Obama appoints Ebola boss

Report says WHO erred from start

Employees with Cleaning Guys Environmental carry equipment into North Belton Middle School Friday, Oct. 17, 2014, in Belton, Texas, as they prepare to disinfect the school. The Central Texas school district has temporarily closed three of its campuses after a family of four, including two students from the district, traveled on the same flight as a nurse who has since been diagnosed with Ebola. (AP Photo/The Temple Daily Telegram, Rusty Schramm) TV OUT, MAGS OUT
Employees with Cleaning Guys Environmental carry equipment into North Belton Middle School Friday, Oct. 17, 2014, in Belton, Texas, as they prepare to disinfect the school. The Central Texas school district has temporarily closed three of its campuses after a family of four, including two students from the district, traveled on the same flight as a nurse who has since been diagnosed with Ebola. (AP Photo/The Temple Daily Telegram, Rusty Schramm) TV OUT, MAGS OUT

WASHINGTON -- President Barack Obama named a trusted political adviser Friday to take control of America's Ebola response, as an internal report revealed the World Health Organization bungled efforts to halt the spread of the disease in West Africa.

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U.S. officials also rushed to cut off potential routes of infection from three cases in Texas, reaching a cruise ship in the Caribbean and multiple domestic airline flights. Republican lawmakers and the Obama administration debated the value of restricting travelers from entering the U.S. from countries where the outbreak began, without a resolution.

Obama named Ron Klain, 53, a lawyer and former chief of staff to Vice President Joe Biden, as the administration's point man on Ebola.

Klain is a longtime Democratic operative who also served as a top aide to Vice President Al Gore. He does not have any medical or public-health expertise. But the White House said he would serve as "Ebola response coordinator," suggesting his key role will be to synchronize the actions of many government agencies in combating the disease.

"This is much broader than a medical response," White House spokesman Josh Earnest said, citing Klain's experience in the private as well as public sector and his relationships with Congress.

"All of that means he is the right person for the job, and the right person to make sure we are integrating the interagency response to this significant challenge," he said.

That assurance didn't satisfy Republican lawmakers, many of whom previously had criticized Obama for not naming a single point-person on Ebola and instead leaving the task to aides with broader portfolios, including Lisa Monaco, his homeland security and counterterrorism adviser.

Rep. Fred Upton, R-Mich., chairman of the Energy and Commerce Committee, said Obama should have appointed someone with a background in health care or infectious disease.

"What has been missing from this administration's response to Ebola is not a new figurehead," he said in an emailed statement. "What we need is a strategy to get ahead of this, and restore the public's faith that they are safe."

Rep. Tim Murphy, R-Pa., who led a hearing where lawmakers grilled federal officials about the Ebola response Thursday, called Klain's selection "shocking and frankly tone deaf to what the American people are concerned about."

Obama until Friday said his existing staff of advisers could handle Ebola, which is the subject of growing fear in the U.S.

"It's not that they haven't been doing an outstanding job really working hard on this issue, but they also are responsible for a whole bunch of other stuff," Obama said at the White House after meeting with members of his team.

Republican lawmakers have faulted the response by the Centers for Disease Control and Prevention in trying to keep Ebola infections contained and in informing the public. After a Liberian man visiting Dallas died of Ebola last week, two nurses who treated him became the first people infected with the virus in the U.S.

errors on outbreak

As the U.S. took actions to respond to the disease that has already killed more than 4,500 people in Africa, the WHO draft report pointed to serious errors by the agency designated as the international community's leader in coordinating response to outbreaks of disease.

The document -- a timeline of the outbreak -- found that the WHO, an arm of the United Nations, missed chances to prevent Ebola from spreading soon after it was first diagnosed in Liberia, Sierra Leone and Guinea last spring, blaming factors including an incompetent staff and a lack of information.

Its own experts failed to grasp that traditional infectious-disease containment methods wouldn't work in a region with porous borders and broken health systems, the report found.

"Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall," WHO said in the report, obtained by The Associated Press. "A perfect storm was brewing, ready to burst open in full force."

