What Ebola Taught Susan Rice About the Next Pandemic

“The U.S. cannot allow EBOLA infected people back. People that go to far away places to help are great-but must suffer the consequences,” Trump tweeted around that time. “The U.S. must immediately stop all flights from EBOLA infected countries or the plague will start and spread inside our ‘borders.’ Act fast!”

Worst of all, from Konyndyk’s perspective, was the news that Samaritan’s Purse had withdrawn from Liberia after Brantly and a second American, Nancy Writebol, fell ill. Doctors Without Borders, the major remaining NGO, didn’t have enough people to plug the gap. U.S. officials at that point were faced with a “nightmare scenario”—that there would be no place in a city of 1 million people for Ebola cases to go. Dead bodies were piling up in Monrovia so fast that local officials were resorting to mass cremation to prevent the corpses from infecting the city’s water supply.

Two days after Brantly’s positive diagnosis came a moment of abject terror for U.S. officials. The CDC learned that a man carrying Ebola had arrived in the capital of Nigeria, a city of 21 million people. “This was absolutely horrifying,” CDC director Thomas Frieden said later. “There’s no doubt in my mind that if we hadn’t stopped it in Lagos, it could’ve spread and changed from what has been a terrible epidemic to a true global catastrophe.” Nigerian officials, with a surge of help from CDC experts, managed to prevent that scenario—but the scare left an impression on Rice and others.

On Aug. 1, as the overall death toll from the outbreak reached 729, the director of the WHO admitted defeat. “This outbreak is moving faster than our efforts to control it,” she conceded. A week later, the WHO declared the Ebola outbreak a “public health emergency of international concern” and called for hundreds of millions of dollars in fresh aid.

The timing was extremely inconvenient for the Obama administration, which was planning to host dozens of African leaders for a first-ever summit the first week of August. Republicans were warning that they could be bringing the virus with them.

“That’s when it really starts becoming a domestic political issue,” remembers Ned Price, a former CIA official who handled crisis communications for the NSC during the Ebola crisis. Some officials wanted to cancel the event; Rice won the argument to proceed. The summit came off without a hitch, but getting the necessary screening procedures in place consumed precious bandwidth. And there was little public discussion of Ebola at the summit, which some experts saw as a missed opportunity.

Testifying before a House subcommittee on Aug. 7, Samaritan’s Purse vice president Ken Isaacs castigated the international response as a “failure.” It was not until the two Americans were confirmed positive, he said, “that the world sat up and paid attention.” Rep. Frank Wolf, a humanitarian-minded Virginia Republican, ripped the Obama administration for underestimating the outbreak. “Little action was taken to get out in front of this problem, and now we’re seeing the results,” Wolf complained.

The U.S. was now sending civilians into West Africa drip by drip—another USAID rapid-response team here; a few dozen more CDC experts there. The military agreed to send a mobile medical unit to Monrovia, but it was just 25 beds, and wouldn’t be operational until October. And none of it was enough. Frieden and Raj Shah, the USAID administrator, were at wit’s end. They needed at least 300 beds, and they needed them now. As Smith observed, “If you’re not moving faster than the virus, then it’s winning.”

By late August, it was evident to everyone that the current plan was failing. USAID and CDC officials were having to take dangerous risks in the field, like hand-carrying blood samples out of remote villages. In Washington, Rice’s staff was working brutal hours trying to come up with a more aggressive approach. One aide recalled being so busy that her husband would pack her a peanut-butter sandwich each day because otherwise she would forget to eat.

In any administration, most of the professional staff members of the National Security Council are experts on temporary loan from their original agencies—Defense, State or CIA, for example. Rice, herself an NSC aide during the Clinton administration, had been careful to surround herself with career officials who had deep working relationships within the agencies they came from. This proved especially useful during the Ebola crisis, because the Obama administration was trying to do something that had never been done before—attacking an epidemic at its source rather than simply hunkering down and trying to keep it out.

Those relationships gave Rice’s staff what Gans called “the ability to call around and get ground truth.” They could dial up their counterparts deep in the bowels of, say, the Pentagon, and find out what untapped capabilities the military was keeping under wraps. They could get “the bad news,” as one Rice acolyte put it, about where things were really going wrong—the kind of weaponizable information that was often guarded jealously or otherwise buried in the bureaucratic labyrinth. Here Rice’s famous bluntness came into play. She expected them to bring her good information, not bullshit, and they worked hard to get it.

These traits became invaluable once it became time to get serious about an idea that had been kicking around the staff level for weeks: sending in the U.S. military.

It wasn’t a crazy idea. The military had grown increasingly involved in humanitarian operations over the years, notably in the aftermath of the 2010 earthquake in Haiti. The Pentagon had unique capabilities, from its ability to airlift supplies to remote areas to its prowess at setting up all kinds of facilities on short notice. And the Defense Department was sitting on piles of cash, while the civilian agencies—the CDC at one point had to scrape together a paltry $3 million just to get its people into the hot zone—had already burned through their meager funds for the year.

Meanwhile, the number of infections was doubling roughly every three weeks. “Our work was expanding in a linear way and the virus was expanding in an exponential way,” explained Konyndyk. “We needed to expand the fight in an exponential way, and that’s why we needed the military.”

