As Thomas Eric Duncan’s family mourns the USA’s first Ebola death in Dallas, one question reverberates over a series of apparent missteps in the case: Who is in charge of the response to Ebola?
The answer seems to be — there really isn’t one person or agency. There is not a single national response.
The Atlanta-based Centers for Disease Control and Prevention has emerged as the standard-bearer — and sometimes the scapegoat — on Ebola.
Public health is the purview of the states, and as the nation anticipates more Ebola cases, some experts say the way the United States handles public health is not up to the challenge.
“One of the things we have to understand is the federal, state and local public health relationships,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Public health is inherently a state issue. The state really is in charge of public health at the state and local level. It’s a constitutional issue. The CDC can’t just walk in on these cases. They have to be invited in.”