State’s Ebola response is unclear, critics say

The state’s health department is being criticized by some specialists and by the Republican candidate for governor for not forcefully and clearly communicating how it would deal with Ebola if someone arrived in Massachusetts infected with the disease.

Some of the criticism comes directly from members of the board charged with helping the agency shape public health policy.

A month after a patient in Dallas tested positive for the deadly virus, igniting concerns about potential infections in other states, the Massachusetts Department of Public Health has yet to brief its Public Health Council on the agency’s plans for containing an outbreak. In a statement Wednesday night, the health department defended its response to Ebola, arguing it has communicated its strategy on many fronts.

The concerns about insufficient communication were brought into focus Tuesday during a televised debate between Republican Charlie Baker and Democrat Martha Coakley as the contenders for governor discussed how they would handle the politically sensitive issue of quarantines for people returning from Ebola-wracked West Africa.

“My big problem with this, to tell you the truth, is no one in Massachusetts has really put out there what the Commonwealth has actually been doing up until this point,” Baker said.

He went on to question the state’s apparent lack of a plan to designate a hospital to be the state’s primary Ebola treatment hub. The Globe reported Wednesday that Boston’s big teaching hospitals are rejecting calls that one of them be designated as a hub of Ebola care.

Coakley did not specifically address the state’s Ebola plan but said, “We need to continue to watch and be ready.”

No one with Ebola has been identified in Massachusetts, and the likelihood of an infection here is considered remote, although possible.

But some public health specialists say the state health department has done a lackluster job on a core mission of public health — reaching out to inform and calm residents about a disease that has left the public confused and fearful.

“One could argue that not communicating proactively about Ebola plans makes the state more vulnerable to overreaction when a sporadic case shows up here,” said David Ropeik, a Harvard University instructor and consultant in risk communication and risk management.

“That’s a failure of public health,” said Ropeik, who has been following the public health department. “Public health includes managing people’s fears.”

Health leaders should be making clear to the public that they are ready to handle a crisis, whether it be Ebola or a new virulent strain of flu, so that residents will know the agency can be trusted, Ropeik said.

“It establishes the foundation for that trust when the crisis happens,” he said.

A health department spokesman declined to be interviewed, but issued a statement Wednesday evening that said the agency has worked hard to stay on top of the issue.

It said the agency has held or participated in three press conferences about Ebola in the past month, and testified at two legislative hearings about its “preparedness efforts and outreach to the public, public safety and the medical community.”

Additionally, the department has shared information through social media outlets and also holds “regular conference calls with hospitals, boards of health, and public safety officials to provide them with the most up to date information,” the statement said.

But the department has yet to brief the Public Health Council, an appointed board of physicians, academics, and consumer advocates that helps set agency policy.

To fill that void, council member Dr. Alan Woodward has requested that members be briefed publicly at their November meeting. Woodward, a former hospital emergency department chief, has frequently criticized the department for its handling of politically sensitive health issues since Cheryl Bartlett became public health commissioner 16 months ago.

Woodward said in an interview that he hopes Massachusetts “can get a very forward-thinking, activist, public health-focused commissioner when the new administration comes into place in January.”

The agency, under Bartlett, has taken a more circumspect approach than her predecessor, John Auerbach, who headed Boston’s health commission before taking the reins at the state agency and was well known for championing health issues.

Paul Lanzikos, a Public Health Council member, said the department’s handling of Ebola has not been its finest hour, but said the same can be said for other states.

“Unfortunately, the public health message has been trumped by the political messaging across the board, nationally, and in other states,” Lanzikos said.

But Harold Cox, associate dean for public health practice at Boston University’s School of Public Health and a member of the health council, said the state health department appears to be doing a good job communicating its Ebola work behind the scenes.

“It appears this commissioner has used her staff . . . to talk with some of the players who are on the front line for dealing with this, like hospitals,” Cox said.