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This Article is From Oct 17, 2014

Obama May Name 'Czar' to Oversee Ebola Response

Obama May Name 'Czar' to Oversee Ebola Response
Members of a hazmat team unload barrels outside an apartment where a health care worker who contracted Ebola after caring for Thomas Eric Duncan lives in Dallas. (Cooper Neill/The New York Times)
Dallas: President Barack Obama raised the possibility for the first time Thursday that he might appoint an "Ebola czar" to manage the government's response to the deadly virus, as revelations that an infected nurse had flown between Dallas and Ohio raised new alarms across the country.

Schools closed in two states, hospitals kept nurses home from work, and parents, health officials and air travelers debated how much they should worry about a disease that has captured national attention but infected only three people here.

A spokeswoman for the Centers for Disease Control and Prevention said the agency had broadened its search for people who had come into contact with the nurse, Amber Vinson, "based on additional information obtained during interviews of close contacts." It is now tracking down passengers on Frontier Airlines Flight 1142 from Dallas to Cleveland, which Vinson took last Friday, raising the possibility that she could have showed symptoms earlier than has been believed.

Vinson reported a fever on Tuesday and was isolated at Texas Health Presbyterian Hospital, where she was one of dozens of employees who cared for the Liberian man who died of Ebola this month.

Seven people in Ohio were voluntarily quarantined because they had contact with Vinson during her trip, health officials said Thursday. The six-person crew who had worked on Vinson's flight was put on a three-week paid leave. And anxieties mounted among parents and students who received notices that their local schools were being closed for cleanings.

"It's put a lot more fear into people," said Michelle Eisenberg, a mother who lives in the Solon school district in Ohio, where two schools were closed Thursday. "They're saying there's no risk, but no one knows for sure."

Obama spoke Thursday night after meeting with several top aides working on the Ebola issue. The president praised their work but said they were also responsible for other tasks, including national security matters and other health care concerns.

"It may be appropriate for me to appoint an additional person, not because they haven't been doing an outstanding job, really working hard on this issue, but they are also responsible for a whole bunch of other stuff," Obama told reporters.

He added that an Ebola chief would make sense "just to make sure that we are crossing all the t's and dotting all the i's going forward." He declined to say when he might make such an appointment.

Earlier in the day, lawmakers on Capitol Hill pummeled federal health officials for their response to the public-health emergency that erupted after the Liberian man, Thomas Eric Duncan, tested positive for Ebola last month. Vinson and another infected nurse, Nina Pham, were among nearly 100 workers at the Dallas hospital who cared for Duncan before his death on Oct. 8.

On Thursday, to ease the burden on Presbyterian, Pham was transferred at the hospital's request to a specialized unit at the National Institutes of Health in Maryland. Vinson was flown on Wednesday to Emory University Hospital in Atlanta, which has successfully treated two other American Ebola patients.

Health officials said that Presbyterian was being strained in its effort to monitor dozens of other health care workers who might have been exposed to the virus. Dr. Thomas R. Frieden, director of the CDC, told members of Congress that the agency "felt it would be more prudent to focus on caring for any patients who come in with symptoms."

Another line of questioning dealt with why Vinson had been allowed to fly even after she called the CDC from the airport and told officials she had a slight fever. It was not known then that she had contracted the virus.

"Were you part of those conversations?" Rep. Tim Murphy, R-Pa., asked Frieden.

"No, I was not," Frieden responded.

The hearing thrust the Ebola virus and the government's halting management of it into the realm of politics in the midst of a national election season.

"Errors in judgment have been made," Murphy said. "We have been told, 'Virtually any hospital in the country that can do isolation can do isolation for Ebola.' The events in Dallas have proven otherwise."

Public-health experts said the school closings were panicked overreactions to a virus that is spread only through close contact with someone who is already sick and showing signs like fever, or with infected bodily fluids.

Across the country, interviews with nearly four dozen parents and air travelers, health care workers and others offered an often-nuanced response to a disease that has saturated television news, social media and conversations outside schools. While some expressed concerns, others said they had little fear that Ebola would become a nationwide outbreak, and even less about their own health.

