CDC: We Could Have Done a Better Job on Ebola If We Just Had More Money
This story is a few days old, but I just ran across it, and it’s a useful vehicle for a little rant:
The United States government has pledged to send help to West Africa to help stop Ebola from spreading—but the main agencies tasked with this aid work say they’re hamstrung by budget cuts from the 2013 sequester.
On September 16, the Senate Committees on Appropriations and Health, Education, Labor, and Pensions held a hearing to discuss the resources needed to address the outbreak. Sen. Patty Murray (D-Wash.) asked NIH representative Anthony Fauci about sequestration’s effect on the efforts.
“If even modest investments had been made…the current Ebola epidemic could have been detected earlier, and it could have been identified and contained.”
“I have to tell you honestly it’s been a significant impact on us,” said Fauci. “It has both in an acute and a chronic, insidious way eroded our ability to respond in the way that I and my colleagues would like to see us be able to respond to these emerging threats. And in my institute particularly, that’s responsible for responding on the dime to an emerging infectious disease threat, this is particularly damaging.” Sequestration required the NIH to cut its budget by 5 percent, a total of $1.55 billion in 2013. Cuts were applied across all of its programs, affecting every area of medical research.
Dr. Beth Bell, director of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, testified before the committee, making a case for increased funding. Her department, which has led the US intervention in West Africa, was hit with a $13 million budget cut as a result of the cuts in 2013. Though appropriations increased in 2014 and are projected to rise further in 2015, the agency hasn’t yet made up for the deficit—according to Bell, $100 million has already gone toward stopping the Ebola epidemic, and much more is needed. The United Nations estimates it will take over $600 million just to get the crisis under control.
This is the usual cry of government: we have done a horrible job, so give us more money. We at the IRS have targeted conservative groups and destroyed the evidence. Give us more money. We at the CDC have failed to plan for an inevitable Ebola case in the U.S., and even told quarantined people to go to the store. Give us more money.
I call bullspit. It’s been seven years since Tom Coburn released his 2007 report on CDC overspending, but there is nothing new under the sun, so let’s take a walk down recent memory lane:
A Republican senator Tuesday released a report critical of spending at the federal Centers for Disease Control and Prevention (CDC), saying the agency “has wasted and continues to waste hundreds of millions of tax dollars, but keeps asking taxpayers for more.”
Sen. Tom Coburn, a practicing physician and ranking member of an oversight subcommittee, issued a 115-page minority office report questioning the CDC’s spending on projects including an employee fitness center with $200,000 in equipment such as zero-gravity chairs and a mood-enhancing light show, and a $1.7 million effort to have accurate medical information portrayed in movies and TV shows.
. . . .
Coburn’s report on the CDC provided details on a massive construction project at the CDC’s headquarters in Atlanta that has exceeded $1 billion.
The new buildings include a $106 million communications center with a 70-foot-wide-by-25-foot-tall wall of plasma video screens for visitors, the report says. The center is named after Sen. Tom Harkin, an Iowa Democrat who was the ranking member of the Senate Appropriations subcommittee overseeing CDC spending. A video production studio at the center cost $18.6 million, the report says.
The new construction includes a $110 million headquarters building named after Sen. Arlen Specter, a Pennsylvania Republican who is the former chairman of the subcommittee shaping the CDC budget. Coburn’s report says the CDC spent $9.8 million on furniture for the building.
Things have not gotten much better. Keeping the country safe from the outbreak of a deadly virus is one of the few things the federal government does that falls within the constitutional framework of limited government. Protecting the country is a core function of government — but as Glenn Reynolds notes, the CDC has lost sight of its “one job” (as in: “You had one job!”):
As The Federalist’s David Harsanyi writes: “The CDC, an agency whose primary mission was to prevent malaria and then other dangerous communicable diseases, is now spending a lot of time, energy and money worrying about how much salt you put on your steaks, how close you stand to second-hand smoke and how often you do calisthenics.”
These other tasks may or may not be important, but they’re certainly a distraction from what’s supposed to be the CDC’s “one job” — protecting America from a deadly epidemic. And to the extent that the CDC’s leadership has allowed itself to be distracted, it has paid less attention to the core mission.
In an era where new disease threats look to be growing, the CDC needs to drop the side jobs and focus on its real reason for existence.
Reynolds notes that the CDC admitted letting its guard down on Ebola:
CDC officials acknowledged that widespread hospital awareness didn’t kick in until the recent case in Dallas.
“We let our guard down a little bit,” said Abbigail Tumpey, a CDC spokeswoman, referring to the country’s health-care systems. “We as a health-care system have to make sure not to let our guard down and be vigilant that patients with Ebola could show up at any U.S. health-care facility. . . . Now that we’ve seen this happen, we know now that we need to do more to make people feel prepared.”
What is needed is not more money. What is needed is focusing on the real job at hand — and doing it without whining about needing more money.
Ding.
Patterico (9c670f) — 10/7/2014 @ 7:31 amWe in Dallas would have done better if there was no CDC at all. Then we would have had no one advising the preezy to let Liberians in to infect us.
Steve57 (b50fab) — 10/7/2014 @ 7:42 amRegrettably, lots of Americans — lots of sheeple — fall for the notion that problem A, B or C is worse because of a lack of funds or, in turn, can be turned around if the budget is increased. Look at opinion polls during the sequester when a majority of people shed tears for the heroic grandstanding of the liberals in Congress and the White House. (I won’t say anything about a majority of Americans, even today, still blaming George W Bush for current ecnomic woes.)
We have met the enemy (or fool), and he is us.
Mark (c160ec) — 10/7/2014 @ 7:49 amWith more money they would simply have hired more underlings to do the same wrong stuff. I’d favor cutting their funding 5% a year until they learn to focus.
Kevin M (b357ee) — 10/7/2014 @ 7:55 amDo they have figures to back them up?
