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OPINION
Thomas Frieden

CDC lost its Ebola gamble: Column

Alex Berezow
Tom Frieden, head of the Centers for Disease Control and Prevention, speaks at a news conference in Atlanta on Oct. 12.

The Ebola situation is testing the world's best infectious disease team, the Centers for Disease Control and Prevention (CDC), at its ability to perform crisis management. While the immediate threat in the United States appears to be receding, it is far from clear that we're up to facing a stronger test.

The CDC is one of the great institutions of our federal government. Microbiologists, such as myself, idolize the scientists who have dedicated their careers and lives to making the planet safer. But the CDC has made some major missteps. Some understandable mistakes are clearly from inexperience in dealing with Ebola, but others are harder to explain. For instance, effective communication is a vital part of all crisis management, which should be a core function at the agency.

Inevitable criticism

But that's also harder than it looks. CDC has found itself in a Catch-22. It's a nearly impossible balancing act to provide accurate information without unnecessarily frightening the public. Whether CDC said too much or too little, it was going to be criticized by the news media. The outbreak spread, so the CDC was condemned for being unprepared. But if the outbreak had fizzled, it would have been chastised for fear mongering.

Likely aware of this, the CDC chose the worst possible action: In an effort to keep the public calm, the CDC pretended to know more about Ebola than it actually does.

First, the CDC insisted that Ebola is very difficult to transmit from person to person. But, that is clearly not true. This particular Ebola strain appears to be more infectious than others. In an interview with Vox, virologist Peter Jahrling worried that this strain exhibits a higher "viral load," which means it produces more virus particles. That could explain why the current outbreak is the largest in history, more than 20 times bigger than the previous record-setter, and in a worst-case scenario, without new mitigating measures, the epidemic could become 3,000 times as large.

Second, the CDC insisted that Ebola is not airborne. That is probably mostly true, but it may not be entirely true. While airborne transmission is unlikely to explain more than just a few cases, it is still theoretically possible. Research published in 2012 suggested that infected pigs could transmit Ebola to monkeys through the air. However, as epidemiologist Tara Smith explains, pigs are thought to be particularly nasty disease spreaders. Just because pigs can pass Ebola through the air does not necessarily mean humans can, too.

Finally, the CDC has relied on a 21-day quarantine period for people who may have been exposed to Ebola. But, a new study by Charles Haas from Drexel University suggests that this may not be sufficient. His research shows that a person has about a 12% chance of being infected with Ebola after the 21-day quarantine period expires.

Not clueless

The CDC is not clueless. It is definitely capable of containing Ebola. But the agency, specifically its chief, Tom Frieden, has conveyed a sense of confidence that is not completely convincing. Frieden's credibility was shaken when nurses Nina Pham and Amber Vinson contracted the disease, despite CDC reassurances that this was unlikely to occur.

What will happen if another person becomes infected, especially if it occurs outside the 21-day quarantine time frame or via the airborne route? Even though fears are fading now, a single new case could completely undermine public confidence.

The solution for the CDC is straightforward. It needs to find a spokesperson who can properly spell out exactly what scientists do and do not know about Ebola. If Frieden is unable or unwilling to do so, then the CDC should find somebody who is. Explaining nuances and embracing uncertainty are never popular public relations strategies, but they are far better than pretending to have all the answers.

Alex Berezow, founding editor ofRealClearScience, is a member of USA TODAY's Board of Contributors and co-author ofScience Left Behind. He holds a Ph.D. in microbiology.

In addition to its own editorials, USA TODAY publishes diverse opinions from outside writers, including ourBoard of Contributors. To read more columns like this, go to the opinion front page or follow us on twitter@USATopinion or Facebook.

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