CDC Multitasking Hurts Ebola Fight

By Glenn Reynolds
USAToday.com

"You had one job!" is the punchline on a popular Internet meme involving organizational screw-ups. Now critics are saying something similar about the Centers for Disease Control and Prevention in response the agency's handling of the Ebola outbreak. Unfortunately, it's not true. While we'd be better off if the CDC only had one job — you know, controlling disease— the CDC has taken on all sorts of jobs unrelated to that task. Jobs that seem to have distracted its management and led to a performance that even the establishment calls "rocky." Going forward, we need to learn this lesson, for the CDC, for other agencies, and for the government as a whole.

Ebola, as fans of The Hot Zone know, is nothing new, and neither are worries about it spreading beyond its usual range. And disease control experts have long known that the key to stopping it is finding people who were exposed, tracing their contacts, and keeping them under observation until they are past the disease's incubation period, and keeping anyone actively contagious under quarantine until they have died or recovered.

Nonetheless, when Liberian patient Thomas Eric Duncan arrived in Dallas, the system didn't work. Having allegedly lied to Liberian officials to get on the plane, Duncan was initially sent home from the hospital in Dallas (originally blamed on a computer glitch, though that story changed), even though he told a nurse he had come from Liberia. Then, once he was quarantined, family members were left in a contaminated apartment for days with Ebola-ridden bedding and linens, while state and federal authorities wrangled over permits needed to clean the apartment. Eventually, the family was moved to housing provided by members of a "local faith-based community." Last week, the CDC admitted that it wasn't ready because "We let our guard down a little bit."

Yes. These are problems that should have been thought of in advance — and maybe would have been, if the CDC actually had only one job. But, in fact, the CDC has multiple jobs, having involved itself in everything from playground safety to smoking in subsidized housing.

In 2014, the CDC received (together with the Public Health Service and related programs) $6.8 billion. But not all of that money went to infectious diseases. In addition to the CDC's supposed raison d'etre, there were programs for:

    Chronic disease prevention (obesity, heart disease, etc): fiscal 2014 budget approximately $1 billion, or just under 15% of the total budget.

    Birth defects: $132 million, or just about 2% of the total budget.

    Environmental health (asthma, safe water, etc): $179 million, 2.6% of total.

    Injury prevention (domestic violence, brain injury, etc): $150 million, 2.2% of total.

    Public health services (statistics, surveillance, etc): $482 million, 7% of total.

    Occupational safety (mostly research): $332 million, 5% of total.

And, of course, the various busy-body looks at playgrounds, smoking in subsidized housing, and the like. 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. But, alas, the problem isn't just the CDC. It's everywhere.

It seems that as government has gotten bigger, and accumulated more and more of its own ancillary responsibilities, it has gotten worse at its primary tasks. It can supervise snacks at elementary schools, but not defend the borders; it can tax people to subsidize others' health-care plans but not build roads or bridges; and it can go after football team names but can't seem to deal with the Islamic State terror group.

Multitasking results in poorer performance for individuals. It also hurts the performance of government agencies, and of government itself. You have one job. Try doing it.

Glenn Harlan Reynolds, a University of Tennessee law professor, is the author of The New School: How the Information Age Will Save American Education from Itself.

Tajha Lanier provided research for this column.