In Fort Worth, Texas, Russell Page, the father of a 5-year-old kindergartner at Lake Pointe Elementary, said he was more worried about people overreacting, hoarding supplies and "doing dumb things." But after school officials ordered janitors to do a high-grade overnight cleaning because the father of a student had been on the flight with Vinson, Page decided to keep his child home.

"Everybody is concerned and wondering how it will affect their children," Page said. "The district is doing the best they can. It's new territory for everyone involved."

David James, a recruiter in Louisville, Kentucky, said he had gotten a call from his 91-year-old godmother urging him not to board an international flight to take a vacation in Argentina. James, like others, was anxious, though not nearly enough to cancel his travel plans. His confidence seemed to be borne out so far by a lack of cancellations of airline bookings.

People said they were taking small precautions - fewer handshakes, more hand-washing - but not altering their lives to avoid a disease they stand almost no chance of contracting. Sean Riley, a teacher in Los Angeles, said he was paying attention to students with flu-like symptoms. In Boston, Katie Couto, a student at Suffolk University, said she was carrying hand sanitizer everywhere and increasing her vitamin intake, hoping it would strengthen her immune system.

Still, she added, "I don't lose sleep over this."

Michael Nunn, 66, a retired social worker in Traverse City, Michigan, said the news of Vinson's travels between Ohio and Dallas had prompted him to avoid planes for a while. He plans to drive the more than 2,000 miles to Los Angeles for Christmas instead of flying.

And in New York, where a possible case - later found not to be Ebola - at Yale University in Connecticut added some unease to the day, a package-delivery messenger named David Evans said that on a worry scale of 1 to 10, "I'm about an 8 1/2 right now." He said that he handled packages from various, unknown locations, and that he had no way to know who had touched them or where their contents originated.

As the revelations about Vinson's travels raised anxieties, at least six schools in Texas and Ohio said they were shutting their doors because students or a staff member had been on Vinson's flight, or had merely flown on the same plane after she had. In Akron, Ohio, the Resnik Community Learning Center was closed for cleaning until Monday because a student's parent had spent time with Vinson, school officials said.

"This is panic," said Dr. Paul A. Offit, chief of the infectious diseases division and director of the Vaccine Education Center at the Children's Hospital of Philadelphia. "This reminds me of the early days of AIDS, when people were afraid to walk into a grocery store and pick up a piece of fruit because they didn't know who'd touched it. This doesn't follow the epidemiology of the disease. This isn't flu or smallpox. It's not spread by droplet transmission. As long as nobody kissed the person on the plane, they're safe."

Thomas W. Skinner, a spokesman for the CDC, said that there was no known medical reason for closings, and that the agency had not advised any school to shut its doors.

Nevertheless, officials who closed facilities or asked workers to stay off the job said they were trying to calm public fears, not inflame them. In statement after statement, they said Thursday that they were acting "out of an abundance of caution."

In Dallas, in response to the fears stirred by Vinson's air travel, county officials asked the more than 70 health care workers at Texas Health Presbyterian Hospital who are being monitored for Ebola symptoms to voluntarily avoid public places and transportation during the virus' 21-day maximum incubation period. State and county officials have drawn up written agreements that appear to effectively limit them to staying at home.

Vinson and other workers at Presbyterian had been under a so-called self-monitoring regimen. Vinson had been checking her temperature twice a day on her own, but there had been no restrictions on her travel. Public health experts have criticized the CDC for not putting all of the hospital workers who had contact with Duncan under intensive monitoring, as opposed to the more loosely followed self-monitoring regimen.

Even as federal health officials widened their efforts to find travelers who had been on Vinson's flights between Dallas and Cleveland, one of those passengers, Byron Watters, said he had been initially frustrated in his efforts to reach out to local and federal officials. He said he had called a CDC hotline repeatedly but had been unable to find answers about what to do, and had then called Dallas officials.

"They said I'm not supposed to call that number and to call the CDC. I call the CDC, and I can't get someone on the phone," Watters said. "When I do get someone on the phone, I get disconnected."

He said a friend had eventually helped him reach CDC officials by phone, and they told him he was at low risk for exposure. Still, he said he and his wife, Tiffany Bramwell-Watters, were planning to stay home for 21 days.

"I don't think there's anything, but we just wanted to make sure that we took the correct precautions and measures," Bramwell-Watters said.

© 2014, The New York Times News Service

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