During the 2014 Ebola outbreak, the U.S. Center for Disease Control held frequent public briefings ... [+]
On September 28, 2014, when a 42 year-old man who had traveled to the United States from West Africa walked into a Dallas hospital with flu-like symptoms, it was a game changer. He had carried Ebola into the heartland of the United States, later dying from the infection. Even though the virus had been spreading in West Africa for some time, the arrival of the illness in the United States sent shockwaves throughout the country. The government needed to act boldly and quickly.
In the summer and fall of 2014, much of the world was gripped by the Ebola epidemic. With pop culture references like the movies “Outbreak” and “Contagion,” many feared the infectious disease was spreading uncontrollably and across borders. The lack of knowledge and unscientific speculation about the disease instilled panic. Now, five years later, the coronavirus is similarly consuming the world’s conscious as it spreads into new cities and countries every day, with communities wondering how and when public health organizations and governments will stop its momentum. The coronavirus is not the first, and certainly will not be the last, global virus to sow seeds of panic and uncertainty, but we have the tools and experience to address this crisis head-on—we’ve done it before.
Identify a Point Person with Authority and Accountability. In 2014, during the height of the Ebola epidemic, I helped manage the crisis for the secretary of Homeland Security. The government quickly understood that a global virus like Ebola demanded a global and whole-of-government response. These diseases are not just a medical issue for the Centers for Disease Control to solve. Rather, these crises impact agencies across government such as the State Department, USAID, the Defense Department, the Department of Homeland Security and, of course, state and local governments.
During the 2014 Ebola epidemic the White House tapped Ron Klain, a former chief of staff to the vice president, to lead a government-wide effort to coordinate every facet of the crisis directly from the White House—from getting more doctors and supplies to West Africa to working with DHS on traveler screening procedures to protect and reassure the public. Having a White House-level leader accountable to the president and with the authority to make decisions and manage the myriad of interested agencies was critical in mounting a thorough, effective and coordinated response.
Lay Out a Plan and Execute It. Pandemic diseases impact a multitude of government mission sets, from medical research and development to border operations and screening, to air transportation safety and security, to foreign relations. The government must have a clear and comprehensive plan charting the course of where it wants to go and how it is going to get there and end the spread of the disease.
In 2014, the Ebola response plan included fighting the disease at its source in West Africa with medical experts and supplies, working with our allies to screen passengers overseas and screening travelers upon arrival in the United States. It also included contact tracing, the time-tested technique of isolating victims and identifying those who may have had contact with a victim—which has worked effectively to fight the spread of other outbreaks including smallpox and SARS. At the same time, scientists were testing experimental medications to fight the virus. All of these efforts had to be advanced simultaneously, which meant that several times each week the White House Situation Room was hosting an Ebola response meeting to ensure that progress was being made to execute on the plan. This framework remains relevant today.
Focus on Facts, Not Fiction. Hysteria and panic are powerful emotions that can easily overwhelm a situation, but in a medical crisis, science must drive the response. During the Ebola crisis, government health officials and the media took pains to explain to the public how the disease was transmitted, what the symptoms were, and what to do if a person had a concern of infection. At the same time, medical experts held a regular seat in the Situation Room. While this focus on facts did not stop all of the unfounded outbursts of fear and conspiracy theories about the supposed ways the virus could spread, it did go a long way toward calming the public and providing concrete information rooted in science.
Communicate Regularly, Be Transparent and Instill Confidence. In 2014, the CDC held regular—sometimes daily—briefings, updating the public on the spread of the disease, containment efforts, progress in attacking the virus at the source, the latest scientific learning about the disease, and the government’s strategy for managing the crisis. At the same time, other agencies, such as DHS, were communicating to the public about travel screening and other precautions the government was taking to protect and reassure the public and demonstrate that its government was on top of it. Regular communication and transparency are key to avoiding panic, maintaining trust and enlisting the public’s help in stopping the advance of the contagion. In the digital age, where misinformation can spread quickly, it is critical to leverage the power of traditional and social media with concise, effective communication strategies. The teams on the front lines of these efforts must have the knowledge and authority to respond in real time.
Think Outside the Box. By definition, crises require confronting the unexpected, which often demands novel solutions. The spread of these viruses is no exception. For example, after the first Ebola-related death in the United States, officials considered a number of additional safety and security measures, including screening international passengers from West Africa arriving in the United States. One of the challenges with implementing such screenings was the number of U.S. airports international travelers fly into—setting up screenings in just a handful of airports would be much more efficient and effective. In this case, the professionals at DHS used the agency’s legal authorities to require that any air passenger originating in West Africa be routed to land at one of five designated airports in the United States, where personnel were trained and equipped to medically screen passengers.
This was not the only novel issue that demanded creative thinking. Indeed, several hard questions arose: How would screeners handle a sick passenger that refused to be quarantined? What were the legal authorities to quarantine a potentially sick passenger? Which government agency would conduct the screening? What if a passenger developed symptoms on an airplane? These questions and others required unconventional solutions and options for decision makers to consider.
None of these examples from 2014 is intended to suggest any particular policy now. Rather, these crises present new challenges and each of them requires creative thinking to solve (not to mention selfless courage by our frontline medical professionals and government employees), rather than hunkering down and hoping the situation will improve on its own. At the same time, any policy response should be appropriately tailored and balanced based on the facts. In the end, many of the challenges during the Ebola crisis were solved through bold, outside-the-box thinking, which resulted in actions that protected and reassured the public while our medical experts fought the disease itself.
The United States and the world have the playbook to fight this virus. But it is not going to disappear on its own. Action and leadership are necessary, and looking back at some of the lessons from the 2014 Ebola crisis can provide a roadmap for addressing this one.
