Ebola Strikes Again

On October 17, Doctors Without Borders physician Craig Spencer arrived at JFK airport after a stint working with Ebola patients in Guinea.  His temperature was normal: 98.7 degrees.  (Some accounts say he returned on October 14).  

On October 23, Spencer was rushed to Bellevue Hospital in New York City with Ebola-like symptoms – a fever of 103 degrees and accompanying nausea.  He has since been positively diagnosed with the ravaging disease.  Hazmat gear, screenings, and good intentions to no avail.

This is a repeat of the Thomas Duncan affair and further proof that screenings do not go far enough in protecting the homeland.  The conundrum still lingers: no matter how many screenings are conducted at airports, they fail to identify individuals who might have been exposed to Ebola, hop on one or several planes bound for the U.S. – fever-free, symptom-free, Ebola-free – and pass all required entry and exit screenings, only to become symptomatic and infectious once in this country.  They go to work, visit  bridal shops, take Uber cabs, fly on planes, hang out with family, and go bowling – exposing countless others to a hemorrhagic fever that has no cure.

With a 21-day incubation period, the only way to ensure that individuals do not carry the infection to our shores is to prevent them from traveling in the first instance and, if they must, requiring that they remain in quarantine for 21 days before entry is granted.  Imagine if Dr. Spencer had been quarantined for 21 days before being allowed back in this country – think of all the people he encountered whose lives wouldn’t be turned upside-down for 21 days: the people in his apartment building, the straphangers in the subway he took to Brooklyn to go bowling, the driver and other riders of the Uber cab he took back to Manhattan, and the folks at the bowling alley.        

Why do we rely on Lady Luck to prevent ticking Ebola time bombs from making it past our borders when commonsense travel bans are a sure thing?  They worked in Senegal and Nigeria, both of which were recently declared Ebola-free by the WHO.  Why take a gamble that, if the infected do arrive in this country, they will be contained, and if they are not, those who are exposed will not succumb because of our fabulous public health procedures and superior medical system?  What if some of the exposed aren’t identified?  Do we really know every step we took on a given day?  Are we not playing Russian Roulette with the lives of millions of Americans in the hopes that nothing cataclysmic will happen?

I am confident that the apartment-mates of Thomas Duncan, passengers on cruise ships, classmates in schools, colleagues at work, shoppers at bridal boutiques, riders in Uber cabs, and bowlers in Williamsburg will be less stressed, less panicked, and less inconvenienced with a travel ban and 21-day quarantine than they would otherwise be. 

We are constantly reminded by those in the know about the economic and political consequences to the Ebola-stricken nations of instituting travel restrictions and quarantines, but what about the economic and political fallout here as individuals – even just one or two – slip through the screening cracks and erupt with Ebola? 

Even though the disease is hard to spread; even though the CDC assures us it is exceptional at tracking and tracing; even though only two people caught the disease from Thomas Duncan, were treated early, and seem to be recovering; even though we have excellent public health procedures and have plugged up the loopholes; even though we can stop this virus in its tracks…the prospect of sleeper carriers like Mr. Duncan and Dr. Spencer unwittingly passing through our border controls and spreading the virus takes a huge toll on our society.  Tracing, tracking and isolating contacts, training and properly equipping hospital staff, transporting, treating and cleaning after patients – all require vast sums of money and resources that taxpayers would gladly shell out.  But why pay for something that can be prevented?  Then there are the lost wages, missed schoolwork, and the immeasurable stress endured by those who have been exposed. 

Allowing all of this to materialize when it could have been circumvented with travel bans and quarantines, by continuing to leave our borders exposed, and by failing to balance the public health against the so-called “right to return” of those who have been in hot zones, only serve to fuel the one thing the administration seeks to avoid: panic.  And now that Dr. Spencer is infected, the little trust people had in the government will be further tested as the potential for hysteria rears its ugly head.  Heaven only knows how many people he came in contact with as he went about his everyday life in New York City – a heavy toll that could have easily been avoided.  I’m sure the Uber cab owner, the subway riders, the doctor’s bowling alley mates, and the folks in his apartment building are thrilled to have him back.