The agency's own bureaucracy was part of the problem, the report found. It pointed out that the heads of its country offices in Africa are "politically motivated appointments" made by the WHO regional director for Africa, Dr. Luis Sambo, who does not answer to the agency's chief in Geneva, Dr. Margaret Chan.

Dr. Peter Piot, the co-discoverer of the Ebola virus, agreed that WHO acted far too slowly.

"It's the regional office in Africa that's the front line," said Piot, interviewed at his office in London. "And they didn't do anything. That office is really not competent."

Piot, director of the London School of Hygiene and Tropical Medicine, also questioned why it took the WHO five months and 1,000 deaths before the agency declared Ebola an international health emergency in August.

"I called for a state of emergency to be declared in July and for military operations to be deployed," Piot said. But he said the WHO might have been scarred by its experience during the 2009 swine-flu pandemic, when it was slammed for hyping the situation.

In late April, during a teleconference on Ebola among infectious-disease experts that included the WHO officials, Doctors Without Borders and the CDC, questions were raised about the performance of WHO experts, because not all of them bothered to send Ebola reports to WHO headquarters, according to the draft document.

In the timeline, the WHO said it was "particularly alarming" that the head of its Guinea office refused to help get visas for an expert Ebola team to go in, and that $500,000 in aid was being blocked by administrative hurdles. Guinea, along with Sierra Leone and Liberia, is one of the hardest-hit nations in the current outbreak, with 862 deaths so far blamed on Ebola.

The Ebola outbreak already has killed 4,546 people in West Africa out of at least 9,191 cases. The WHO says within two months, there could be 10,000 new cases of Ebola every week unless stronger measures to fight the outbreak are put into place.

The WHO declined to comment on the document, which was not issued publicly, and said Chan would be unavailable for an interview with the AP. She did tell Bloomberg News that she "was not fully informed of the evolution of the outbreak. We responded, but our response may not have matched the scale of the outbreak and the complexity of the outbreak."

travel ban resisted

In the U.S., Republican lawmakers continued pushing the administration Friday to consider restricting travel to the U.S. from the three Ebola-stricken West African countries. But despite Obama's statement Thursday that he was not "philosophically opposed" to such a ban, Earnest affirmed the White House's resistance to such a move.

Republican Mike Leavitt, a former health secretary under President George W. Bush, said Friday that he sees "lots of problems" with such a ban. While it may seem like a good idea, Bush administration officials who considered it to contain bird flu concluded that it would not work, while raising a host of difficult questions about who would be allowed to travel.

Other nations have taken steps to prevent travelers from the affected areas from crossing their borders. The Central American nation of Belize announced that it would immediately stop issuing visas to people from West African countries where Ebola had spread.

Republican Texas Gov. Rick Perry reversed course and joined other top conservatives in calling for an air-travel ban from the countries hardest-hit by Ebola, saying Friday that he'd pushed the idea with Obama and suggested creating a "no-fly list" for Americans potentially exposed to the virus.

As criticism rose for Texas Health Presbyterian Hospital, where the Liberian man was treated and two nurses were infected, Perry also said he'd asked Obama to "fast-track" Ebola cases to better-equipped CDC facilities.

The governor also said it was "indefensible" that one of the health care workers who had treated Ebola patient Thomas Eric Duncan was allowed to fly from Ohio to Texas "with a low-grade fever" before being diagnosed with Ebola.

Perry said he asked Obama to consider creating "a no-fly list that the airlines then respect" of people in the U.S. who had been potentially exposed to Ebola.

The Texas state health agency and Dallas County officials on Thursday approved restrictions that nearly 100 health care workers who treated Duncan are being asked to follow for the 21-day maximum incubation period of the virus.

Under the restrictions, the health workers are not allowed to visit grocery stores, movie theaters or other places where members of the public congregate. They also are not permitted to travel by airplane, ship, long-distance bus, train or other modes of commercial transportation.

Anyone who does not adhere to the measures "may be subject" to a disease control order, in which they would be under a state-ordered quarantine, officials said Friday.

The documents were drawn up after an infected nurse, Amber Joy Vinson, took two flights between Dallas and Cleveland in the days before she developed symptoms of Ebola and was diagnosed with the disease.