Michael Ejercito (becea5) — 10/7/2014 @ 8:00 amHow much does it cost to suspend entry for individuals from infected countries, or to require quarantine for the incubation period prior to entry? It was once standard procedure.
ropelight (b553c4) — 10/7/2014 @ 8:03 amEvery crisis has a gold and silver lining with this administration. And in the end, it’s always Bush’s fault.
bobathome (5ccbd8) — 10/7/2014 @ 8:16 amCDC apparently continues to be very proud of their ‘Zombie Apocalypse Preparedness’ web page:
http://www.cdc.gov/phpr/zombies.htm
RNB (d95551) — 10/7/2014 @ 8:23 amI never met Tony Fauci, but I know people that had and at lest one that worked with him for a period of time at NIH. An excellent scientist.
But I agree that more money is not the issue.
Where there is a will there is a way. People on the front lines knew a disaster was brewing in Liberia early summer or spring, and those doing the work were overwhelmed, and neither WHO or the US or anyone did anything about it. Doctors Without Borders, though as left leaning as can be, are the recognized experts in Ebola outbreaks and were overwhelmed, hence recruited Samaritan’s Purse, already working in Liberia on non-Ebola needs, to take over in Liberia while they concentrated on Guinea and Sierra Leone.
Liberia is just a poor country not of any strategic importance to anyone, so who cared what happened there.
Everybody who works in an ER, every doc that does primary care, has to have in mind a handful of rare but devastating things in the back of their mind when seeing a patient. Ebola and other Hemorrhagic Fevers needed to be on that list in this age of air travel, even if way, way down on the list.
MD in Philly (f9371b) — 10/7/2014 @ 8:47 amIMO, all of the fuss about bringing Brantley to the US took away from the real threat, that people like Duncan would be arriving to the US because things had gotten so bad in Africa. We even had the air traveler to Lagos, Nigeria, as a warning.
But hey, in the midst of a generally busy and overwhelming day, sometimes thinking about being the first person to ever encounter something (an Ebola case in the US) does not cross one’s mind.
You often only see what you look for. The doc in Dallas had thousands of other things to look for, especially if the patient did not say, “Hey, I think it might be Ebola”. If he did, and the doc missed the possibility, that was a big mistake.
Here is the Bloomberg Business Week September 29 – October 5 cover story on ebola, which deals with money ineffectively spent on ebola – and the federal government is spending a lot:
http://www.businessweek.com/articles/2014-09-24/ebola-drug-zmapps-development-delayed-by-pentagon-agency
The Pentagon is spending $3.9 billion a year on a list of biological threat agents. Now this was primarily, at least originally, in a military context. The list is classified, but the number of agents is known to be 18 (thanks to a 2014 analysis by the GAO) and ebola is almost certainly on it and getting a lot of money, because ebola was part of the biological warfare program of the Soviet Union, and the Aun Shinrikyo cult in Japan wanted to use it, sending some people in 1993 to what was then called Zaire to get a sample (they failed, and eventually used a chemical poison, sarin)
In addition, after the anthrax attacks in 2001, the Department of Health Human Services also began investigating biological threats. In two years, the budget at the National Institute for of Allergy and Infectious Diseases (NIAID) went up from $2.04 billion to $3.7 billion.
The classified Pentagon program and the unclassified NIAID were being done completely indeonndently of each other.
In 2006, the Bish administration noticed there was a problem with the NIAID program. Money was
going for research at uninversity and commercial labs, but never moved out of the laboratory. Neither did the Pentagon attempt to get anything licensed. Robert Kadlec, who held several different positions in bio-defense during the Bush II Administration, told Bloomberg Business week, the Pentagon had enough money for research and development, but not for licensure. It “nevergot enough money to be a pharmaceutical company.”
Just enough to do research which never went out of the lab. Note here: the really expensive part of medical reaseach these days, is licensing, not gaining knowledge.
There is an approval process, which is extremely expensive and time-consuming.
Senator Richard Burr (R-N.C.) called this gap the “Valley of Death” There is no commercial potential to pull anything through the gap. There wasn’t going to be any company doing the work. It was no longer 1960, or even the 1970s. The cost to get something approved, and the uncertainty, had just gone up and up and up. The only potential customer is the government (and the government is simply not going to pay enough to cover the licensing costs)
Nobody made an attemt to short-circuit this in any way. Well, they did, but not enough.
What they did was establish the Biomedical Advanced Research and Development Agency, or BARDA for short.
It had fast track contracting authrority. But it didn’t have authority to license.
And it never got enough money to get FDA drug approval for drugs. The cost to push something through to approval is unbelievable.
It was getting only $100 million a year at the end of the Bush administration. Kadlec persuaded President Bush, at the end of his term, to ask for $900 million. But this never made it into the 2009 stimulus bill.
The rest of the article is about ebola version of Solyndra: ZMapp, and how it got money out of teh Defense Threat Reduction Agency.. DTRA doesn’t have fast track contracting authoroity so everything it did is very slow.
Sammy Finkelman (067111) — 10/7/2014 @ 8:55 amthe US government is a whiner
a useless incompetent cowardly whiner
happyfeet (a785d5) — 10/7/2014 @ 9:01 amMD in Philly (f9371b) — 10/7/2014 @ 8:47 am
Where there is a will there is a way.
There is no will. Nobody says that a whole lot of the requirements are unnecssary. Nothinbg moves ouut of the lab, or very little.
We like to say that if it were not for the United States there would be no medical progress, but the truth is, the drug and medica device development process is broken in the United states too, and only a subset of possibe drugs are moved to the patient, and taht only at extremely high prices.
Only something that can be patented. No currently available drugs or vitamins, unless maybe they are combined with something largely irrelevant.
Only patents that are owned by the people interested in getting something approved.