Still, the U.S. had never deployed soldiers to battle an epidemic, let alone one as frightening as Ebola. An extraordinary number of details would have to be worked out in a hurry, from the scope of the mission to the protocols for protecting the troops from the virus. Congress would be nervous. Many in the uniformed brass were more comfortable planning for tank battles across the Fulda Gap or airstrikes against terrorists in Iraq than they were grappling with cross-border threats like Ebola. Asking for troops would be no small thing.

As August turned to July, at one of her standing 5:30 p.m. interagency meetings on Ebola, Smith polled the room. “Do you think we can get ahead of this virus with only civilians?” she asked. “Do you think we need the military?” The answer was a unanimous yes.

Ebola was just one of several hair-on-fire emergencies facing Rice at the time. The Islamic State was beheading people in Syria; Russia had annexed Crimea and invaded eastern Ukraine; the Iran nuclear deal was still being hashed out; the U.S. had intervened to save the Yazidis, a minority sect, from certain slaughter. There was the usual endless cycle of meetings, summits to strategize for, world leader calls to plan.

But in early September, while traveling with Obama for the NATO summit in Wales, Ebola was on her mind. She recalls fielding a late-night call from Smith, who was despondent over the administration’s inability to keep pace with the virus. “It was a race to evade a tsunami, and we were losing,” Rice writes.

They talked through some ideas for how to scale up the civilian response. “As we talked,” Rice recounts, “I realized there was one option we hadn’t yet discussed: utilizing the unmatched capacity of the U.S. military. They could bend the curve.”

Still, some in the administration remained leery of greater involvement. A Sept. 10 meeting in the White House Situation Room was pivotal. Rice had orchestrated the meeting, and the key participant was Frieden, his memory still fresh from a disturbing trip to West Africa that he described to others as “like a visit to Dante’s inferno.” Frieden passed around a graph projecting as many as 1.4 million infections if aggressive new measures were not taken to halt the epidemic. In the argot of White House power meetings, Frieden’s move was known as a table drop—unveiling a crucial piece of information that hadn’t already been circulated.

Frieden’s message, despite the sharp upward trajectory shown on his hockey-stick graph, was actually meant to be optimistic. “Ebola has always been beaten. Ebola will be beaten,” he told the room.

Rice, who hadn’t seen the graph before that moment, was stunned by the presentation. “I couldn’t stop staring at the hockey stick. It blew my mind,” she recalls in her memoir.

“I think it scared everybody,” remembered Amy Pope, who at that point was leading the NSC’s transportation security team. In her own book, Samantha Power refers to Frieden’s single-page handout simply as “The Slide,” and describes the assemblage of top officials sitting in stunned silence for “a full thirty seconds” as its implications sunk in.

Rice quickly sized up the potential consequences of Frieden’s projections. “It could spread across the globe and kill hundreds of thousands, potentially millions,” she recounts in her memoir, “while sinking West Africa and much of the rest of the African continent under the weight of economic collapse, and massive refugee flows.”

“The global economic implications,” she continues, “were also mind-boggling—a halt to much international air travel and commerce, quarantines of whole regions, panic, and a Hobbesian inferno where no man helped another out of fear.”

Frieden’s graph proved to be a galvanizing moment. So, after securing Obama’s blessing, Rice worked to get Gen. Martin Dempsey, the chairman of the Joint Chiefs of Staff, to bring the might of the U.S. military to bear on the problem.

The Pentagon had been reluctant to get involved, wary of a mission well outside its traditional duties. The military was busy fighting a newly potent terrorist insurgency in Iraq and Syria, while still trying to fend off the Taliban in Afghanistan. Never in its history had the U.S. deployed troops to stop an epidemic. What if some soldiers got infected? They had signed up to be shot at, not to get Ebola. How was this even supposed to work?

Chuck Hagel, the defense secretary, was skeptical, as were some in the military brass. “If we’re gonna engage the U.S military, I want to be damn sure what we’re talking about,” he remembers thinking at the time. “It wasn’t a matter of being obdurate or skeptical or difficult.” Hagel was conservative by nature, and reliably suspicious of missions outside the military’s traditional role. A Republican and hardly a Rice ally, he was already at loggerheads with the White House, and would be gone by late November.

“I keep hearing you all saying, our soldiers will ‘suit up’ and do this and that,” Power recalls Hagel saying during one meeting. “Suit up? What does that even mean? My guys have never even seen these HAZMAT suits, apart from in horror movies.”

At another point in the discussions, Frieden explained the CDC’s request for the military to transport and build Ebola Treatment Units—essentially tented field hospitals to treat patients. “Hire the circus if you want to put up tents,” Dempsey quipped, in Power’s telling.

In reality, Dempsey didn’t need much pushing. Months earlier, he had asked his aides to quietly investigate what sorts of capabilities the Defense Department could offer to help fight Ebola, and to begin thinking through options. He had been deeply affected by reading “The Coming Plague,” a prescient 1994 book by pandemic expert Laurie Garrett, and did not take lightly the national security threat a virus could pose to U.S. interest.

Still, Dempsey wanted absolute clarity before committing. He had hesitated, but now he was committed to finding solutions. After an intense flurry of meetings and discussions, he laid down his red lines: The military would provide logistical muscle, but not medical personnel. That was a job for civilians. And U.S. soldiers would come nowhere near the virus.

“To his great credit,” Rice writes, “Dempsey decided to find a way to get to yes, rather than marshal a plethora of excuses to avoid action, as the Pentagon is adept at doing when it wants to avoid an unwelcome tasking. … It was a gutsy move.”

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