Vinson's air travel has stirred fears across the country. Federal health officials said Friday that they had contacted all 132 passengers on Monday's Frontier Airlines Flight 1143 to Dallas.

Frontier Airlines said it would contact passengers on seven flights, including the two that carried Vinson and others afterward that used the same plane.

Concerns persisted Friday about people who might have been in contact with Vinson during the trip. Police said Vinson stayed at the home of her mother and stepfather in Tallmadge, northeast of Akron, and the home has been cordoned off with yellow tape. Eight individuals in northeast Ohio were under quarantine, health officials said.

Vinson is being treated at Emory University Hospital in Atlanta, one of four hospitals with specialized isolation units designed to handle highly infectious cases.

Meanwhile, doctors at the National Institutes of Health in Maryland said another Dallas nurse, Nina Pham, who was taken there for Ebola treatment was very tired but resting comfortably Friday in fair condition.

"We fully intend to have this patient walk out of this hospital," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which also has a special isolation unit.

Pham, 26, arrived shortly before midnight Thursday and was admitted to the clinical studies unit. She is being treated by staff specializing in infectious disease and critical care.

Elsewhere, U.S. officials said they were working to remove a worker from the Dallas hospital who had handled an Ebola lab specimen from a Caribbean cruise ship, although she had gone 19 days without showing any sign of the infection.

The Carnival Cruise Lines ship was headed back to its home port of Galveston, Texas, on Friday after failing to get clearance to dock in Cozumel, Mexico, and officials in Belize would not allow U.S. officials to evacuate the woman through their territory.

The lab worker and her spouse were in isolation and she is "not deemed to be a risk to any guests or crew," a cruise line spokesman said.

The cruise industry is increasing scrutiny of passengers, denying boarding to guests and crew members from countries for which the CDC has issued travel warnings. Ship operators also have begun "contact screening," questioning boarding passengers to determine who may have come in contact with an Ebola patient, the Cruise Lines International Association trade group said in a statement.

In Virginia on Friday, health officials said a woman who became ill in the Pentagon parking lot does not have Ebola, ending a daylong scare that forced the temporary quarantine of military members going to a Marine Corps ceremony in Washington.

Negative tests in Spain

In Spain, where a nursing assistant is being treated for Ebola, four other people tested negative for the disease Friday, the government said.

Deputy Prime Minister Soraya Saenz Santamaria said the four people taken into hospitals Thursday with fevers will be tested a second time in the coming days.

They include a passenger on an Air France jet that was isolated at Madrid's airport Thursday and a person who traveled in the same ambulance used to hospitalize infected Spanish nursing assistant Teresa Romero on Oct. 6.

The other two were a Red Cross health worker who recently worked with Ebola patients in Sierra Leone and a missionary who came down with a fever after returning from Liberia.

Health Ministry spokesman Fernando Simon said Romero's infection was almost under control and there was increasingly less reason to be worried.

Meanwhile, France's government announced Friday that it is strengthening its anti-Ebola efforts even though no cases have been detected in the country.

The prime minister appointed a prominent doctor, Jean-Francois Delfraissy, as Ebola "czar" to coordinate France's international and national responses to the crisis.

Despite the stepped-up attention to the disease, World Bank President Jim Yong Kim warned Friday that officials in many countries were focused too much on their own borders.

"I still don't think that the world has understood what the possible downside risk is not just to the West African economy but to the global economy. And we are still losing the battle," he said.

Information for this article was contributed by Maria Cheng, Adam Geller, Angela Charlton, Ricardo Alonso-Zaldivar, Jessica Gresko, Lara Jakes, Jim Kuhnhenn, David Dishnea, Ann Sanner, Michelle Chapman, Patrick Jones, Will Weissert, Lolita C. Baldor and staff members of The Associated Press; by Angela Greiling Keane, Kathleen Hunter, Toluse Olorunnipa, Caroline Chen, Alex Wayne, Ketaki Gokhale, Christopher Palmeri and James Rowley of Bloomberg News; and by Manny Fernandez, Alan Cowell, Michael R. Gordon, Mitch Smith, Sabrina Tavernise, Alan Blinder and Timothy Williams of The New York Times.

A Section on 10/18/2014

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