Only something for which an arm and a leg can be charged.
Only sure things, or very not sure things whose cost is sunk. (they can be or are underr patent, and they went through safety testing.)
No changes in protocol as more knowledge and experiene is gained, because that starts the whole approval process all over again.
Sammy Finkelman (067111) — 10/7/2014 @ 9:02 amThere is no will.
I agree with that, but my point is that we knew what we needed to do to stop this in Liberia without 1 cent spent on research of drugs or vaccines, but didn’t do it.
MD in Philly (f9371b) — 10/7/2014 @ 9:06 amNo comment on the rest of your posts.
And you ignore the reality that there are only so many P4 labs around the world where much of the necessary work on Ebola can be done.
MD in Philly (f9371b) — 10/7/2014 @ 9:07 amIt’s worse than you let on. Those little prizes are turds in their in-house expenditure. Last I checked, roughly half their budget consisted of patronage distributed to state and local governments (and, presumably, state-dependent philanthropies). The next Republican president needs to do to things: 1) see to it that ‘grants, subsidies, and contributions’ distributed by CDC are reduced to zero and 2) appoint a director who will identify every subunit of the agency concerned with something other than staff support, communicable illness, or environmental illness and RIF them.
Art Deco (ee8de5) — 10/7/2014 @ 9:08 amEverybody who works in an ER, every doc that does primary care, has to have in mind a handful of rare but devastating things in the back of their mind when seeing a patient. Ebola and other Hemorrhagic Fevers needed to be on that list in this age of air travel, even if way, way down on the list.
Especially when there’s not an epidemic raging. When there is an epidemic they can try to stop people from boarding. The thing about ebola is, it was almost non-existent for a long time A case would be discovered somewhere in Africa, and it would be contained.
That worked, until..
http://www.nytimes.com/2014/08/10/world/africa/tracing-ebolas-breakout-to-an-african-2-year-old.html?_r=0
It took 3 months to get in contact with health care workers, and I suspect the reason is the Moslem Brotherhood or al Qaeda or some other Salafis – plus it was never seen there before, and there is more travel now within Africa.
Islamic sal Qaeda.
IMO, all of the fuss about bringing Brantley to the US took away from the real threat, that people like Duncan would be arriving to the US because things had gotten so bad in Africa. We even had the air traveler to Lagos, Nigeria, as a warning.
Sammy Finkelman (067111) — 10/7/2014 @ 9:11 amBut hey, in the midst of a generally busy and overwhelming day, sometimes thinking about being the first person to ever encounter something (an Ebola case in the US) does not cross one’s mind.
You often only see what you look for. The doc in Dallas had thousands of other things to look for, especially if the patient did not say, “Hey, I think it might be Ebola”. If he did, and the doc missed the possibility, that was a big mistake.
Oops. MD in Philly:
The New York Times has a letter today.
http://www.nytimes.com/2014/10/07/opinion/weighing-the-responses-to-ebola.html
(actually, in most cases, that would be endangering citizens of another country)
And there is a little bit more, and other letters, with various points of view.
Sammy Finkelman (067111) — 10/7/2014 @ 9:18 amFirst, the Obama administration is at war with the pharmaceutical industry.
Second, Democrats are at war with vaccines. The Clinton administration wrecked the vaccine industry when it took over vaccine production to end “profits.”
the National Academy of Science’s Institute of Medicine has now pinned much of the blame on Hillary Rodham Clinton.
Well, not in so many words. The panel of doctors and economists issuing a report on vaccines last week was too polite to mention the former First Lady by name. But they identify as a fundamental cause of the problem the fact that the government purchases 55% of the childhood vaccine market at forced discount prices. The result has been “declining financial incentives to develop and produce vaccines.”
The root of this government role goes back to August 1993, when Congress passed Mrs. Clinton’s Vaccines for Children program. A dream of Hillary’s friends at the Children’s Defense Fund, her vaccines plan was to use federal power to ensure universal immunization. So the government agreed to purchase a third of the national vaccine supply (the Clintons had pushed for 100%) at a forced discount of half price, then distribute it to doctors to deliver to the poor and the un- and under-insured.
Of course, industry lost interest in vaccine production as in any socialist scheme.
Now, we have Ebola. First, Africa is mostly black people. A Fox News babe got in trouble with CNN this week by saying that Africans sometimes go to witch doctors instead of hospitals. Racism !
That’s why we can’t ban flights from Liberia where the airport “screeners” don’t know how to use the screening gear.
The CDC has been spending a lot of time on the critical issue of guns in the home. This research was banned in 1996 (no doubt by the GOP Congress) and Obama resumed this critical function of the CDC.
The 1997 appropriations bill stated, “None of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” Congress also threatened more funding cuts if the gun research continued.
Now, if this epidemic was of gun violence, the CDC would be prepared.
Mike K (90dfdc) — 10/7/2014 @ 9:19 amThe Greeks have a saying, “A doctor will tell you what you told him”.
The ridiculous: “Doctor, I keep getting these boils on my butt.” “You have recurrent furuncolosis.” “What does that mean?” “You keep getting boils on your butt.”
The helpful: “Doctor, I think I may have Ebola.” “Why do you think that?” “I just flew in from Liberia, where I helped a lady who later died from Ebola get to the hospital, and now I have a fever and I’m throwing up.” “I think you may have Ebola.”
nk (dbc370) — 10/7/2014 @ 9:23 amMd in Philly:
But hey, in the midst of a generally busy and overwhelming day, sometimes thinking about being the first person to ever encounter something (an Ebola case in the US)
An ebola case that you didn’t know was coming.
does not cross one’s mind.
You often only see what you look for. The doc in Dallas had thousands of other things to look for, especially if the patient did not say, “Hey, I think it might be Ebola”. If he did, and the doc missed the possibility, that was a big mistake
We only know what made it into the written record.
