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Ebola in the Homeland: the Importance of Effective International, Federal, State, and Local Coordination EBOLA IN THE HOMELAND: THE IMPORTANCE OF EFFECTIVE INTERNATIONAL, FEDERAL, STATE, AND LOCAL COORDINATION FIELD HEARING BEFORE THE COMMITTEE ON HOMELAND SECURITY HOUSE OF REPRESENTATIVES ONE HUNDRED THIRTEENTH CONGRESS SECOND SESSION OCTOBER 10, 2014 Serial No. 113–88 Printed for the use of the Committee on Homeland Security Available via the World Wide Web: http://www.gpo.gov/fdsys/ U.S. GOVERNMENT PUBLISHING OFFICE 93–646 PDF WASHINGTON : 2015 For sale by the Superintendent of Documents, U.S. Government Publishing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 COMMITTEE ON HOMELAND SECURITY MICHAEL T. MCCAUL, Texas, Chairman LAMAR SMITH, Texas BENNIE G. THOMPSON, Mississippi PETER T. KING, New York LORETTA SANCHEZ, California MIKE ROGERS, Alabama SHEILA JACKSON LEE, Texas PAUL C. BROUN, Georgia YVETTE D. CLARKE, New York CANDICE S. MILLER, Michigan, Vice Chair BRIAN HIGGINS, New York PATRICK MEEHAN, Pennsylvania CEDRIC L. RICHMOND, Louisiana JEFF DUNCAN, South Carolina WILLIAM R. KEATING, Massachusetts TOM MARINO, Pennsylvania RON BARBER, Arizona JASON CHAFFETZ, Utah DONALD M. PAYNE, JR., New Jersey STEVEN M. PALAZZO, Mississippi BETO O’ROURKE, Texas LOU BARLETTA, Pennsylvania FILEMON VELA, Texas RICHARD HUDSON, North Carolina ERIC SWALWELL, California STEVE DAINES, Montana VACANCY SUSAN W. BROOKS, Indiana VACANCY SCOTT PERRY, Pennsylvania MARK SANFORD, South Carolina CURTIS CLAWSON, Florida BRENDAN P. SHIELDS, Staff Director JOAN O’HARA, Acting Chief Counsel MICHAEL S. TWINCHEK, Chief Clerk I. LANIER AVANT, Minority Staff Director (II) C O N T E N T S Page STATEMENTS The Honorable Michael T. McCaul, a Representative in Congress From the State of Texas, and Chairman, Committee on Homeland Security: Oral Statement ..................................................................................................... 1 Prepared Statement ............................................................................................. 4 The Honorable Bennie G. Thompson, a Representative in Congress From the State of Mississippi, and Ranking Member, Committee on Homeland Security: Oral Statement ..................................................................................................... 5 Prepared Statement ............................................................................................. 7 The Honorable Sheila Jackson Lee, a Representative in Congress From the State of Texas: Prepared Statement ............................................................................................. 8 WITNESSES PANEL I Dr. Toby Merlin, Director, Division of Preparedness and Emerging Infection, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services: Oral Statement ..................................................................................................... 11 Prepared Statement ............................................................................................. 12 Dr. Kathryn Brinsfield, Acting Assistant Secretary and Chief Medical Officer, Office of Health Affairs, U.S. Department of Homeland Security: Oral Statement ..................................................................................................... 17 Joint Prepared Statement ................................................................................... 19 Mr. John Wagner, Acting Assistant Commisioner, Office of Field Operations, U.S. Customs and Border Protection, U.S. Department of Homeland Secu- rity: Oral Statement ..................................................................................................... 21 Joint Prepared Statement ................................................................................... 19 PANEL II Dr. David Lakey, Commissioner of Health, Texas Department of State Health Services: Oral Statement ..................................................................................................... 54 Prepared Statement ............................................................................................. 57 Dr. Brett P. Giroir, Executive Vice President and CEO, Texas A&M Health Science Center, and Director, Texas Task Force on Infectious Disease Pre- paredness and Response: Oral Statement ..................................................................................................... 60 Prepared Statement ............................................................................................. 61 Hon. Clay Lewis Jenkins, Judge, Dallas County, Texas: Oral Statement ..................................................................................................... 