Canada and Australia Make the Right Choice on Ebola

On October 28, Australia became the first developed nation to ban visas for citizens of Sierra Leone, Liberia, and Guinea because of concerns over the international spread of Ebola. Canada followed suit with analogous visa bans soon after on October 31.

Australia and Canada were not the first nations to issue travel bans related to Ebola: 23 other nations had done so before them. In response to Canada's decision, Sierre Leone accused the Canadian government of “discrimination.” Apparently, discrimination on the basis of causing a potential global health catastrophe is a valid concern in geopolitics? Maybe Sierra Leone can file a human rights complaint against Canada with the UN, whose human rights council is headed up by such notable human rights advocates as Algeria, Benin, Botswana, Burkina Faso, China, Congo, Cuba, Ethiopia, Gabon, Kazakhstan, Kuwait, Namibia, Russia, Saudi Arabia, Sierra Leone itself, the United Arab Emirates, Venezuela, and Vietnam. These nations will undoubtedly conduct an impartial investigation. And has Sierra Leone accused all of the other nations with Ebola travel restrictions of “discrimination,” or just Canada?

Ebola has become a politicized issue, along the lines of climate change. Following the moves by Australia and Canada, many in the center and left portions of the political spectrum came out with scathing criticism. Words such as “cowardly” and “despicable” were thrown around, along with allegations that there was no “science” to support the decision. On the contrary, the criticisms exposed how a number of pundits do not understand the difference between science and policy, and how a lack of knowledge in itself supports the decisions made by the Canadian and Australian governments.

Arguments have been raised that travel bans will make the Ebola epidemic worse. These allegations have no merit. An effective travel ban could halt the spread of the disease. But, as we all know, a truly effective travel ban is almost impossible -- short of a full military lockdown on national borders -- given the nature of international travel today. However, even slowing the spread of the disease is a desirable policy goal. This gives us time to develop and deploy responses to the epidemic, ranging from working actively to quench the epidemic at its source through to the use of vaccines at home and abroad, improving screening measures at border crossings, providing better training and equipment to health professionals, and on the list goes. Time is valuable, and it saves lives. This cannot be disputed.

International travel bans are the macroscale equivalent of the same travel bans and quarantine procedures we have in healthcare facilities when a patient has Ebola. In this case, what is sensible policy at the microscale is equally sensible at the macroscale. We do not allow just any individuals to go into and out of an Ebola victim's hospital room -- only healthcare professionals with appropriate training and protection are allowed to enter and leave. The same reasoning applies to geographic regions such as West Africa.

The key word regarding travel bans is “effective.” Individuals can, and do, lie about their prior travel routes and destinations in an attempt to get around travel bans -- as was apparently the case with an Ebola victim in Texas. The correct policy response is not to say travel bans are worthless or even damaging, it is instead to institute better tracking mechanisms for international travel so that arrivals cannot claim they were not in or around a problem region. The goal is effective travel bans, not how to develop stop-gap responses to ineffective ones.

Another reason given against travel bans is that “responses to humanitarian crises are not well-organized affairs.” So we should draft incoherent policies based upon even greater incompetence? Of course not. Perhaps the correct answer is for the medical community to pull itself together and respond to the Ebola crisis more coherently? That apparently would make too much sense. In fact, shouldn't the World Health Organization -- a giant mess of bureaucracy -- be ensuring the efforts are indeed “well-organized”? After all, the WHO's budget is $4 billion for 2014-2015. But alas, a leaked memo suggests the WHO has -- instead -- severely “botched” Ebola containment efforts.

The least defensible argument against travel restrictions to West Africa is that “it will devastate the economies of West Africa.” Economic considerations are of secondary nature during these types of events, and even less relevant when looked at from the perspective of the developed world. If Ebola becomes established in the West, the economic devastation will eclipse anything possible for the tiny economies of West Africa by orders of magnitude. As well, each Ebola scare in the West has significant negative economic impacts in its own right.

Nations must look out for their own national interests first and foremost. International concerns are secondary. Where national and international concerns coincide, policy decisions are relatively easy. When they do not -- as may be the case with Ebola -- political leaders are obligated to place priority on domestic interests. Canada and Australia have done this. If West Africa must be sacrificed to relatively minor economic devastation in order to prevent a far greater level of economic devastation in developed nations, so be it.

The combined 2013 GDP of Sierra Leone, Liberia, and Guinea is only US$13 billion. By comparison, the GDP of the OECD members is US$47,351 billion. The OECD could absorb complete devastation costs for the economies of Sierra Leone, Liberia, and Guinea and barely notice (their economies comprise 0.027 percent of the OECD's economy -- not even at the level of a rounding error). Ergo, this concern about Ebola travel bans is readily dismissed.

Overall, as The New Yorker points out, we know very little about Ebola. The Washington Post tells us that “airport Ebola screenings are largely ineffective.” Ebola has a 70 percent mortality rate, placing it above the Bubonic plague, tuberculosis, and avian flu, and just below untreated HIV and untreated rabies. Healthcare workers in the West are repeatedly reminding the public and policy makers that we are not prepared, that they have been lied to by those above them in the policy chain, and that hundreds of them have been killed already by Ebola. There are also valid concerns about the CDC's response in light of its continually shifting, and often contradictory, positions which have been questioned by other scientists. Research suggests that 21 days is not a long enough quarantine period for Ebola.

The head of the Red Cross has stated that the “threat of a global health catastrophe” from Ebola is real. Oxfam is warning that the Ebola outbreak could be the “definitive humanitarian disaster of our generation.” The WHO is ordering 3 million hazardous material suits for healthcare workers and patients to meet demand over just the next 9 months. Ebola may be mutating to become more contagious. The most recent data indicates the number of reported cases has increased by more than 30 percent over only a 4-day period -- and the number of actual cases may be much higher.

Even NPR is publishing interviews indicating “why it's OK to worry about Ebola.” The Pentagon is now “seeking research that shows federal public-health officials and the broader medical community have a limited understanding of the Ebola virus, despite their assurances that the public should not panic about the deadly disease.” Recent modeling efforts suggest real risks for the international community, and researchers at Yale University are reporting work showing optimism that the epidemic may be slowing down could be premature, and that deaths could skyrocket in the near future.

Thus, the science around Ebola is far from settled, and we know far less about Ebola than we need to. What we do know is troubling. It is both what we do and don't know about Ebola that makes travel restrictions supported by the state of “the science,” despite the contrarian claims on the political left. It is also interesting to note how some policy makers on the left advocate the use of the precautionary principle for some topics, but not others. Nothing to see here, everyone just move along.