There's no shortage of ideas being put forth by politicians about how to stem the Ebola outbreak that claimed its first victim on U.S. soil last week. Monday, it was announced that a nurse who treated Thomas Eric Duncan has been infected with the virus, raising fears of a wider outbreak and questions about training and safety precautions. Some conservatives even have called for the resignation of Centers for Disease Control and Prevention Director Dr. Thomas Frieden.
But most emergency preparedness and public health experts aren't impressed with the suggestions. The most widely supported proposal seems to be banning citizens from Sierra Leone, Liberia and Guinea from traveling to the U.S. A letter (PDF) from 26 House members, including two Democrats, calling for a ban was sent last week to President Barack Obama. “Such a ban should be instituted by suspending earlier-issued visas until further notice, halting the issuance of such visas, and denying entry to the nationals of such countries upon presentation of a passport from those countries at our ports of entry,” the letter reads.
Dr. William Schaffner, an infectious diseases expert at Vanderbilt University Medical Center, Nashville, argues that prohibiting individuals from traveling to the U.S. would be a vast overreaction to just two cases of Ebola confirmed in the country. He further points out that thousands of individuals have safely traveled to the U.S. from those countries since the outbreak began in March.
“It has an inherent appeal to lay people,” Schaffner conceded of the proposed ban. “But from a public health point of view, it's a major intervention with very low benefit.”
Jeff Schlegelmilch, managing director for strategy and operations at Columbia University's National Center for Disaster Preparedness, argues that a travel ban could make it difficult for supplies and personnel needed to contain the outbreak to reach West Africa. “What are the consequences of that travel ban?” Schlegelmilch asked. “In some cases it may actually restrict the ability to contain the outbreak.”
The calls for tougher border security typically draw an even less enthusiastic response. Tillis raised the issue in a debate with Sen. Kay Hagan (D-N.C.) last week. “Ladies and gentlemen, we've got an Ebola outbreak. We have bad actors who can come across the border,” Tillis said. “We need to seal the border and secure it.”
Public health experts point out that there have been no cases of Ebola confirmed in either Mexico or Canada, raising questions about why heightened border security would make any difference in preventing the spread of the disease. “I'm just not seeing the rationale behind that at this point,” said Schlegelmilch. “I don't think we're seeing people infected trying to come across the border.”
Schaffner suggested that increased education efforts about the actual threat to public safety would be more useful than any of the proposals put forward by politicians in response to public safety concerns. “The anxiety epidemic of Ebola is much larger than the actual Ebola epidemic in the United States,” Schaffner said. “I think frankly we've all been surprised by the extent of the public's concern.”
Follow Paul Demko on Twitter: @MHpdemko
