Richard NicolazzoIncreasingly, we rely on large government institutions to guide and protect us against everything from terrorism, to street crime, to deadly diseases.

Ebola, a terrible infectious virus that has already killed at least 4,300 people in Western Africa, burst on the American scene in full blown dramatic mode when an American doctor contracted the disease, returned to America, and was saved in a specially equipped infectious disease facility in a Nebraska hospital.

Thomas Eric Duncan, who was treated at Texas Health Presbyterian Hospital in Dallas, wasn’t as lucky. He died, and one of the nurses who treated him, Nina Pham, has Ebola.

To complicate matters, a second nurse who cared for Duncan, Amber Vinton, contracted the disease and boarded a commercial jet on Monday, October 13. Vinton contacted the CDC to check if she could get on a plane with an elevated temperature, and was not barred from taking the flight. She is now being treated at a hospital in Atlanta. The CDC, which is losing credibility daily, now admits she should have never left the ground.

At this point, it’s anyone’s guess how many other Americans in Texas or other cities will catch the life-threatening disease.

What seems clear is that, once again, crisis communications is left holding the bag after systematic, operational failures. As the onion is peeled back by investigative journalists, we bear witness to the tension that exists when lives are at stake.

What happened in Texas is a good example.

Now, weeks after Duncan was first seen in the emergency department (and inexplicably sent home with what appeared to be Ebola symptoms), a nurses’ union released a scathing statement claiming “confusion and frequently changing policies and protocols,” at the Texas hospital and inadequate protection against contamination and spotty training. Nurses were forced to use medical tape to secure openings in their flimsy garments, worried that their necks and heads were exposed as they cared for a patient with explosive diarrhea and projectile vomiting, said Deborah Burger of National Nurses United.

Officials at Texas Health Presbyterian defended their efforts to “provide a safe working environment,” but said they would review any concerns raised by nurses. That review may be too late for some.

The same type of conflict has surfaced in Boston and other major cities. A long-time nurse at Brigham and Women’s Hospital in Boston was quoted in the Boston Globe as saying nurses have received little to no training to protect themselves and patients from the deadly virus. “At Brigham,” said Patricia Powers, an operating nurse for more than two decades, “we’re not the type to air our dirty laundry per se, but we’re afraid.”

The response from a hospital spokesperson was predictable: “Our commitment is to training our caregivers to ensure they feel ready and comfortable to provide the safest care for our patients and for each other.”

Talk about a canned statement.

CDC Back Peddles

The federal Centers for Disease Control and Prevention, the government body that is responsible for protecting us from diseases, has its own communications nightmare. After the nurse in Texas contracted the disease, Dr. Thomas R. Frieden, CDC, director, said, “I wish we had put a team like this on the ground the day the patient, the first patient (in Texas) was diagnosed. That might have prevented this infection...we could have sent a more robust hospital infection-control team and been more hands-on with the hospital from Day 1.”

That is another example of an operational failure that further confuses the communications process.

Sen. John McCain, R-AZ, has spoken out. On a Sunday talk show, he said, “I don’t think we are comforted by the fact that we were told there would never be a case of Ebola in the United States, and obviously that’s not correct.”

Dr. Frieden, once again on the hot seat, said his agency looked back to see if any official said that a case of Ebola would “never” come to the U.S. “Although many media outlets and healthcare officials have urged people not to panic about Ebola, we could not find a single instance where someone said it would ‘never’ get here,” he said.

Back on July 28, after the two Americans contracted the disease in Africa, the CDC said “...there is no significant risk in the U.S.” On September 17, during testimony at a Congressional hearing, the CDC again said, “...we do not view Ebola as a significant public health threat to the United States.”

One has to wonder if the government is trying to over-communicate. Same for the hospitals that are treating Ebola patients. While we are clearly in an age when the public demands information and answers, over communicating can sometimes lead to mixed messages and misinformation.

It reminds me of the vortex that swirls downstream from Niagara Falls. You watch the water, watch it spinning, and are never sure which way it’s flowing.

Similarly, with the Ebola scare becoming more complex and seemingly widespread on a daily basis, we begin to wonder what to believe and from whom.

In my view, the people in charge of communicating during this crisis need to be extremely careful and deliberate in executing their duties. We need to know, but doublespeak and information that is not 100 percent fact-based should be verboten.

As this crisis enters yet-to-be-seen territory, we’ve already learned some lessons:

  • In general, U.S. hospitals are not prepared for a disease like Ebola. When nurses – the people on the front lines – complain that training is lacking and they don’t’ have adequate protective gear, something is clearly wrong.
  • The government, in particular the CDC, does not have a well-orchestrated, cohesive protocol to ensure that communications accurately tracks events on the ground. This lack of clarity creates, fear, confusion, and misunderstanding.
  • Misinformation is seeping into the public domain. At first, it was stated that soap and water could prevent the spread of Ebola. Now, we learn that bleach kills the virus. The term “bodily fluids” is being bandied about. It’s not just blood, urine and saliva that can spread the disease, it’s even sweat.
  • The President has been late to the party. Early on, President Obama echoed the sentiments of the CDC, claiming there was no major risk to the public. As the crisis has intensified, Obama called a special meeting at the White House to gather the best minds in combatting Ebola. To meet with his cabinet, Obama even canceled campaign events.

With an increasing number of Americans being exposed to people who have treated Ebola patients, the crisis is fast-moving and full of twist and turns that no one can accurately predict.

Let’s hope America’s healthcare establishment and the CDC can stop the Ebola virus before more lives are lost.

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Richard Nicolazzo runs Nicolazzo & Associates in Boston.