BEFORE, AFTER, DURING: MICHAEL CHERTOFF'S POST-KATRINA ARGUMENTS
On August 23, 2005, Homeland Security Secretary Michael Chertoff told reporters that if avian influenza broke out in the United States, responsibility would be distributed between a number of agencies, including the Department of Health and Human Services (HHS) and the Centers for Disease Control (CDC), but that "The Department of Homeland Security has the responsibility for managing an incident" (as cited in Nesmith & McKenna, 2005b, para. 32). When told that HHS made a similar claim to primary decision making authority, he replied, "We are reviewing the plan now" (para. 33). His spokesperson, Russ Knocke, added, "At the management level, we would have the ball" (para. 34). Chertoff's decision was a logical outgrowth of the "shift in paradigm" represented by adoption of an all-hazards approach to emergency response: "At both federal and state levels of government, it [all-hazard mitigation] cuts across long-established boundaries of jurisdictional authority, forcing ... a significant increase in interagency cooperation" (Erickson, 2006, p. 232).
If done well, this had the potential to streamline operations and close gaps in expertise at critical moments; but the promise of a bold stride toward organizational elegance was cold comfort to professionals who found themselves unexpectedly attached to a new boss not mistakable for the old boss: "Public health officials expressed dismay" (Nesmith & McKenna, 2005a, para. 2). Dr. Georges Benjamin, director of the American Public Health Association, fired back,
They don't have the infrastructure at Homeland Security, or the technical expertise, to handle [a pandemic] ... HHS and CDC need to be manning[sic] that process.... To the extent it is coordinated with other federal agencies, Homeland Security, I am sure, will be in charge of interagency coordination* But at the end of the day, the command decisions for this ought to be made by public health practitioners. (as cited in Nesmith & McKenna, 2005a, para. 3, 11)
Dr. Arthur Kellerman, chief of emergency medicine at Emory University, concurred:
It's hard to imagine that Homeland Security, which has not worked on epidemics, could engage with an issue of this level of complexity, coming up to speed almost from scratch.... Pandemic flu is a naturally occurring health threat of the first order, and the people who need to be at the center of that should be health care professionals first and foremost. (as cited in Nesmith & McKenna, 2005a, para. 13-14)
Had Chertoff's assertion of authority come in the middle of an ordinary week, it might have passed as a run-of-the-mill Washington, DC turf fight. However, just forty-eight hours later, Louisiana governor Kathleen Blanco declared a state of emergency at the approach of what David Liebersbach, immediate past president of the National Emergency Management association, would call "the 9/11 of natural disasters" (as cited in Judd & Borden, 2005, p. 1A): Hurricane Katrina. Over the next several weeks, the lines of command and models of decision-making in the United States federal government's public health agencies would seize headlines and saturate political commentary at all points on the ideological spectrum.
As the levees crumbled and New Orleans flooded, Chertoff began a slowly mounting parade of press availabilities, trying to reassure television audiences that Washington was not ignoring the plight of stranded New Orleans residents. Throughout those appearances, Chertoff relied upon an argumentative strategy that might have been successful in the days before he claimed ownership over the avian flu response, but now drove him into direct conflict with the professionally-sanctioned reasoning patterns of the public health officials over whom he asserted authority. The argument field mismatch was not obvious at the outset, but under pressure to defend himself from the agency's history-making set of missteps, Chertoff very sharply, if unintentionally, marked the gap between his argumentative orientation and the field assumptions peculiar to epidemiology. …