATLANTA — Dr. Thomas R. Frieden, the nation’s top public health official, has always overcome obstacles. He stopped outbreaks of tuberculosis in New York City and made headway against the disease in India. He banned public smoking in New York when he was the city’s health commissioner. And at 49, he ascended to his dream job — director of the Centers for Disease Control and Prevention. “Tom Frieden is a tactical commander,” said Dr. Jonathan Mermin, a C.D.C. disease detective now anchoring the agency’s response to Ebola in Liberia. “At times I have thought of him as a honey badger. It’s the most tenacious mammal in the animal kingdom. It never gives up.” Now, Dr. Frieden, 53, has been pitched into the biggest test of his career. He has become the face of the Obama administration’s flawed response to Ebola in the United States, and on Thursday he is likely to face withering questions about his record during a congressional hearing.On his watch, two health workers in Dallas who were caring for a Liberian man with Ebola have become infected with the disease. And on Wednesday, health officials said the second worker had taken a flight shortly before she tested positive for Ebola, leaving officials scrambling to identify dozens of passengers.Dr. Frieden has publicly acknowledged that the agency he leads should have sent an infection control team to a Dallas hospital as soon as the Liberian patient’s illness was diagnosed. “It was the first case of Ebola diagnosed in the U.S. and I think all of us look at what we did and what we could have done differently because there should never be a health care worker infected,” he said on Tuesday as he strode to his office across the C.D.C.’s grassy campus. “If a health care worker gets infected, that’s on us, all of us.” The Dallas cases have exposed weaknesses in the ability of American hospitals to deal with Ebola, and left Dr. Frieden — who is described as a perfectionist, a workaholic and a visionary — struggling to maintain his credibility. Dressed in a somber dark suit, he has stood before television cameras almost daily, presenting what he hopes has been a calming narrative about Ebola — that most American hospitals could handle such cases and that it could be “stopped in its tracks.” But his talent for talking has left him vulnerable now that some of those assurances ring hollow. “The fact that we are where we are with Dallas has given everyone pause,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “We’ve got to stop being so certain.” Dr. Frieden’s job is a delicate one. He must strike a balance between informing the public and keeping it from panicking. Many public health experts defend the job he is doing. They say he is managing during a fast-moving crisis, with limited information and partial authority. The C.D.C. must be invited in by states, which have strong powers. “It’s like being on a battlefield,” said Dr. Kenneth Bernard, who was special assistant to President George W. Bush on biodefense from 2002 to 2005. “No battle plan survives contact with the enemy.” But congressional Republicans contend he and the administration should take tougher measures to protect Americans from Ebola. On Wednesday, House Speaker John A. Boehner became the highest-profile Republican to call on President Obama to consider a travel ban, something Dr. Frieden has opposed. Representative Tom Marino, a Republican from Pennsylvania, called for Dr. Frieden’s resignation. “This Ebola situation is beginning to spiral beyond control,” Mr. Marino said in a statement. At the White House, the president and his top aides stuck by Dr. Frieden as an effective leader, but officials also said that Mr. Obama was concerned about what they called “shortcomings” that led the two health care workers in Dallas to contract the disease from their patient. Nearly all health experts say that the infection of two nurses, while tragic, does not constitute an uncontrolled outbreak, and that the main danger to ordinary Americans still comes from West Africa, as Dr. Frieden has stressed. He has deployed about 150 of his disease detectives to help find cases of Ebola in West Africa and build systems to track them and report back to tell the world whether it is winning the battle against the virus. So far, it is not. “He’s not a warm and fuzzy guy,” said Laurie Garrett, senior fellow for global health at the Council on Foreign Relations in New York. “He cuts to the chase. What does the data say? Boom boom boom.” He was born in Manhattan and raised in Westchester County. He said he learned to be punctual and work hard from his father, who was a cardiologist. He graduated from Oberlin College and attended medical school at Columbia. In 1990, the C.D.C. hired him into the Epidemic Intelligence Service, an elite group of disease detectives. He documented a large outbreak of drug-resistant tuberculosis in New York City, which he later sharply reduced. Dr. Frieden learned to manage big emergencies when he became New York City’s health commissioner shortly after Sept. 11, 2001. He took on issues like smoking and obesity. Some said New York was becoming a nanny state, but life expectancy grew during his tenure. These days, Dr. Frieden gets to most meetings by running. He marks time by remembering which vacation he had to cancel. And when he is in Atlanta, he eats lunch at his desk to save time. (On a recent Tuesday, it was sliced red peppers, peeled Asian pears and a plate of Trader Joe’s mojito salmon.) He sounded the alarm about Ebola after traveling to West Africa in August. “It’s a really horrific situation,” he said in an interview last week. “We just don’t see this in public health very often. This is what I became a doctor to do.” Michael D. Shear, Julie Hirschfeld Davis and Jonathan Martin contributed reporting from Washington. A version of this article appears in print on October 16, 2014, on page A19 of the New York edition with the headline: C.D.C. Director Becomes Face of Nation’s Worry and Flawed Response . Order Reprints|Todays Paper|Subscribe
Posted on: Thu, 16 Oct 2014 04:23:45 +0000
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