Now that two health workers have contracted Ebola on U.S. soil, and evidence has emerged that hospital officials weren’t properly trained to contain the spread of the deadly virus, public panic about the global epidemic is intensifying. The director of the Centers for Disease Control and Prevention (CDC), Thomas Frieden, will testify at a congressional hearing on Thursday, during which he’ll likely face tough questions about why the U.S. hasn’t halted flights from the Western African region that’s been hardest hit by Ebola.
An increasing number of lawmakers on both sides of the aisle, as well as some former Obama administration officials, are calling for implementing a travel ban — a policy that also has the support of two thirds of the American public, according to the latest polling. On Wednesday, House Speaker John Boehner became the highest-ranking Republican to suggest that President Obama should impose temporary travel restrictions on flights from the affected region.
Banning flights from Ebola-stricken countries sounds like a logical step to contain the spread of an outbreak that’s been spiraling out of control in West Africa for months. But the policies that give people a sense of security aren’t always the ones that get the best results from a global health perspective. Experts say there are a couple significant reasons why travel bans are actually the wrong approach:
1. It will prevent health officials from being able to effectively track people with symptoms.
The CDC’s Frieden has been firmly opposed to a travel ban from the start, and has repeatedly explained that such restrictions will undermine one of the best tools we have to contain the epidemic: The ability to track people’s movements. “Even when governments restrict travel and trade, people in affected countries still find a way to move and it is even harder to track them systematically,” he wrote in an op-ed earlier this month.
Right now, government officials can coordinate with airport security to figure out where Ebola-infected people may have traveled before and after they started displaying symptoms. That’s something the U.S. infrastructure is well-equipped to do. If travel becomes less systematic, however, airports won’t serve as the same kind of resource. Considering the fact that the World Health Organization (WHO) has said that the failure to effectively track patients has been one of the biggest reasons that Liberia hasn’t been able to contain Ebola, this is not a direction we want to go in.
2. It will only delay the inevitable spread of Ebola while the outbreak continues in West African countries.
Travel bans are a temporary solution. We can’t suspend air travel from West Africa forever, and even if we do, it would certainly be possible to fly to another country first before landing in the U.S. (The Liberian man who was diagnosed with Ebola in Dallas, for instance, flew from Belgium.) The policy would simply be delaying the inevitable in order to make Americans feel safer for a few weeks.
According to Alex Vespignani, a physicist at Northeastern University who developed a computer model to predict how air traffic can influence the spread of Ebola, an 80 percent reduction in air traffic only delays the risk of an Ebola-infected passenger coming to the U.S. for about four weeks. A 90 percent reduction would delay it for another month or so. “We’re a little safer for a finite amount of time, but then you are not really solving the problem,” Vespignani explained to Forbes.
3. It will become a logistical nightmare.
Health experts have maintained that sealing off the countries affected by the Ebola outbreak would actually make it more difficult to address the virus at its source. Travel restrictions could hamper efforts to get critical medical supplies into Western African countries, as well as restrict the movements of medical personnel who are needed on the ground in Liberia, Guinea, and Sierra Leone.
Even if the U.S. implemented a more nuanced policy that exempted doctors and aid workers from the travel ban, it would still be too difficult to coordinate in practice. Who would decide who gets approved to travel? How long would the application process take? As Vox recently reported, responding to humanitarian crises is complicated and messy, and we can’t afford to slow down the process by putting obstacles in front of a Doctors Without Borders volunteer who’s trying to get to and from Liberia.
In fact, workers with Doctors Without Borders say that the current scarcity of flights is already impeding their work as they coordinate with 240 international staff members currently in West Africa. “We need the flights to operate. That’s the bottom line,” Tim Shenk, the press officer for the group, told the Detroit Free Press.
4. It could destabilize the countries at the heart of the outbreak.
Limiting travel can lead to lasting economic consequences for the countries that are cut off from the rest of the world. For instance, in 2006, the World Bank estimated that a potential international flu pandemic could lead to a $1.5 trillion reduction in global gross domestic product — and two thirds of that number represents the cost of people restricting their movements and avoiding traveling to infected countries. The World Health Organization may put that figure even higher. According to WHO’s estimates, recently cited by director general Dr. Margaret Chan, about 90 percent of the economic costs of outbreaks “come from irrational and disorganized efforts of the public to avoid infection.”
Plus, the researchers who have examined the effects of the 2003 SARS outbreak say quarantining people within an infected country is often an overly broad approach that can end up facilitating social and political unrest. In Liberia and Sierra Leone, which are not incredibly stable countries to begin with, that could actually allow the virus to spread even further in the impoverished region.
“If we completely isolate them… we know from experience with public health, that marginalizes them,” Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Disease, recently explained on Fox News. “You can have civil unrest, governments can fall. Then you wind up having spread of the virus to other countries in West Africa, which would only compound the problem.”
If the things that the CDC has been doing aren’t working, and if health workers aren’t educated about the proper protocols to prevent Ebola transmissions, that obviously needs to change. The federal agency has already taken some steps to ensure that what happened in Dallas won’t happen again; it has issued stricter guidelines for American hospitals dealing with Ebola patients, and is preparing to deploy emergency teams to any areas that report new infections. The second health worker has also been transferred to one of the four hospitals in the country equipped with a special isolation unit, something that might become standard protocol if more Americans become infected with Ebola in the future.
But there’s a fine line between holding federal health officials accountable and pursuing policies simply to give Americans the illusion of safety. After all, as political figures remain singularly focused on what we should be doing to prevent Ebola here at home, the risks here are still incredibly low, and the real crisis continues to worsen in Liberia — which just declared a shortage of body bags, dire news that’s mostly been buried under the headlines about Dallas.