Should CDC Director Dr. Tom Frieden step down?

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Should CDC Director Dr. Tom Frieden step down?

  • Yes

    Votes: 15 38.5%

  • No

    Votes: 20 51.3%

  • Not Sure

    Votes: 4 10.3%
  • Total voters
    39
  • Poll closed .
BuzzPhreed

BuzzPhreed

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Only two votes so far?!??! Come on. This is one of the most opinionated forums on this whole site!
 
Absolutely he should resign.
 
Why? Because I don't think he should.

Managing a large governmental agency is difficult. I think Frieden has been there every step of the way. The current panic that we are seeing can't and shouldn't be blamed on him. I think we, the public, love a scapegoat. But who would take over? Someone like Bill Frist? Can he do any better? Doubtful.

This is a fluid situation. Frieden is calm. He's not too calm. As it changes, the leadership and recommendations will adapt. I think we will develop a reservoir of plasma from Ebola patients and we will determine how much individual patients need. This young ICU nurse in TX is already responding to treatment. It's not the time to create more panic and confusion by replacing Frieden. Give the guy a chance. He's responding. Maybe not like every layperson thinks he should, but he is.
 
BuzzPhreed said:
Last night Bill O'Reilly called Tom Frieden a "propagandist" for sending the "keep calm and carry on" message and not having a handle on the Ebola epidemic.
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Bill O'Reilly called someone a "propagandist"?!? That's funny, I don't care who you are, that's funny right there.

And no to the poll.
 
I just don't know how you find someone else with that specific training, willingness to do the job, and credentials.
 
At this point, he's a politician first, a physician second. I think this whole thing is quickly getting away from the CDC.
 
jwk said:
At this point, he's a politician first, a physician second.
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The politician-ness is a characteristic of ALL physicians who work in that arena. That doesn't necessarily mean he's wrong about something or anything in particular, or that the politician-doctor who replaces him would be better.


jwk said:
I think this whole thing is quickly getting away from the CDC.
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I've posted at length about this before so I won't rehash it, but I don't see any real evidence of that at all.

Let's not lose sight of the fact that at this time we have one dead and a second infected.
 
This. Anyone on the short list for the job would be marginally qualified at best. Who would you replace him with? Someone known and popular? Sanjay Gupta? Mehmet Oz?

Someone political? Like a IM boarded Surgeon General who has been in practice for 3 minutes, but was the second best community organizer ever?

Who is a better choice? You may think Frieden is a putz, but at least he knows where his parking space is, how to find the john, and the names of the people who report to him. But I also said I mostly believe the CDC in that other thread, so what do I know? 😵
pgg said:
The politician-ness is a characteristic of ALL physicians who work in that arena. That doesn't necessarily mean he's wrong about something or anything in particular, or that the politician-doctor who replaces him would be better.



I've posted at length about this before so I won't rehash it, but I don't see any real evidence of that at all.

Let's not lose sight of the fact that at this time we have one dead and a second infected.
Click to expand...
 
Ipassgas said:
Who is a better choice? You may think Frieden is a putz, but at least he knows where his parking space is, how to find the john, and the names of the people who report to him.
Click to expand...


I hope he knows golf, as that seems a pretty big requirement for this administration......
 
I yelled this from the rooftops the day Duncan tested positive so it's not hindsight--anyone who understood the public health implications of this should have gotten this guy to a center which is already trained and equipped to care for patients with a CDC Biosafety Level 4 infection. How could they leave this guy at Texas Health Presbyterian? How could the benefit of using taxpayer money to transport him to Nebraska or Emory not have been appreciated? And if not that, how could they not have immediately sent a CDC task force to help the hospital put appropriate precautions immediately in place and monitor compliance? This is the very definition of an index case. Huge oversight/negligence.
 
Firing a general in the middle of a war seems a bad idea. Right now, he knows more about what's going on with the logistics, organizing teams, relevant research, etc. than anyone.
 
gtb said:
Firing a general in the middle of a war seems a bad idea. Right now, he knows more about what's going on with the logistics, organizing teams, relevant research, etc. than anyone.
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And therein lies the problem - supposedly knowing what's going on, and acting on that knowledge, quickly and decisively, are two entirely different concepts. He may be great on the former - but is woefully lacking on the latter.

Sanjay and Oz? LOL hahahahahaha - great joke
 
Oh absolutely he should resign. I can see that if only 1 or 2 people were infected, then okay. But now with 3....? This is clearly way over his head. I mean all the textbooks say that anything over two infections is way more worrisome and clearly a serious epidemic.

Finally, how is it that our head of CDC wasn't smart and brave enough to stop everyone in the United States from getting infected? He is totally responsible for making sure not a single one of us gets bad and rare infections. It's all his fault.
 