On October 17, Doctors Without Borders physician Craig Spencer arrived at JFK airport after a stint working with Ebola patients in Guinea.  His temperature was normal: 98.7 degrees.  (Some accounts say he returned on October 14).  

On October 23, Spencer was rushed to Bellevue Hospital in New York City with Ebola-like symptoms – a fever of 103 degrees and accompanying nausea.  He has since been positively diagnosed with the ravaging disease.  Hazmat gear, screenings, and good intentions to no avail.

This is a repeat of the Thomas Duncan affair and further proof that screenings do not go far enough in protecting the homeland.  The conundrum still lingers: no matter how many screenings are conducted at airports, they fail to identify individuals who might have been exposed to Ebola, hop on one or several planes bound for the U.S. – fever-free, symptom-free, Ebola-free – and pass all required entry and exit screenings, only to become symptomatic and infectious once in this country.  They go to work, visit  bridal shops, take Uber cabs, fly on planes, hang out with family, and go bowling – exposing countless others to a hemorrhagic fever that has no cure.

With a 21-day incubation period, the only way to ensure that individuals do not carry the infection to our shores is to prevent them from traveling in the first instance and, if they must, requiring that they remain in quarantine for 21 days before entry is granted.  Imagine if Dr. Spencer had been quarantined for 21 days before being allowed back in this country – think of all the people he encountered whose lives wouldn’t be turned upside-down for 21 days: the people in his apartment building, the straphangers in the subway he took to Brooklyn to go bowling, the driver and other riders of the Uber cab he took back to Manhattan, and the folks at the bowling alley.        

Why do we rely on Lady Luck to prevent ticking Ebola time bombs from making it past our borders when commonsense travel bans are a sure thing?  They worked in Senegal and Nigeria, both of which were recently declared Ebola-free by the WHO.  Why take a gamble that, if the infected do arrive in this country, they will be contained, and if they are not, those who are exposed will not succumb because of our fabulous public health procedures and superior medical system?  What if some of the exposed aren’t identified?  Do we really know every step we took on a given day?  Are we not playing Russian Roulette with the lives of millions of Americans in the hopes that nothing cataclysmic will happen?

I am confident that the apartment-mates of Thomas Duncan, passengers on cruise ships, classmates in schools, colleagues at work, shoppers at bridal boutiques, riders in Uber cabs, and bowlers in Williamsburg will be less stressed, less panicked, and less inconvenienced with a travel ban and 21-day quarantine than they would otherwise be. 

We are constantly reminded by those in the know about the economic and political consequences to the Ebola-stricken nations of instituting travel restrictions and quarantines, but what about the economic and political fallout here as individuals – even just one or two – slip through the screening cracks and erupt with Ebola? 

Even though the disease is hard to spread; even though the CDC assures us it is exceptional at tracking and tracing; even though only two people caught the disease from Thomas Duncan, were treated early, and seem to be recovering; even though we have excellent public health procedures and have plugged up the loopholes; even though we can stop this virus in its tracks…the prospect of sleeper carriers like Mr. Duncan and Dr. Spencer unwittingly passing through our border controls and spreading the virus takes a huge toll on our society.  Tracing, tracking and isolating contacts, training and properly equipping hospital staff, transporting, treating and cleaning after patients – all require vast sums of money and resources that taxpayers would gladly shell out.  But why pay for something that can be prevented?  Then there are the lost wages, missed schoolwork, and the immeasurable stress endured by those who have been exposed. 

Allowing all of this to materialize when it could have been circumvented with travel bans and quarantines, by continuing to leave our borders exposed, and by failing to balance the public health against the so-called “right to return” of those who have been in hot zones, only serve to fuel the one thing the administration seeks to avoid: panic.  And now that Dr. Spencer is infected, the little trust people had in the government will be further tested as the potential for hysteria rears its ugly head.  Heaven only knows how many people he came in contact with as he went about his everyday life in New York City – a heavy toll that could have easily been avoided.  I’m sure the Uber cab owner, the subway riders, the doctor’s bowling alley mates, and the folks in his apartment building are thrilled to have him back.