The patient, and the patient’s girlfriend/fiance may not have said that, because in their minds it was ruled out because they didn’t know what the first signs of ebola are, or how long it takes and it didn’t fit with their picture of ebola – or it was up to the doctor to tell them, and they weren’t going to poison his mind – and if he had ebola he was dead anyway, and his girlfriend too – or they were too shy, or perhaps he knew he had done something against the law in checking the NO box to Question 4 at the airport in Monrovia, and didn’t want to confess unless it was necessary. (in the case of the last one, he could just have brought up the idea of ebola anyway, so that’s probably not the reason.)
We don’t know why he and nobody with him didn’t bring it up.
Sammy Finkelman (067111) — 10/7/2014 @ 9:27 amMuch needed standard hospital supplies have been shipped to Sierre Leone and are being held up by Sierre Leone’s customs agency.
The United States is being too deferential to the government of Sierre Leone. Just because getting these supplies there were sent in part as a political stunt is no reason to (silently) refuse to use them.
http://www.nytimes.com/2014/10/06/world/africa/sierra-leone-ebola-medical-supplies-delayed-docks.html
Sammy Finkelman (067111) — 10/7/2014 @ 9:32 amGreetings:
As long as I’m up, can I get you another cup of “Never let a crisis go to waste.” ???
11B40 (844d04) — 10/7/2014 @ 9:36 amRe: Mike K gun control:
That reminds me of a faulty statistic I heard on Fox News Sunday with regard to ebola that is also used with regard to gun control.
The statistic was that 80 people had been stopped from travelling out of the affected countries.
This is like the statistic about the number of people prevented from buying guns by background checks.
First thing wrong: A lot of the people being stopped did not have ebola, and a lot of the people stopped by background checks were and are no danger.
Second thing wrong: Many people who would be stopped simply don’t try.
Another statistic was that 40,000 passengers had travelled by air out of (the affected countries I think) since this began.
Problem: At the beginning, there was hardly any ebola. It is increasing.
Sammy Finkelman (067111) — 10/7/2014 @ 9:40 amMedical students are taught that a travel history is part of any evaluation of GI symptoms and the Ebola patient in Dallas was vomiting and had diarrhea. He was probably seen by a nurse practitioner as ERs are mostly staffed with NPs and PAs these days. The “representativeness heuristic” is a big problem but many be more so for NPs and PAs as they are usually dealing with the routine stuff that clogs ERs. My ex-wife was an NP and she would call me when the GP who was supposed to supervise her was too busy. This is the weakness of the WalMart model of primary care.
A good electronic medical record system would include a series of prompts that would pop up when data seems suspicious for something. This is why I was an advocate for EMR long ago. Unfortunately, the EMR systems I have seen are crap designed by programmers who are thinking of anything but clinical medicine. At one time a few years ago, I read that the head of Cedars-Sinai’s IT department was a nurse who had gotten a computer science PhD at Stanford. That is who should be designing these systems but I doubt there are many, if any.
Mike K (90dfdc) — 10/7/2014 @ 10:00 amREQUIRING TRAVELERS WHO HAVE BEEN TO EBOLA EPIDEMIC NATIONS TO BE CLEAR OF FEVER FOR 30 DAYS BEFORE ENTRANCE TO THE USA DOESN’T COST A PENNY.
reliapundit (fb63eb) — 10/7/2014 @ 10:03 amRealpundit – it doesn’t cost anything, but I think there’s a fair point that it’s very difficult to enforce. If you enforced by relying on self-reports, then you’ll get a lot of people who lie; if you rely on something more than self-reports (eg, mandatory pre-travel quarantine), then it’s going to cost a lot more than expected.
aphrael (001863) — 10/7/2014 @ 10:21 amif the silly whores who work for the United States government had the same zero tolerance for ebola that america’s dimbulb unionwhore public teacher thugs have for gun-shaped pop tarts we’d be sitting pretty today I think
happyfeet (a785d5) — 10/7/2014 @ 10:27 amhappyfeet, you have until October 20 to register to vote and until October 28* to vote by mail in California. Remember, Obama’s policies are on the ballot. You cannot register in Illinois for any place you will not have lived in for thirty days before the election.
*That’s Greece’s second biggest national holiday from when Greece’s fascist dictator said “No” to Italy’s fascist dictator. You say “No” to Obama, too.
nk (dbc370) — 10/7/2014 @ 10:37 amI’m still waiting for my NY absentee ballot, nk. (I’ll be in Mexico on election day).
aphrael (001863) — 10/7/2014 @ 10:38 am“We only know what made it into the written record.”
You don’t Sammy, as you prove day after day on this site on a myriad of subjects.
daleyrocks (bf33e9) — 10/7/2014 @ 10:40 amIn Illinois, absentee ballots are counted only if there is no concession. I’m toying with the idea of voting early. Michell is in town to encourage it.
nk (dbc370) — 10/7/2014 @ 10:43 amnk, I find that system bizarre. Absentee ballots should always be counted just like regular ballots are.
aphrael (001863) — 10/7/2014 @ 10:43 amit’s just a mess Mr. nk
i’m vacating here on the 15th and I don’t have a new place til the first of November
this all just happened yesterday when I talked to movers and realized Plan A wasn’t super-realistic – if you want to time your move then you pay a huge premium for that – what they do these days is consolidate your move with other people
maybe they always done it that way but it’s not how mom and dad did it with … I think they usually used Mayflower – so I wasn’t expecting all these wrinkles
plus the car is on a totally separate timetable
so it just makes a world of sense to take this time to see a lil bit of america
happyfeet (a785d5) — 10/7/2014 @ 10:50 amaphrael, it’s a little bit more complicated than the way I put it http://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=001000050K19-8 but that’s how it works out in practice.
nk (dbc370) — 10/7/2014 @ 10:54 amso, we’re not getting together for tacos?
redc1c4 (abd49e) — 10/7/2014 @ 10:58 ammeanwhile, here’s the brilliant governmental geniuses hard at w*rk…
nothing but optics, all the way down: when everything is seen as a political issue, nothing concrete will happen
redc1c4 (abd49e) — 10/7/2014 @ 11:02 amThe CDC has been spending a lot of time on the critical issue of guns in the home. This research was banned in 1996 (no doubt by the GOP Congress) and Obama resumed this critical function of the CDC.
