CDC nixed jet for TB patient to avoid precedent

updated 9:27 p.m. ET June 5, 2007

While federal health officials agonized over precedent and protocol for flying sick people internationally, a honeymooner with a rare strain of tuberculosis panicked and took commercial flights from Europe back to North America.

Health officials hesitated to offer a jet leased by the Centers for Disease Control and Prevention — planes already under scrutiny for their cost — because of the precedent it might set, a government spokesman said Tuesday.

Usually, when an American must be medically evacuated from another country, the U.S. State Department helps make arrangements. If the flight home is on a military jet, the patient is billed.

“They don’t fly people back for free,” said Glen Nowak, a CDC spokesman.

Congress has scheduled hearings for Wednesday to assess how the CDC and other federal agencies handled the situation.

“One way or the other, the CDC should have had arrangements in place to bring this man home before they called him,” said Jeffrey Levi, executive director of Trust for America’s Health. “Something should have been in place so he was not driven underground.”

Video: TB scare Restrictions on TB patient may ease June 4: Andrew Speaker, the TB patient who traveled to Europe for his wedding and is now being held under quarantine in Denver, has had two negative contagion tests. NBC's Lorie Hirose in Denver reports. Why did man with TB travel? TB patient begins treatment How infectious is TB? TB-scare man's dad-in-law a TB researcher Speaker's doctor discusses TB case TB patient transferred to Denver hospital Feds probe how TB man entered U.S. What are the health implications of TB case?

The CDC has leased three jets for years, using them for specimen retrieval, medicine transport and personnel deployment. One was used to shuttle Health and Human Services Secretary Mike Leavitt to news conferences and meetings, before an Atlanta newspaper reported on the practice and it was halted.

Jets rarely used
Questions arose again last week when the news broke about Andrew Speaker, a TB-infected Atlanta attorney who went on his wedding trip last month against the advice of health officials.

Speaker has an extremely rare, hard-to-treat form of tuberculosis and was deemed potentially contagious. When contacted in Europe and told the latest diagnosis, Speaker concluded that the only lifesaving treatment available was back in the United States.

But the CDC jets had not been used in a patient-retrieval situation like that, and CDC officials discussed other, more customary options, such as a private air ambulance or a U.S. military transport.

In a conference call with reporters last week, CDC Director Dr. Julie Gerberding noted additional legal and diplomatic issues. It had to be worked out whether Italian officials had medical authority over Speaker while he was in Rome, she said.

The Atlanta Journal-Constitution last month reported that the jets are rarely used. In the past year, the three were used for a total of nine emergency flights, the newspaper reported.

The three jets cost taxpayers nearly $7 million a year, the newspaper said, in a report based on public records and interviews.

Public health leaders see value in the CDC having jets for emergencies, said Levi, of the public health advocacy organization.

“The concern is we don’t have exercised protocols in place to deal with someone — or multiple persons — with infectious disease that have to be moved quickly. That’s disturbing,” he said.

‘Obligation to ensure safe transport’
While in Rome, Speaker and his wife bought tickets on commercial aircraft to fly to the Czech Republic and on to Montreal, then rented a car and drove into the United States.

Once back in the country, he went to a New York City hospital and was placed in isolation under a federal order. Three days later, he was flown to Atlanta — on a CDC jet — where he was isolated in a hospital.

“Because the patient was under a federal order, the determination was made that we had an obligation to ensure safe transport,” Nowak said.

The CDC has not discussed whether Speaker will be billed for the New York-to-Atlanta flight, Nowak said.

When he was flown to a Denver hospital last week by private air ambulance, Speaker’s health insurer paid the $12,000 tab.

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