The CDC isn't just Tom Frieden sitting in an office by himself calling all the shots. He is surrounded by public health maestros-- in this era of JCAHO, Infection control, Handwashing police its crazy that they didn't descend on that hospital ET style as soon as Duncan's case became known.
 
He needs to step down to an advisory position. We shouldn't discard him with the trash but rather use his knowledge. Just take him out of the decision making process. Its a tough f'in job but when you accept the job of CDC director your main obligation is to protect the US public. He has failed that one job.

I started a thread over a week ago on this because any idiot could see this coming. Yes, I wasn't completely candid with the post but that was not needed. I think everyone saw and understood what I was getting at and if you didn't then, you do now.

America has a tendency to crucify our leaders when their actions lead to undesired consequences. This is not the time or place to point fingers but rather to align the forces. This guy has proven that he isn't made of the stuff we need to stand up for what makes sense or for what is right. But he has knowledge ( I think ) and we should utilize that.

If I were CDC director I would shut down all flights with any contact with affected areas. That means any passengers making connections. All persons in contact with an Ebola pt would be placed in a facility with all the most amazing amenities possible for 30 days so that they would say, " hell yeah, I'll go there for a month". The Four Seasons is pretty nice. And I would compensate the Four Seasons to a point that they couldn't refuse.

We are looking at 10,000 new cases a week soon. This is no bullsh*t. We don't know where we are headed with this virus and we need to stop worrying about people panicking. Until we see the number of newly infected starting to decline we need to be coming up with creative ways to halt the spread.

The plasma transfusion is promising. I just hope enough people survive this to create enough plasma to treat the masses when this really gets going. I know, that's a bit pessimistic. I hope.
 
Noyac said:
Its a tough f'in job but when you accept the job of CDC director your main obligation is to protect the US public. He has failed that one job.
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I question the mental stability of any masochist who would actually want that job right now.

Noyac said:
The plasma transfusion is promising. I just hope enough people survive this to create enough plasma to treat the masses when this really gets going. I know, that's a bit pessimistic. I hope.
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It all hangs on the success of the vaccine. If the vaccine doesn't work and convey significant herd immunity, then we are hosed.
 
I am watching the congressional hearing, and my gut says Dr. Frieden is first of all a politician, not a doctor. His answers are as inexact as a politician's during an election campaign.

Right now, I would really feel safer if this guy is replaced. He's just a career bureaucrat.
 
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It is still too early to know who the ******s are/were. 🙂

Right now this is like bull vs. bear market predictions. Only time will tell. But with such a killer disease, I would rather that they err on the side of being too cautious.
 
dhb said:
Sad to see a physician forum go full ****** on this issue
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Umm... you are grossly misinformed, if this is your opinion and you are serving no other purpose here than to cast aspersions.

The WHO has been saying for at least 2 months now that this is out of control in Africa. There are 10,000 new cases predicted per week in western Africa by the end of the year. What are we going to do? Permanently quarantine western Africa?

If the vaccine doesn't work and the disease, with a current attack rate of 2 new patients infected per each person with the disease, how else do you think we're going to get this under control? There's even talk about it becoming endemic in that part of Africa.

I suggest you go back to medical school and re-take microbiology. It appears you've forgotten how this works. And, you apparently either don't care or haven't been paying attention to the costs involved with treating these few patients to prevent the spread here in the U.S. as well as what's happened to the financial markets this week.

So, remind me again: Who's going "full ******" here?
 
I don't know if having him step down will do anything - like most governmental jobs, there is no one that is competent.

I agree, stop flights but we need to help contain it in Africa and stop transmission because no matter how conservative we are, it's going to get into this country. Problem is you can't educate people who are totally irrational (hiding the ill and not listening to transmission education). Parts of Africa still believe having sex with a virgin will cure AIDS. How do you convince people to do what makes scientific sense if they have no education whatsoever and trust no medical professional?

I really am glad the CDC has formed ebola teams that will fly into institutions with necessary equipment and professionals if a case pops us. I do think all these patients should be in one facility though since no matter how careful health care workers are, if they are not properly educated and trained, the risk of contamination is high.

If the projected numbers above are true then its very unlikely we will contain this infection. I think no matter what was done, it would have found it's way into the US. Hopefully plasma transfusions will work and we can develop treatments. I'm still not freaking out (and I'm currently six months pregnant). I don't think the zombies are coming either but I'm sure all the preppers are licking their chops right now. Wish I would have bought that underground bunker and canned six months worth of food 😉
 
We need a solution: vaccine or cure. Quarantine soon won't be enough. If you don't believe me, just look at the case number dynamic.
 