Personnel is policy. A motivated director needs a free hand to identify subunits of CDC, shut them down, and discharge their employees. It’s only when you get down to the nubbin working on real diseases that you’ve completed the clean up. The agency culture is all wrong.
Art Deco (ee8de5) — 10/7/2014 @ 11:05 amyep, good link red,
MD in Philly (f9371b) — 10/7/2014 @ 11:10 amit doesn’t say, though, that they are seeing kids with Enterovirus D68 with neurological complications, weakness and such like polio.
I know they had some cases documented in CO, now I here there are some kids hospitalized in Philly with focal weakness as well.
let’s play it by ear Mr. red I think we might still can
happyfeet (a785d5) — 10/7/2014 @ 11:11 am25. reliapundit (fb63eb) — 10/7/2014 @ 10:03 am
REQUIRING TRAVELERS WHO HAVE BEEN TO EBOLA EPIDEMIC NATIONS TO BE CLEAR OF FEVER FOR 30 DAYS BEFORE ENTRANCE TO THE USA DOESN’T COST A PENNY.
Because this would be done on the honor system.
If you mean has no medical record of a fever, that would still cost money to implement, and would catch very few people, AND the odds of this person being contagious for ebola would be less than that of someone never seen by a doctor.
Sammy Finkelman (067111) — 10/7/2014 @ 11:12 amSenator Schumer proposed screening people in the United States.
The reason the idea of asking the questions again is supposed to make sense, is that once here, they won’t be sent back on the next plane, or on some special chartered plane, (but would they believe that – and what if they had a family member planning to come the next day?) so might feel motivated to confess if there was something to confess.
Sammy Finkelman (067111) — 10/7/2014 @ 11:16 amYou can get a quick and dirty idea of the problem looking at the organization chart
CDC subunits include
Center for Global Health
[chop up, send a portion to the overseas development apparat, shut rest]
National Institute for Occupational Safety and Health
[remove to Labor dept or health and safety assemblage]
Office for State, Tribal, Local and Territorial Support [patronage distributor. shut down]
Office of Equal Employment Opportunity [patronage distributor. shut down]
Office of Infectious Diseases [retain]
National Center for Emerging and Zoonotic Infectious Diseases
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
National Center for Immunization and Respiratory Diseases
Office of Minority Health and Health Equity [shut down]
Office of Noncommunicable Diseases, Injury and Environmental Health [split]
National Center for Chronic Disease Prevention and Health Promotion [shut down]
National Center for Environmental Health/Agency for Toxic Substances and Disease Registry
[retain?]
National Center for Injury Prevention and Control [shut down]
National Center on Birth Defects and Developmental Disabilities [shut down]
Office of Public Health Preparedness and Response [retain]
Office of Public Health Science Services [retain]
Art Deco (ee8de5) — 10/7/2014 @ 11:17 amCenter for Surveillance, Epidemiology and Laboratory Services
National Center for Health Statistics
31. nk (dbc370) — 10/7/2014 @ 10:43 am
In Illinois, absentee ballots are counted only if there is no concession.
I think that’s also true in New York for provisional or affidavit ballots.
Sammy Finkelman (067111) — 10/7/2014 @ 11:18 amnothing but optics, all the way down: when everything is seen as a political issue, nothing concrete will happen
I take it you saw Jonah Goldberg’s column the other day. Capable summary demonstrating the core issue of this administration.
Art Deco (ee8de5) — 10/7/2014 @ 11:20 amPersonnel is policy.
Yes but the political wind blows one way or the other. Look at a lot of these things and remember that the Congress flipped in 1994-95, then flipped back in 2006.
Look at the stock bull market that began in 1995 (Look at the charts), look at the CDC interest in guns (ended in 1996, resumed in 2007), look at the Community Reinvestment Act which got a boost with each Democrat in the White House and then, finally, when the Democrats took Congress in 2006. The collapse followed.
The link on the CRA also implicates Bush and I agree with this. He and Thatcher both supported the idea of poor people owning their own homes. The idea was that no one washes a rented car but it went wild when the Democrats blocked every effort at reform.
Mike K (90dfdc) — 10/7/2014 @ 11:22 amSenator Schumer proposed screening people in the United States.
Not necessarily bad. First let’s stop commercial aviation, rail, and bus travel into and out of the infected provinces, having relief workers travel on special transports.
Art Deco (ee8de5) — 10/7/2014 @ 11:23 amGood grief.
Seems like this agency is bloated to a dysfunctional point, and I suspect rolling it into FEMA and a few other agencies while cutting 90% of the budget would do no overall harm.
Right now we have a disease with a long incubation period, and once someone is symptomatic, every door knob is a potential death sentence for thousands of others. It would be very easy to drastically cut down on the risks by stopping travel, especially in a world where email and video conferencing make travel less necessary. We don’t need more bureaucracy. We just need some basic hard calls to get made.
Dustin (801032) — 10/7/2014 @ 11:26 amI hear you, Mike. I’m suggesting you have to clean out the permanent government to restore agency function. In an inattentive administration (and, by the way, business Republicans can go native quickly), it will be business as usual. Also, you have to take away from the Democratic Party the tools they use. Cutting the budget of subunit x by 20% and attempting to regulate its activities is less effective than closing down unit x and discharging its staff.
