Posted on Tuesday, October 14, 2014 - 12:05 am:

U.S. Lacks a Single Standard for Ebola Response

… Public health is the purview of the states, and as the nation anticipates more Ebola cases, some experts say the way the United States handles public health is not up to the challenge.

"One of the things we have to understand is the federal, state and local public health relationships," says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "Public health is inherently a state issue. The state really is in charge of public health at the state and local level. It's a constitutional issue. The CDC can't just walk in on these cases. They have to be invited in." …

Murphy says some of the issues in Texas stem from a "system problem" in the way public health care is managed in the USA. The Centers for Disease Control provides only guidance for infection prevention and management. "What they do in Texas, what they do in Illinois, it's up to the state," he says.

"The question is, who's in charge?" Murphy says. "The states can follow all the guidelines and take the advice, which they usually do, but they don't have to. It's not a legal requirement. So there really is no one entity that's controlling things."