Why Entrance Screenings For Ebola Are Pointless

The process of taking a passenger’s temperature to screen for Ebola CREDIT: AP PHOTO/ SUNDAY ALAMBA
The process of taking a passenger’s temperature to screen for Ebola CREDIT: AP PHOTO/ SUNDAY ALAMBA

Now that a second health worker has been diagnosed with Ebola in the United States, public anxiety regarding the spread of the disease is higher than ever, and Americans are particularly concerned that infected people may be able to enter the country. Enhanced entrance screenings for Ebola have begun at airports around the world, including in Canada, the United Kingdom, and the United States — even though experts say this is a fruitless endeavor that doesn’t actually keep us safer.

Although millions of dollars are now being spent on entrance screening in airports, health experts seem to be in agreement that this measure does not work and is actually a diversion of valuable resources that are better put to work in the front lines of fighting the disease. The only effect that screenings are likely to have is to calm people down in countries where the emotional response to Ebola has been disproportional to the risk the virus actually poses.

“You’re looking for a needle in a haystack. The probability that you will find something on screening someone coming in is quite low,” Dr. Bruce Aylward, Assistant Director General of the World Health Organization, told the BBC World Service this week. “What’s going to be effective is controlled measures in the affected countries and screening people who are leaving those countries.”

“This is mostly optics to make the country feel safer,” said Dr. Jay Keystone, a senior staff physician at Toronto General’s tropical disease unit. “Is it going to stop Ebola from entering the country? Highly, highly, highly unlikely.”


According to an article in the British Journal of Medicine (BJM), it’s statistically unlikely that screening flights arriving from West Africa for Ebola will have any positive effect. The BJM pointed to statistics from SAARs screening in Canada to prove that point. In that instance, screening included a questionnaire and the use of thermal scanners to check for fever. Of the 2,478 people who responded ‘yes’ to one of the questionnaire questions and were subjected to further screening, none had SAARs. Similarly, of the 467,870 people who had their temperature taken, 95 were referred to a nurse for further assessment. Once again, none of them actually had the disease.

In fact, Ebola screening is statistically even more unlikely to yield results than the fruitless SAARs screening described in the BJM article. Canada did mass fever screening for SAARs, which the U.S. is refraining from doing for Ebola. Only about 150 travelers a day will receive the screenings. The fact that Ebola has a 21-day dormancy period — more than twice than that of SAARs — also does not help. Thomas Eric Duncan, the Liberian man who died of Ebola in a Dallas hospital last week, was screened for fever three times at the Liberian airport. A fourth screening here in the U.S. would not have stopped him from entering the country.

This has not stopped politicians from insisting on even more screening locations in the U.S. Senator John Cornyn (R-TX) and Rep. Michael McCaul (R-TX) sent a letter to the U.S. Customs and Border Protection Commissioner on Friday, demanding that screening take place at two additional airports.

“Because those traveling from Guinea, Sierra Leone, and Liberia can transit to the United States from many other countries, we have concerns that the current decision to screen only at five airports may not adequately protect Americans and others traveling to America from the Ebola virus,” the letter read.

Pundits and politicians on both sides of the aisle also constantly float the idea of stopping flights from Ebola ridden countries as a whole, a measure which health experts say is counter-productive and will only facilitate the spread of disease.


All of this comes at a time when ramping up the resources to fight the spread of the virus in West Africa is of extreme urgency. Over 4,000 people have died, the overwhelming majority of them in Liberia, Guinea, and Sierra Leone. On Tuesday, the WHO said that the outbreak could grow to 10,000 cases a week by December. As President Obama said last Friday, the world as a whole is not doing enough to stop the spread of disease in West Africa.

To address that, a good start would be to divert the millions being spent on entrance screenings to fund activities in the front lines of the disease. The conclusion of the BMJ article is worth quoting in full:

“Adopting the policy of ‘enhanced screening’ gives a false sense of reassurance. Our simple calculations show that an entrance screening policy will have no meaningful effect on the risk of importing Ebola into the UK. Better use of the UK’s resources would be to immediately scale-up our presence in West Africa — building new treatment centres at a rate that outstrips the epidemic, thereby averting a looming humanitarian crisis of frightening proportions. In so doing, we would not only help the people of these affected countries but also reduce the risk of importation to the UK.”