Noyac said:
If I were CDC director I would shut down all flights with any contact with affected areas.
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That might help - or there could be unintended consequences that make containment worse.

Right now we can track everyone coming from those areas. They can be screened, followed, and quarantined. If we block direct flights, that task becomes harder. People will start taking circuitous routes, and it will be that much harder to track who's coming from where.

Travel restrictions would harm public health efforts in Africa. Africa is where this needs to be stopped. The African nations with thousands of cases already can't do it without help.


The only two transmissions here were to people in contact with a very, very sick patient. They were also apparently using inadequate PPE. While that's just headsmackingly ******ed, it is a fixable problem. None of the dozens and dozens of other contacts, including close contacts like Duncan's family, have turned up infected. It's been 18 days since he was admitted, and not one other person he was in contact with has been diagnosed with Ebola yet. We're rapidly approaching the point that we'll be able to say with confidence that he didn't infect anyone prior to admission. That is not the picture of a disease that will spread like wildfire at the hands and spit of asymptomatic people, which is the one key feature of a hard-to-contain organism.

Nigeria - Nigeria - appears to have contained Ebola. After 8 deaths, mostly health care workers in contact with an infected patient during his sickest periods (sound familiar?), there have been no cases in 6 weeks. But somehow, in the US, with two infected nurses, we're hosed?

I am really, really concerned for Africa. Not so much the USA at this point. The evidence doesn't support the hysteria.
 
pgg said:
Nigeria - Nigeria - appears to have contained Ebola. After 8 deaths, mostly health care workers in contact with an infected patient during his sickest periods (sound familiar?), there have been no cases in 6 weeks. But somehow, in the US, with two infected nurses, we're hosed?
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They had 20 cases only. That's nothing, if properly isolated. Nigeria is also far from the 3 main affected countries, so even 20 cases is too much. This is how they got them:
The first death in Nigeria was reported on 25 July.[39] A Liberian-American with Ebola flew from Liberia to Nigeria and died in Lagos soon after arrival.[40] As part of the containment efforts, 353 possible contacts were monitored in Lagos and 451 in Port Harcourt.[41] As of 22 September, the WHO reported a total of 20 cases with 8 deaths. They continue to monitor a few contacts, but the disease appears to now be contained in Nigeria.[42]
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http://www.wikiwand.com/en/Ebola_virus_epidemic_in_West_Africa#/Outbreak

Again, the concern is what will happen when the number of cases in West Africa will reach a million, or millions. We only have 8,000 cases until now, but the numbers are growing exponentially. Let's hope quarantining entire countries will limit the problem.
 
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dhb said:
Is there? that's incredible, it blows my mind that a disease that has ben endemic for 20y could now be talk about as maybe becoming more endemic maybe?
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It was not endemic before 2014. Maybe you should revisit the definition of the term (as per Google):
1.
(of a disease or condition) regularly found among particular people or in a certain area.
"areas where malaria is endemic"
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Having done my Ebola/PPE training yesterday, its completely understandable how those nurses got infected. Given the major burden of taking care of these patients-- dealing with massive amounts of emesis and diarrhea (MASSIVE), doffing the PPE is no simple task. There are so many ways in the doffing process to expose yourself. Not to mention the "buddy" that helps you doff. And that is all with a coordinated training effort. Still millions of ways the process needs to be improved, lots of questions.
 
pgg said:
Travel restrictions would harm public health efforts in Africa. Africa is where this needs to be stopped. The African nations with thousands of cases already can't do it without help.


I am really, really concerned for Africa. Not so much the USA at this point. The evidence doesn't support the hysteria.
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I think we are talking about travel restrictions placed on civilians. Public health teams would and should not be restricted.

I agree that the hysteria may be unwarranted however, our government including the CDC have not handled it all that well.

But the press must love all of this. They fees the hysteria well.
 
It doesn't matter whether hysteria is "warranted" or not. That's the part some of you aren't comprehending. This is how people have and are going to react. Heck, they were even closing public schools in TX this week.

Appointing a Czar to come up with a sound plan and coordinate the intervention efforts was a good thing. This should be the model for all such future (and possibly more terrible) epidemics. If nothing else, this has been a huge wake up call.
 
I think everyone is comprehending just fine. There are just different takes on the situation. I take is that it is not time to panic and probably never will be. It is highly unlikely that this gets out of control on our soil. BUT I feel there is much more that could have been done to prevent this from even getting this far. Now we don't know how far it will go here.
If anything, it is a wake up call to our healthcare system. I don't know about any of you but we have not received any protective training at my facility. Just emails.
 
FFP said:
It was not endemic before 2014. Maybe you should revisit the definition of the term (as per Google): 1.
(of a disease or condition) regularly found among particular people or in a certain area.
"areas where malaria is endemic"
Click to expand...
You are confusing widespread with endemic, Ebola has been endemic in parts of Africa for years.
 
