• With: Scott Gottlieb, Joe Rago, Dan Henninger, James Freeman, Allysia Finley

    This is a rush transcript from "Journal Editorial Report," October 18, 2014. This copy may not be in its final form and may be updated.

    PAUL GIGOT, HOST: This week on the "Journal Editorial Report," President Obama steps up his administration's Ebola response as the disease has spread testing faith in domestic and international agencies in charge of containing the outbreak.

    Plus, another wild week on Wall Street. What the stock market swings signal for the fragile U.S. recovery.

    And they swept into office on promises of tax cuts and pension reforms, why are some GOP governors facing a difficult battle for re- election this November?

    Welcome to the "Journal Editorial Report," I'm Paul Gigot.

    President Obama vowed this week his administration would tackle the Ebola threat in a, quote, "much more aggressive way," authorizing the Pentagon to call up Reserve and National Guard troops to assist U.S. efforts in Liberia and deploying medical SWAT teams to any hospital reporting a new case here at home. But news of another U.S. infection, along with dire predictions of the virus's continued spread in West Africa, raise questions about how well domestic and international agencies are responding, and whether institutions like the CDC and the World Health Organization are failing in their core mission to contain such outbreaks.

    Joining the panel this week, Wall Street Journal columnist and deputy editor, Dan Henninger; editorial board member, Joe Rago; and former FDA deputy commissioner and frequent "Wall Street Journal" contributor, Dr. Scott Gottlieb.

    Scott, good to have you here.

    You've been predicting all along that this would be worse than a lot of people in Washington were saying. Now that's turned out to be true. Is the administration finally getting its arms around the extent of the problem?

    DR. SCOTT GOTTLIEB, CONTRIBUTOR & FORMER FDA DEPUTY COMMISSIONER: I think they are finally recognizing the scope of the problem both here and abroad. In the case of Dallas, CDC underestimated how hard it would be in the hospital to handle a hot pathogen like this. It didn't have experience. And it might turn out to be the case our health care workers are at greater risk domestically than health care workers in Africa by virtue of the fact, when we deliver critical care here, we're much more invasive so we create much more risks.

    GIGOT: When you say much more invasive, what does that mean? Because we would think normally, well, we're so much more advanced. We have experience with these teams and with protecting health care workers. Why would it be worse?

    GOTTLIEB: Well, Frieden specifically cited intubation and dialysis. But if you think about what we do in a critical care setting --


    GIGOT: Intubation is where you --


    GOTTLIEB: Put a breathing tube down someone's throat. But there's frequent blood draws and frequent bed changes. And even something as simple as an NG tube, a nasal gastric tube creates a lot of risk. We do a lot of interventions in critical care. That's going to expose health care workers.

    I think what this points out is you probably need to make sure the team that's taking care of these patients is a very constrained team. You don't want a lot of people to be involved. That seems to be where CDC is going. They are learning and adapting quickly, and you have to give them some credit for that.

    GIGOT: What did Washington miss? Just the extent of the biggest issue, just the extent of the problem?

    GOTTLIEB: I think, first of all, they probably missed how quickly it would come to the United States. I think they didn't anticipate this many cases this early. And they didn't think there would be this much secondary spread, especially among health care workers. They probably thought the immediate family could be at risk but not the health care team. That was clearly missed in this case.

    GIGOT: Joe, let's talk about some of these public institutions, CDC and the World Health Organization in particular. The World Health Organization was created, in large part, to deal with this kind of thing. They dropped the ball.

    JOE RAGO, EDITORIAL BOARD MEMBER: Yeah, I think they were very slow to recognize the outbreak in West Africa as a region. They thought they had it under control only for it to flare up again. And I think, in part, this is due to the transformation of public health. Its mission, it priorities over the last --


    GIGOT: What do you mean by that?

    RAGO: Well, the World Health Organization, in particular, used to be about securing the conditions necessary for human survival, which meant transmissible diseases. Now this week, for example, they had a big conference on tobacco. They're focused on things -- obesity, chronic diseases.

    GIGOT: Sounds like they're making their agenda the modern political agenda, political priorities of the developed world, not dealing -- instead of these basic fundamentals --


    RAGO: You're seeing the same thing at the CDC, to a lesser extent, with a focus on, you know, salad bars in public schools, workplace wellness, and some of the other marginal pursuits that distract from its core mission.

    GIGOT: Do you agree with that --

    GOTTLIEB: It's an interesting question, how much incompetence makes you culpable.


    -- made very competent projections about the scope of this outbreak based on faulty information, and the world was relying on that. And that's what caused the outbreak in West Africa to get out of control in the first place.

    GIGOT: Dan, what does this tell you about the question you deal with a lot, which is kind of the competence of the public institutions and governments?

    DAN HENNINGER, COLUMNIST & DEPUTY EDITOR: Well, it tells us that we're in a lot of trouble if we're relying on the competence of public institutions in the United States at least. The Ebola problem was identified at least as far back as March. So the CDC and the World Health Organization knew about it then. And President Obama himself, in September, said we are dealing with it aggressively. They were not dealing with it aggressively, OK? That was happy talk as sometimes happens with Barack Obama.

    But there's a larger problem. And anyone who's involved in emergency preparedness will tell you this with institutions in the United States. They know that they should prepare, whether it's a police department or hospital. And when you ask them to do that, they'll say, we don't have time to assign people to take on the preparation like that. So that it simply doesn't get done. I think what we've learned now is these hospitals have got to do this. They cannot say, "We're too busy." That's not a sufficient excuse.

    GIGOT: Scott, you've -- a lot of people are saying Dr. Tom Frieden, the head of CDC, is the major culprit. But you disagree with that.

    GOTTLIEB: Well, he's been pushed out as the public spokesperson and he doesn't help himself in front of the podium because he's not that adept at working to his talking points. But the bottom line is I think CDC has done a laudable job in many respects. Clearly, there were missteps, some that had tragic consequences. But if you look at what they've done, they deployed 200 people to West Africa, an unprecedented mobilization for that agency. They've adapted quickly in terms of the approach they are taking in dealing with hospitals. And I think if you go back to the trip that Frieden took in early September, when he came back from West Africa and really hit the alarm bell and used some really almost apocalyptic language to describe the scope of the outbreak in West Africa, he was way in front of the White House. And I think he forced the White House to take action. It takes a lot of courage to be a political operative in front of your president and it takes a lot of courage I think, particularly in this Washington, to do that.

    GIGOT: Is the charge that somehow budget cuts are responsible for these -- this weakness? Does that have any credibility? You looked at the numbers.

    RAGO: Looked at the numbers, I don't think it has any credibility. If you look at CDC, they've got about a $10 billion budget now, counting all sources of funding. That's up from about $8 billion during the George W. Bush years. 35 percent increase over 10 years ago. If you look at NIH, for example, Dr. Francis Collins came out and said we would have had an Ebola vaccine years ago if NIH had more funding. And I think it's uncharacteristically foolish thing for him to say.

    GIGOT: Stop all flights from West Africa and any entry into the United States, that's the other big political hot issue?