Art Deco (ee8de5) — 10/7/2014 @ 11:27 amNK, I’m confused, because that link says the ballots will be counted.
Early absentees: “Each absent voter’s ballot returned to an election authority, by any means authorized by this Article, and received by that election authority before the closing of the polls on election day shall be endorsed by the receiving election authority with the day and hour of receipt and shall be counted in the central ballot counting location of the election authority on the day of the election after 7:00 p.m.”
Mailed absentees received by the deadline: “Each absent voter’s ballot that is mailed to an election authority and postmarked by the midnight preceding the opening of the polls on election day, but that is received by the election authority after the polls close on election day and before the close of the period for counting provisional ballots cast at that election, shall be endorsed by the receiving authority with the day and hour of receipt and shall be counted at the central ballot counting location of the election authority during the period for counting provisional ballots.”
“Counting required under this Section to begin on election day after the closing of the polls shall commence no later than 8:00 p.m. and shall be conducted by a panel or panels of election judges appointed in the manner provided by law. The counting shall continue until all absent voters’ ballots and special write-in absentee voter’s blank ballots required to be counted on election day have been counted.”
aphrael (001863) — 10/7/2014 @ 11:27 am“Therefore the basic human survival instinct will drive travelers to do and say whatever they must to get into the United States.”
When you cruise you are asked to fill out a form “did you throw up within the past week?” It is intended to keep norovirus from being introduced to the ship. I often wonder how many people “self report?” How many people will do or say what they must to get on board the ship?
Jim (145e10) — 10/7/2014 @ 11:32 amSpeaking as a former elections official, in California, I know for a fact that all absentees and provisionals are counted *if they are valid ballots*.
In New York, under election law section 9-209, all absentee ballots are counted prior to the official canvass. If “ballots cast by voters with registration poll records missing on days of election or voters who have not had their identity previously verified or who have moved after registering” is the same thing as “provisional ballots”, then those votes are also counted *regardless of whether or not one side or the other has conceded* – there’s literally no provision in the law for not counting in the face of a concession. See http://www.elections.ny.gov/NYSBOE/download/law/2014NYElectionLaw.pdf.
aphrael (001863) — 10/7/2014 @ 11:32 am#36: Speaking of optics, the first clue that HteWon is fully engaged and determined to do something will be when he holds a press conference in the rose garden with all the WH interns dressed in HazMat suits lined up behind him. But he won’t be able to answer any questions because he has a prior committment with a golf pro.
It’s occurred to me that all our past experiences in dealing with serious disease threats took place when we had a functional health care system. Your average citizen facing an emerging health problem is now looking at two to four weeks for an appointment with some functionary at what purports to be a healthcare facility. Every single disease and headache that needs attention in the near-term will end up at the ER or the local dropin “urgent care” storefront. These are all walkin type situations where disease can be spread much more easily and widely than in past practice where you went to a Doctor who knew you, and knew all of the other patients in his practice. It is not clear that our past experiences will provide any means to judge the likely effectiveness of our response to the present crisis.
bobathome (5ccbd8) — 10/7/2014 @ 11:49 amThis explains it all… http://www.youtube.com/watch?v=EUzMPlQb2G4&sns=em
Colonel Haiku (2601c0) — 10/7/2014 @ 11:57 amThey lied! No government organization lost budget money because of the sequester. Only one person in the Justice department lost their job. That’s it, sequester did not cause the CDC to loose an budget money.
They need to remember that the money they get really isn’t theirs. That it came from the pockets of hard working people and needs to be spent responsibly.
Tanny O'Haley (3bbc7b) — 10/7/2014 @ 12:07 pm51, I don’t think a concession (that’s maybe just Illinois) has any validity, but the question of whether or not a vote could affect the outcome does.
I don’t think affidavit ballots are routinely counted in New York State because there was a bill passed in the New York State Senate (probably one of those 1-House bills) to count them. It doesn’t say the year but it has to be this year or the last because Jeffrey d. Klein is the Deputy Majority Leader.
http://www.nysenate.gov/files/pdfs/Election%20Reform%204.15.10.pdf
This does not clearly say they are not counted now, and this press release claims by implication that the bill will become law, and that’s not true.
I doubt that bill became law.
They probably definitely do count absentee ballots, but I am not sure about ballots whose validity needs to be investigated. They maybe are only counted if needed to determine who won an election.
I think only real insiders know. And nobody’s telling.
In a recount, everything is looked at, of course.
Then they discover a lot of dead people voted by absentee ballot.
Sammy Finkelman (067111) — 10/7/2014 @ 12:08 pmIf people who cast an affidavit ballot don’t even get automatically registered for the next election, I don’t think anybody is looking at them.
Sammy Finkelman (067111) — 10/7/2014 @ 12:09 pmIt doesn’t cost any anything to quarantine travel from those countries. Then you don’t have to worry about travelers lying to you, only politicians, bureaucrats, do gooders who believe the “ends justify the means” for the good their doing, so it’s okay to lie. You find this last group mostly on the left.
Tanny O'Haley (feadb2) — 10/7/2014 @ 12:11 pmLook at this:
http://www.brennancenter.org/analysis/letters-ny-election-officials-treating-affidavit-ballots-voter-registration-applications
OK< so here it says they are not or were not considered the equivalent of a voter regstration application.
This still doesn't say whether anybody actually looks at them if they are not needed to determine the outcome of an election.
It would be a lot of work to review every one of them.
If they are not routinely counted, this is not what the insiders would want anybody to know.