65 Prepared Statement ............................................................................................. 66 (III) IV Page Ms. Catherine L. Troisi, Ph.D., Associate Professor, Division of Management, Policy, and Community Health Center for Infectious Diseases, The Univer- sity of Texas: Oral Statement ..................................................................................................... 67 Prepared Statement ............................................................................................. 69 FOR THE RECORD The Honorable Michael T. McCaul, a Representative in Congress From the State of Texas, and Chairman, Committee on Homeland Security: Letter From Chairman Michael T. McCaul and Senator John Cornyn ........... 48 The Honorable Bennie G. Thompson, a Representative in Congress From the State of Mississippi, and Ranking Member, Committee on Homeland Security: Chart ..................................................................................................................... 7 The Honorable Sheila Jackson Lee, a Representative in Congress From the State of Texas: Press Release ........................................................................................................ 31 Chart ..................................................................................................................... 77 Letter from Rep. Jackson Lee to Director Frieden ............................................ 87 The Honorable Kenny Marchant, a Representative in Congress From the State of Texas: Letters ................................................................................................................... 46 APPENDIX Questions From Honorable Lamar Smith for Toby Merlin .................................. 93 Questions From Honorable Beto O’Rourke for Toby Merlin ................................ 93 Questions From Honorable Eric Swalwell for Toby Merlin ................................. 93 Questions From Honorable Lamar Smith for John P. Wagner ........................... 94 EBOLA IN THE HOMELAND: THE IMPOR- TANCE OF EFFECTIVE INTERNATIONAL, FEDERAL, STATE, AND LOCAL COORDINA- TION Friday, October 10, 2014 U.S. HOUSE OF REPRESENTATIVES, COMMITTEE ON HOMELAND SECURITY, Dallas, TX. The committee met, pursuant to call, at 12:10 p.m., in the In- Transit Lounge, D–31, Dallas-Fort Worth International Airport, 233 South International Drive, Dallas, Texas, Hon. Michael McCaul [Chairman of the committee] presiding. Present: Representatives McCaul, Chaffetz, Sanford, Clawson, Thompson, Jackson Lee, Barber, O’Rourke, Vela, and Swalwell. Also present: Representatives Farenthold, Marchant, Barton, Burgess, Veasey, and Johnson. Chairman MCCAUL. The Committee on Homeland Security will come to order. The committee is meeting today to examine the co- ordinated Federal, State, and local response to the recent Ebola case right here in Dallas, Texas. First, I want to thank everybody, including the witnesses, for attending this hearing today, and I ap- preciate the efforts taken on behalf of all those involved to have this important field hearing. This is an official Congressional hearing as opposed to a town hall, and as such, we must abide by certain rules of the committee and the House of Representatives. I would like to kindly remind our guests that demonstrations from the audience, including ap- plause and verbal outbursts, as well as the use of signs or placards are a violation of the rules of the House of Representatives, and it is important that we respect the decorum and the rules of this com- mittee. I have also been requested to state that photography and cameras are limited to accredited press only. Before I recognize myself for an opening statement, I also ask unanimous consent that the gentlemen from Texas, Mr. Joe Bar- ton, Mr. Michael Burgess, Mr. Kenny Marchant, Mr. Blake Farenthold, and Mr. Mark Veasey, and the gentlelady from Texas, Ms. Eddie Bernice Johnson, be permitted to sit on the dais and participate in today’s hearing. Without objection, so ordered. I will now recognize myself for an opening statement. We are here today to discuss the threat to the United States homeland from the Ebola virus and what is being done to stop the spread of this terrible disease. This crisis is unfolding at an alarm- ing pace. Thousands have died in Africa and thousands more have (1) 2 been infected, including four selfless Americans working in Liberia who have been flown home for treatment. Now the virus has begun to spread to other parts of the world, and the American people are rightfully concerned. They are con- cerned because the Ebola virus is an unseen threat, and it is only a plane flight away from our shores. We have witnessed that with the recent case here in Dallas, the first fatality
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