W

ASHINGTON — It would be hard to blame Ron Klain for being distracted from his day job as general counsel at a venture capital firm. He was President Obama’s Ebola czar (officially, Ebola response coordinator) from October 2014 to February 2015. So even from outside government, he is following news about Zika virus day by day and informally offering counsel to his former White House colleagues.

Plus there’s the campaign; he coaches Hillary Clinton for every one of her debates.

But Zika was Topic A (mostly) as we sat down in his downtown office here this week. The conversation that follows has been edited and condensed.

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Should we be worried about Zika?

Spring will come. Mosquitoes will come back to life in the United States. And we will have transmission of the disease. I understand why people are worried about that.

I don’t think it’s one of those horrific scenarios, but I think it is a public health risk to the United States and it needs a robust response.

What’s the biggest lesson from Ebola?

We learned a lot of things in the Ebola response that color how the administration will look at what it’s doing with Zika. The administration got behind the eight ball and we were playing catch-up all along on Ebola. And to their credit they are ahead of it on Zika.

In the case of Ebola, we submitted our emergency funding request to Congress the first week of November, six or seven weeks into the peak of the Ebola fear. President Obama has already sent a $1.8 billion funding request to combat Zika. So acknowledging the fears and trying to get at them preemptively is definitely a lesson learned.

Should there be a Zika czar?

I don’t think there needs to be a Zika czar.

I do think that it would make sense for perhaps the next president to set up a pandemic response directorate inside the National Security Council. We have a permanent directorate to manage threats from [weapons of mass destruction]. We have a permanent directorate to manage threats from climate change. We have a permanent directorate to manage threats from terrorism. We need one to manage threats from pandemics.

A pandemic czar?

Well, a person who is a senior White House staffer whose responsibility is pandemic preparation and response. That said, the whole czar thing is a big misnomer. I was in charge of the Ebola response at the White House. I didn’t feel very czar-like. Nor should someone. We’re a democratic society. We don’t have czars.

I’m not complaining. I’m just saying that one thing we have to understand about all these epidemic outbreak responses is we live in a society in America with a very diffuse and pluralistic health care system, right? So even the senior federal official working on one of these things doesn’t control what the governors do.

Even if someone, somehow, in our system — which would never happen — had power over all public officials, we have a largely private health care system in the United States. The Ebola response was powered largely by people who work for private organizations, nonprofit providers, agreeing to go volunteer to fight this disease.

Are you angling for pandemic coordinator?

No. I’ve had my experience dealing with one of these things and I’m very happy here living life in the private sector. That’s a job for someone else.

Zika has come up only a bit in the presidential campaign. Should the handling of it be an issue?

It probably will become one as time passes. I know that Secretary Clinton has come up with a statement about her approach, and some of the Republican candidates have. You’d hope that how a country fights an epidemic illness would not become a political issue. You’d hope we could agree that this is something where science and medicine should decide it — not politics.

Has your Ebola experience greatly deepened your interest in science and medicine?

No question. I was brought in to serve what was largely a bureaucratic function.

But in the course of doing it, it piqued my interest in how we as a country prepare for what’s coming. To me, Zika is front and center. But what America should really be concerned about is how prepared — or not — we are for a truly dangerous pandemic, which will come, sooner or later.

The Ebola experience was a bit of a test run for that. It was a relatively easy test run in the sense that Ebola is relatively hard to transmit, it broke out in three very small countries. And they were countries that were happy to accept outside help, well-aligned with the West, where we could send a few thousand troops to Liberia, and they’d be greeted as a welcome addition.

The world faces a pandemic threat that’s very different than that. Some kind of pandemic flu that is airborne and transmits very easily and very rapidly. It could break out in a global megacity, in a densely populated area, it could break out in a country where lots of travelers every day come to the United States. It could break out in a country where 3,000 US troops would not be welcome, where thousands of US volunteers would not be welcome. And I still think as a country and as a world, we’re not prepared for that.

You were the longtime top aide to Vice President Biden. What’s your take on his cancer moonshot?

It’s so hard to separate my feeling about his personal loss and his personal pain and just how hard it’s been for him and his family. But what’s great is seeing him turn that into an effort to help a lot of other families and turn that pain outward to how we can galvanize a stronger cancer response. He deserved credit for not overpromising. He hasn’t said that cancer will be gone in a year.

But isn’t it really tough as a lame duck to achieve what he wants?

It’s hard but I also think this is an issue where it will be hard for bureaucrats and agency heads to say no to him. Both because he is the vice president of the United States, and because of what has happened to him and his family. It’s hard: There are entrenched bureaucracies. There are entrenched budgets. There are entrenched perspectives. But between the irresistible force of Joe Biden and the immovable object of the bureaucracy, I would bet on the irresistible force of Joe Biden.

Are you at risk for contracting Zika virus? Your level of risk depends in part on your living conditions. Alex Hogan/STAT

 

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