Sammy Finkelman (067111) — 10/7/2014 @ 12:16 pmwell look what a bangup job, they did with the VA
http://freebeacon.com/issues/veterans-affairs-fires-four-senior-officials-or-maybe-three/
narciso (ee1f88) — 10/7/2014 @ 12:17 pmTanny O’Haley (feadb2) — 10/7/2014 @ 12:11 pm
It doesn’t cost any anything to quarantine travel from those countries. Then you don’t have to worry about travelers lying to you, only politicians, bureaucrats,
The person who had ebola who traveled to Nigeria was a VIP. They can have ebola, too.
https://www.premiumtimesng.com/investigationspecial-reports/166560-exclusive-how-liberian-govt-cleared-patrick-sawyer-to-travel-to-nigeria-while-under-observation-for-ebola.html
That was back in July.
Sammy Finkelman (067111) — 10/7/2014 @ 12:24 pmThis was also before they were taking people’s temperatures or anything.
By the way, the doctor who refused to release him, despite importunings by people at that conference he was supposed to attend, died of ebola.
Sammy Finkelman (067111) — 10/7/2014 @ 12:27 pmIf they’re not counted, then the election agencies in question are violating the law, because the law requires them to be counted.
aphrael (001863) — 10/7/2014 @ 12:27 pmDoes the law require all affidavit ballots to be carefully examined to see if they are valid votes before an election can be certified? Does the law allow any extra votes to be added to the total after certification?
If the answer is no to both, they’re not counted.
Sammy Finkelman (067111) — 10/7/2014 @ 1:27 pmI think maybe the only votes that are counted in New York State are the ones that somebody is likely to go into court to obtain a court order to have them counted if they haven’t been counted already.
And that’s not affidavit ballots in decided races.
Sammy Finkelman (067111) — 10/7/2014 @ 1:32 pmI think maybe the only votes that are counted in New York State are the ones that somebody is likely to go into court to obtain a court order to have them counted if they haven’t been counted already.
And that’s not affidavit ballots in decided races.
At one time, absentee ballots were meticulously counted, and I’ve participated in such counts. At that time, early voting was not the vogue it is today. Affidavit ballots are so unusual (you see a single digit number in a county with 140,000 people in it), that it scarcely matters.
Art Deco (ee8de5) — 10/7/2014 @ 1:54 pmSammy, as I read 9-209 and 9-210 of http://www.elections.ny.gov/NYSBOE/download/law/2014NYElectionLaw.pdf, yes, they are required by law to count absentees and provisionals before certifying the results.
aphrael (af3e66) — 10/7/2014 @ 8:42 pmGoogle “CDC doctor arrested”.
Look at her job description.
She was allowed to go back to work.
Everyone was endangered by that.
CDC should be held accountable.
Drn (b1153c) — 10/7/2014 @ 8:52 pmThe way it works with absentee ballots in Texas is that they are only opened and counted if there are enough of them to change the outcome of an election. For example if candidate A won by 100 votes and there are 101 absentee ballots, they will be counted. If there are 99 absentee ballots they will not be counted.
I had thought all states did this. In 2000, California Governor Gray Davis ordered all the absentee ballots to be counted in the presidential race, in contravention or normal practice since Al Gore had unquestionably won California’s electoral votes. That is why everybody believes that Al Gore won the popular vote in that election. Texas Governor Rick Perry did not order the absentee ballots counted in Texas because George Bush had unquestionably won the Texas electoral votes and counting the absentee ballots costs taxpayers’ money. This sort of thing is why Texas is financially stable and California is dodging bankruptcy and default only with smoke, mirrors and clever accounting tricks.
ChuckFinley (6ef348) — 10/7/2014 @ 9:03 pmLook, this is just a standard line with everyone hired by Obama and testifying to Congress: “We are great at our jobs, but you troglodytes refuse to give us enough money.” Had the budget doubled, tripled, or quadrupled in the last 5 years? That’s not enough; enough is more than that. Had the budget slashed 1 percent by sequestration? Obviously, we were crippled by not enough money. It’s never enough, because enough is only more, ever more.
Except, of course, for the one job that government actually should be doing: Defense. There, more with less, less, and less is the right way to go.
David (d8f992) — 10/7/2014 @ 9:07 pmGeorge Russell has a piece up at Fox News on the grant spending at the State Dept, and the waste that the IG has found going back at least a decade. The IG has made wholesale suggestions, which have been forwarded to the appropriate officials, including the Under Secretary of State for Management, Patrick Kennedy – the man who could not be bothered to approve requests for additional security for Benghazi. Tellingly, Russell notes: “…The State Department’s response was also simple. All of the alert’s recommendations have been accepted…”
askeptic (efcf22) — 10/8/2014 @ 5:40 amI’m sure implementation is only a simple matter of getting Jen and Marie to issue hashtags.
This tired excuse has become the leftists’ equivalent of “the dog ate my homework”.
ToursLepantoVienna (a088b1) — 10/8/2014 @ 6:33 am…along with “the hard-drive crashed”.
askeptic (efcf22) — 10/8/2014 @ 6:38 am66. aphrael (af3e66) — 10/7/2014 @ 8:42 pm
Absentee ballots yes, affidavit ballots, no. Unless an affidavot ballot is to be considered a form or absentee ballot.
But I don’t think anybody checks them very carefully, unless there is a recount. Maybe they check to see if someone voted in person.
I don’t think anybody ever finds out what happened with an affidavit ballot. The voter can’t (except maybe by using the state freedom of information act) A candidate or a poll watcher maybe could.
Art Deco (ee8de5) — 10/7/2014 @ 1:54 pm
At one time, absentee ballots were meticulously counted, and I’ve participated in such counts.
They may still been but was this in an uncontested race – where there wasn’t a recount?
At that time, early voting was not the vogue it is today.
I don;t think it existed, and it doesn’t exist in New York State and a dozen other states or so. (Early voting means voting in person, not by mail)
New York State does not have no excuses absentee voting, so it is rare, but if somebody has requested it on the grounds they are confinded to home, or only leave with difficulty, they contionue to get one every year even past the time when they are dead, so long as the mail is delivered. (I think people are now getting removed from the registration lists. It used to be that if you didn’t vote two years in arow you had to re-register. Then it became 4 years. Then there was a hold on doing that altogether because of a lawsuit, and it only happened was mail was returned.. Now they maybe check death certificates or other regstrations, I don’t know.
