"Who's in charge?" It was a question that everyone seemed to have in early October last year. Thomas Eric Duncan had just become the first person to be diagnosed with Ebola in the United States and no one, it seemed, knew what to do, as documented in February's Vanity Fair.
The Texas governor, Rick Perry, held a press conference at Presby Wednesday afternoon. At meetings before and after, local officials tried to understand what was expected of them; at least initially, that was far from clear. Most of the Dallas politicians, including Mayor Mike Rawlings, an avuncular former Pizza Hut C.E.O., had assumed that the C.D.C. was taking over, but what little they were hearing from the C.D.C. suggested that wasn't in the cards. "It was obvious to me and the mayor there was broad confusion over who was in charge and what would happen next," recalls Judge Jenkins, a steely Democrat whose job essentially makes him the mayor of Dallas County. "Mike came up to me at one point and said, 'I am freaking out here.' I told him, 'I'll get this fixed by dark.' "Late that afternoon Jenkins and the Texas health commissioner, Dr. David Lakey, repaired to a Presby conference room to teleconference with Tom Frieden and other C.D.C. officials. This was the meeting where Jenkins had assumed Frieden would take charge. Instead, Lakey urged they adopt an "incident command structure," or I.C.S., which would place a single local official at the helm of the entire crisis.
"Well, who's going to be in charge?" Jenkins asked.
"You would be in charge, Clay," Frieden said.
"Well, I'm not a doctor," Jenkins replied. "David, you should be in charge," he said to Lakey. Both of the doctors, however, insisted that Jenkins take charge.
Afterward, talking to Mayor Rawlings, Jenkins tried to explain how the I.C.S. would work. But Rawlings cut him off. "I don't give a fuck about that," he said. "Who's in charge?"
Tuesday, the Texas Senate passed a bill on a 26-4 vote that defines a clear command structure in the event of any new infectious disease outbreak. Authored by Charles Schwertner, a Republican from Georgetown, the measure would allow the governor to declare a state of infectious disease emergency, which "gives the commissioner of state health services authority for all state and local public health policy decisions."
The state would be given the power to quarantine an airplane or another means of transportation that had been used by anyone carrying the disease, which raised the hackles of some Republicans who felt that the bill gave the state too much power.
"There was a lot of confusion and concern among our citizens over who was in charge and could take action," Schwertner responded to his colleagues.
Texas was just lucky to escape an Ebola outbreak, he said.
"This is not simply a reaction to Ebola, but a proactive approach to preparing the state for the next infectious disease outbreak. It is the responsibility of the state to step in in these cases," Schwertner said.