Nope. Ebola had (geographically- and time-) limited outbreaks in various parts of Africa (especially the Congo, Sudan and Uganda, most of which are not affected now). It was not endemic, definitely not where the current outbreak started.

In epidemiology, an infection is said to be endemic (from Greek ἐν en "in, within" and δῆμος demos "people") in a population when that infection is maintained in the population without the need for external inputs. For example, chickenpox is endemic (steady state) in the UK, but malaria is not. Every year, there are a few cases of malaria reported in the UK, but these do not lead to sustained transmission in the population due to the lack of a suitable vector (mosquitoes of the genus Anopheles).
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http://www.wikiwand.com/en/Endemic_(epidemiology)

There is an obvious animal (especially primate) reservoir of Ebola in Africa, from where it gets transmitted to humans occasionally. From that standpoint, you can say that it was endemic among animals in a few very limited regions of Africa, where it pops up once in a while.

For a disease to be endemic, it has to reach a steady state.
An infection that starts as an epidemic will eventually either die out (with the possibility of it resurging in a theoretically predictable cyclical manner) or reach the endemic steady state, depending on a number of factors, including the virulence of the disease and its mode of transmission.
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This one used to pop up in a cyclical manner, so I personally don't consider it endemic anywhere in the past. What we have right now is an epidemic.

P.S. Let's agree to differ. My mistake for being a stickler about terminology. It really doesn't change the magnitude of what's going on now.
 
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Noyac said:
I think everyone is comprehending just fine.
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No, I don't think they are.

"Panic" and "hysteria" are natural human reactions when people feel out of control and threatened. It makes no sense that people should fear sharks more than electrocuting themselves with their toaster oven. But they do.

Expecting people not to panic (a individual reaction) or suffer from hysteria (a group reaction) because of a personal fear simultaneously echoed in others is like expecting them not to feel pain when someone whacks them in the foot with a sledgehammer.

That was my point. Panic and hysteria are natural and expected human reactions in these situations. The way to calm those fears and reduce panic is to provide information, formulate a plan, and get control of the situation. Not simply saying it's "not warranted", which is akin to saying "get over it". That's what the armchair professors, who apparently don't understand population dynamics, aren't comprehending.
 
Noyac said:
If I were CDC director I would shut down all flights with any contact with affected areas. That means any passengers making connections.
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Travel bans are not an evidence-based intervention.

After the emergence of the H1N1 influenza in 2009, some countries responded with travel-related controls during the early stage of the outbreak in an attempt to contain or slow down its international spread. These controls along with self-imposed travel limitations contributed to a decline of about 40% in international air traffic to/from Mexico following the international alert. However, no containment was achieved by such restrictions and the virus was able to reach pandemic proportions in a short time.
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I trust Dr. Fauci, so I believe him when he says they are counterproductive.
 
BuzzPhreed said:
No, I don't think they are.

"Panic" and "hysteria" are natural human reactions when people feel out of control and threatened. It makes no sense that people should fear sharks more than electrocuting themselves with their toaster oven. But they do.

Expecting people not to panic (a individual reaction) or suffer from hysteria (a group reaction) because of a personal fear simultaneously echoed in others is like expecting them not to feel pain when someone whacks them in the foot with a sledgehammer.

That was my point. Panic and hysteria are natural and expected human reactions in these situations. The way to calm those fears and reduce panic is to provide information, formulate a plan, and get control of the situation. Not simply saying it's "not warranted", which is akin to saying "get over it". That's what the armchair professors, who apparently don't understand population dynamics, aren't comprehending.
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My bad. I was referring to the people on this site, not the general public.
 
Painmd, neither is the **** they are giving these pts in hopes of treating them. Nothing in the situation is evidence based. But here's how I look at it. Travel bans may or may not help but they won't hurt. We can still send people to the area to treat and assist W. Africa. We can even bring these people home with a quarantine of what seems to be 21 days.

On another note, I see some hope here. It appears to me that this may not be as contagious as some think. I personally didn't know how contagious it was in the beginning ad wasn't totally sure that anyone else really knew. But this guy in Dallas was sent home with symptoms and was cared for by his family who have all tested negative to this point. But the nurses that were caring for him at the height of his disease got it. So to me it is starting to look like the virus is transmitted just like the CDC says it is. Time will tell. I still think we should have had better safeguards in place prior to the first pt coming across our borders though. And for that I blame the CDC.
 
Noyac said:
My bad. I was referring to the people on this site, not the general public.
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And I was referring to everyone and anyone who said that a subsequent natural human reaction to a perceived threat was "unwarranted".
 
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