I think we now have three states that only vote by mail: Oregon, Washington, and I think Colorado is joining them.
Affidavit ballots are so unusual (you see a single digit number in a county with 140,000 people in it), that it scarcely matters.
They are not that rare, but good ones may be.
ChuckFinley (6ef348) — 10/7/2014 @ 9:03 pm
In 2000, California Governor Gray Davis ordered all the absentee ballots to be counted in the presidential race, in contravention or normal practice since Al Gore had unquestionably won California’s electoral votes. That is why everybody believes that Al Gore won the popular vote in that election. Texas Governor Rick Perry did not order the absentee ballots counted in Texas because George Bush had unquestionably won the Texas electoral votes and counting the absentee ballots costs taxpayers’ money.
I didn’t know this.
This is a big falure on the part of all the reporting of the news. Was this a departure from the past?
I would think something like this would throw all these statistics on how many popular votes a candidate for president got, off.
This are certain things, related to integrity, you shouldn’t save money on, and besides it lets voters send a message and lets prople interested in elections – politicians – know how the sentiment really went.
Sammy Finkelman (067111) — 10/8/2014 @ 7:38 amThe normal procedure, at least here in CA (and I would assume that it is similar in other large states) is that the absentee ballots that were not counted prior to Election Day, are not counted if their numbers are insufficient to effect a race that is “close”.
askeptic (efcf22) — 10/8/2014 @ 7:53 amTo be counted prior to the election, the ballots must be received by the Registrar usually by the Friday before the election – I believe the individual County Registrars have some discretion on this. Ballots dropped off at polling places are deemed to arrive after the election, and will not be counted except when their numbers could alter the outcome.
74. In New York State I don’t think anybody counts anything before election day – do they open up the absentee ballots in California before Ekection Day to see for whom the votes were cast? Or do you mean, counted as having been cast?
Sammy Finkelman (067111) — 10/8/2014 @ 8:11 amWhen the the government invariably screws something up don’t worry, the solution is always MORE government.
HeftyJo (b5c096) — 10/8/2014 @ 8:31 amI believe the ballots are counted starting the morning of the election, and the results are released as soon as the polls close.
askeptic (efcf22) — 10/8/2014 @ 9:27 amYMMV!
I have lost all respect for Fauci, who I thought was an honorable man. He may be a top scientist, but he is a fool and a hack.
Patricia (5fc097) — 10/8/2014 @ 11:17 amSeems to me that firestone had one job as well and it had nothing to do with controlling outbreaks of disease. This is endemic at all levels of govt and in all areas. It is not about the size or scope of govt it is about focus. The agencies have no interest in protecting anything but their bottom line. By that, I mean they only want to protect themselves and how much they can garner in the next budget. CDC is scaring the US with all of their studies of gunshot violence, smoking, lately the new esmoke, and heart disease where they change their view about once a decade. Center for Disease Control…Disease Control. Classifying obesity, smoking and just about everything else under the sun as a disease was a design, intended to bring it under the purview of the CDC thus expanding it’s scope. It grew out of it’s budget and now needs to resume it’s course and adhere to it’s core responsibility.
fishaddict (9a8117) — 10/9/2014 @ 8:02 amThey may still been but was this in an uncontested race – where there wasn’t a recount?
No recount, but the machine count was close enough that the absentees mattered. Again, the final certifications from elections commissioners are not filed (as a rule) until some weeks after an election. This is a reason for that. Again, verrry few affidavit ballots.
Art Deco (ee8de5) — 10/9/2014 @ 8:27 amSimple question: why does the whole world assume it is our responsibility to handle global health threats? Who else in the world do you see rushing to solve this and make it go away? We do have a knee-jerk American mindset to assume it is our responsibility. Then if we don’t “do” it exactly as “they” think we should, we knee-jerk start defending ourselves and/or casting about to fix blame on each other (Democrats blaming GOP for whatever was done, or is being done wrong, race-baiters claiming that white medical workers let Duncan die because he was black, etc.). I am SO SICK of America being the scapegoat for everything.
justsayin' (bdfce3) — 10/9/2014 @ 7:21 pmThe budget was cut, by by Obama and the Democrats in Congress, in 2009, and if it hadn’t been, we might have had a (not-so-good) vaccine against ebola right now. (not so good because it’s against the other, main, strain)
http://www.businessweek.com/articles/2014-09-24/ebola-drug-zmapps-development-delayed-by-pentagon-agency
There was a big research program at the National Institute of Allergy and Infectious Diseases (NIAID), part of the HHS, and also a secret one at the Pentagon.
And the same problem also existed at the Pentagon, according to Robert Kadlec, who held a number of high posts in biodefense at the Pentagon during the Bush II Administration.
The soluton that Congress came up was, not to change or rethink any requirements, but create another agency and add money – except that didn’t work. The agency wasn’t enough freedom to spend money.
Sammy Finkelman (6f9c3d) — 10/15/2014 @ 7:42 amMark (c160ec) — 10/7/2014 @ 7:49 am
fall for the notion that problem A, B or C is worse because of a lack of funds or, in turn, can be turned around if the budget is increased.
It probably can. But if don’t change anything, you may need to increase the budget ten times, as Kadlec proposed. (Well he proposed mutiplying it by nine)
This was for BARDA, an agency that existed, not to do any original research, but to push things through the FDA approval process. It didn’t get enough money or contracting freedom to do the job. And it didn’t get any 2009 stimulus funds. Bush was on his way out when he proposed that.
Sammy Finkelman (6f9c3d) — 10/15/2014 @ 7:46 am