Ebola in the US: More quarantines or border closings?

The Texas ebola case is raising questions about whether travelers from the stricken West Africa region to the US should be quarantined until it’s clear they’re symptom-free.

LM Otero/AP
Hazardous material cleaners hang black plastic outside the apartment in Dallas where Thomas Eric Duncan, the Ebola patient who traveled from Liberia to Dallas, stayed last week.

UPDATE 2:25 PM ABC News reports: "United flight 998 from Brussels landed at Newark Airport and has been met by Centers for Disease Control officials based in Newark after passengers on board, believed to be from Liberia, exhibited possible signs of Ebola."

Is America ready for “Ebola tourism?” the conservative Daily Caller wants to know. Sen. Rand Paul says the US should shut down flights from Ebola-stricken nations. Rush Limbaugh proclaims “Ebola is political.”

Understandable concerns about an Ebola epidemic have morphed into a vigorous, if at times less-than-helpful, debate about whether the US, and the Obama administration in particular, is doing enough to protect Americans from the viral fever that is ravaging parts of Africa.

A Liberian traveler, Thomas Eric Duncan, is being treated for the illness at Texas Health Presbyterian Hospital. His immediate family has been put under full quarantine and 10 others with whom he made contact are being closely observed for signs of the illness. A Kentucky family was put under precautionary quarantine on Friday as medical authorities tested a potential Ebola case.

The specter of Ebola in the US is testing the readiness of American public health officials, and at the same time taking on politically loaded meaning around whether the US should quarantine travelers from the stricken West Africa region until it’s clear they’re symptom-free.

As the crisis unfolded this week, a GOP Senate aide called the decision not to limit travel from Africa “a powder keg,” according to Fox News.

To be sure, invoking worst-case scenarios in the midst of a crisis may be less than helpful in containing any sense of panic in the US. But others note such questions are nevertheless important, because they’re at the forefront of many Americans’ consciousness as they follow developments in Dallas.

“I think we should be talking about these things [like travel bans]. It doesn’t mean we have to do them, but taking them off the table is not helpful,” Tevi Troy, a former deputy Health and Human Services secretary, told Politico.

One backdrop to the criticism is the Obama administration’s 2010 decision to scrap stricter quarantine rules first proposed by the George W. Bush administration in 2005, amid avian flu concerns. While it’s not clear those regulations would have been helpful now, they would have given US authorities more power to control potential passengers’ itineraries into the US. In rejecting the standards, the White House and civil libertarians called the proposed rules too onerous.

Moreover, the response in Dallas has been bumpy. Mr. Duncan was not diagnosed on his first visit to the hospital, and it was unclear as to whether his travels from Liberia had been flagged by hospital personnel. What is known is that he was sent home until he returned in an ambulance two days later, after being exposed to the public.

The Dallas apartment where Duncan was staying remained unsanitized for days as officials debated how best to quarantine the family and monitor others who may have had second-hand exposure. After a jittery week where cleaning company employees balked at sanitizing the apartment, the apartment was finally cleaned and the family was moved to a more comfortable four-bedroom home in a Dallas suburb.

Another simmering question is whether Duncan exposed weaknesses in airport screening by lying about not having contact with Ebola, perhaps in order to get to the US for medical care. (He had helped a stricken pregnant woman.) Whether others will try the same kind of “Ebola tourism” for American healthcare plies a poignant human dilemma, writes Dallas Morning News columnist James Ragland: “Do I want to lie and live – or do I want to be an honest dead man?”

For now, the US continues to expand its presence in West Africa, led by Centers for Disease Control airport testing and arriving US troops who will be put to work building much-needed treatment facilities for victims.

Shutting down air traffic from the region would be counterproductive, argued White House homeland security adviser Lisa Monaco, at a press briefing. She said CDC screening has already stopped dozens of potentially infected people from traveling to the US, and a ban would just make it harder to get medical personnel into the region to stop the outbreak at its source.

“I wish we could get to zero risk by sealing off the border, but we can’t,” CDC Director Tom Frieden told Fox News.

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