The Campaign Spot

The CDC Needs an Ebola Plan that Accounts for Human Errors.

From the Thursday Morning Jolt:

The Only Thing We Have to Fear is Fear Itself. Well, That and Ebola.

Fear is not always a bad thing*. Fear can be useful. Fear is an indicator that we care about something and fear losing something. Fear can be a powerful motivator to action.

For weeks, officials at the National Institutes of Health, the Centers for Disease Control and Prevention, and the Obama administration have told us that we have the very best people in government and medicine working on the problem of Ebola. They told us that they would “stop it in its tracks.” They assured us they could handle this. Anyone who said otherwise was fear-mongering.

Now they’re admitting to us they “dropped the ball.”

In the case of Amber Vinson, the Dallas nurse who flew commercially as she was becoming ill with Ebola, one health official said “somebody dropped the ball.”

The Centers for Disease Control and Prevention said that Vinson called the agency several times before flying, saying that she had a fever with a temperature of 99.5 degrees. But because her fever wasn’t 100.4 degrees or higher, she didn’t officially fall into the group of “high risk” and was allowed to fly.

Thus, we see the familiar pattern, from the VA scandal, from Healthcare.gov, from insurance cancellations, to our foreign-policy crises. Someone notices a problem. The government assures us they’ve got this under control. People outside government publicly express doubts. Government officials scoff and dismiss the critics. And then the critics turn out to be a lot more right than the government admitted.

Rick Wilson’s chilling — and at least somewhat prescient — little story on Twitter from late July stands out for his main point that in a crisis, human beings make mistakes. That is not avoidable, no matter the preparation, the amount of resources, or the leadership. It’s baked in the cake. So a realistic plan has to have contingencies to deal with those inevitable human errors.

So far, it seems that the Centers for Disease Control designed and implemented a plan that would have worked . . . as long as no one made any mistakes.

If the screener at the Liberian airport where Duncan got on the plane had detected an elevated temperature, or he had not lied in his answers on the questionnaire, as Liberia’s government claims, the plan would have worked.

If he had clearly communicated that he had recently been to West Africa, and the hospital had clearly understood, the plan would have worked, or at least worked better.

If the first nurse indeed made (some yet undetermined) error in removing her protective gear, then yes, the plan could have worked better.

If the second nurse had not made the decision to get on an airliner while “being monitored,” and chosen to get onto a return flight with a 99.5-degree fever, the plan would have worked better.

And then the CDC “dropped the ball,” telling her it was okay to get on that flight.

The problem is that human beings make mistakes, and because of a variety of psychological factors — including fear and denial — they sometimes get worse at assessing risk and reward in circumstances like this one. Even people with a background in medicine and knowledge of the virus take risks that seem unacceptable to others. Nurses get on airplanes. The NBC News medical correspondent goes out for soup.

President Obama canceled his fundraising event and economy speech scheduled for today.

* A counter-argument from Paul Atreides: “Fear is the mind-killer.”

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