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Ebola: Preventing Its Spread Here
There is a piece on the website Politico entitled “Travel Ban, Visa Ban, Either Way It Won’t Work.” It is written by Tara C. Smith, who is an associate professor of epidemiology at Kent State University.
In arguing against keeping out or quarantining abroad those who have been in the countries in which Ebola has been rampant — Sierra Leone, Liberia and Guinea — she has two points to make. First, she points out, there are no direct flights between the US and the affected countries — which is true, but irrelevant. Her real argument can be found in this paragraph:
What, then, about restrictions on visas or passports? With outright flight bans widely criticized as unrealistic, some Republican leaders now are looking instead to visa restrictions—an issue Florida Sen. Marco Rubio has said he will press when Congress returns to work in November. This would be logistically more possible to enact—but would it actually make U.S. citizens safer here or abroad? Unlikely, for the same reasons a flight ban wouldn’t—people can still get in and out, even with a reduction in travel.
Note the character of the argument. A travel ban would not be infallible. It would only reduce the number of those apt to have been exposed to Ebola that would get through. Some would get through. They might slip in with the illegal immigrants from south of the border. The fact that they had spent time in the affected countries in West Africa might escape notice. So, she concludes, this would not “actually make U. S. citizens safer here.”
One does not have to have a degree in epidemiology to see that there is something amiss with Professor Smith’s argument. She is no doubt right in supposing perfection impossible. She is no doubt right in supposing that someone might slip through. But is she right in supposing that “a reduction in travel” would not “actually make U. S. citizens safer here?” After all, the real question is not whether we cannot handle a case or two of Ebola here. The real question is whether we can handle a larger outbreak here. The travel ban instituted in Nigeria worked brilliantly. Why, you might ask, should such a travel ban fail here?
Professor Smith is not stupid, She knows the weakness of her argument. From our perspective, what is wrong with her approach is that she is not all that interested in our welfare “here.” Consider the one objection she makes to immigration controls:
As CDC Director Dr. Tom Frieden has already pointed out, any reduction in flights would also hamper the ability to get medical personnel, outbreak experts and supplies in and out of these countries. Even if military transports could be effectively used in place of commercial transports (a dubious and expensive proposition), would additional people volunteer in the uncertain light of serious flight and travel restrictions? Would you volunteer your 30 or 60 days in an epidemic-hit country if you weren’t certain you could get back out?
The kicker is this: “[W]ould additional people volunteer in the uncertain light of serious flight and travel restrictions? Would you volunteer your 30 or 60 days in an epidemic-hit country if you weren’t certain you could get back out?”
This is, in fact, a genuine concern — and it explains why epidemiologists such as Thomas Frieden and Tara C. Smith are willing to peddle to us lies with regard to our own safety. Their primary focus is on Sierra Leone, Liberia and Guinea, and they sympathize with those who volunteer to serve in the danger zone constituted by those countries. Consider Professor Smith’s concluding sentences:
Visa bans would either be overly broad—and unfairly ensnare anyone from the affected countries, whether in Ebola-affected areas or not—or overly narrow, and miss someone from Senegal who recently visited Liberia or Sierra Leone.
The key to her concern is fairness. Would it have been fair to require that Dr. Craig Spencer be quarantined abroad for twenty-one days or more before returning to the United States? He was, after all, as many have noted, a hero of sorts. He risked his life for the welfare of others — and the same can be said for Kachi Hickox, who has been quarantined in New Jersey and does not like it one bit.
I admire the courage of Dr. Spencer and Nurse Hickox, and I sympathize with Professor Smith’s concern. But, in the end, public health is not about fairness. It is about the safety of one’s fellow citizens here at home, and that requires that one subordinate one’s compassion for those suffering overseas and one’s admiration for those who risk their lives in seeking to help those overseas to a concern for the welfare of one’s own fellow citizens here at home. This is what Andrew Cuomo, Chris Christie, and Pat Quinn did when they imposed a quarantine on those coming into their states from the affected areas of West Africa. It is precisely what Barack Obama, who was elected to defend the United States, resolutely refuses to do.
We live in an era in which left-liberals not themselves up for re-election think it shameful to prefer the citizens of their country to those who hail from or live abroad. “Think globally, act locally” has long been their motto. The legitimacy of patriotism is what is at stake, and it is our misfortune that we now have a President in power who thinks patriotism something shameful.
Here is a question you should ask yourself: Can you think of a single Democratic officeholder not up for re-election ten days from now who has spoken up in favor of restrictions on travel from the affected regions of West Africa to the United States?
Published in General
[Redacted for CoC]
AIG
“A degree in epidemiology would only get in the way of your arguments, so surely, it is not needed.” I beg to differ.
Epidemiology (science, we are told) prescribes quarantines to contain disease. When disease is epidemic, the entire area is quarantined. This is bedrock epidemiological practice. That is what epidemiologists usually practice. Is it different only because those wishing to be protected by normal means in this case are US citizens, whose government knows few bounds when it comes to coercing the behavior of its own citizens. When it comes to coercion, the principle of this administration is citizens before aliens; allies before adversaries.
A critical insight, Paul. Those arguing against travel restrictions are one-worlders–those who wish to put everyone on the same level, refusing to prefer American citizens to anyone else.
Here they argue against travel restrictions because our borders are so porous that nearly anyone could enter the country anyway. Elsewhere, though, they’re the very people who argue in favor of porous borders in the first place. What right have we, they ask, to keep the poor of the world from joining us here?
What a mess.
On an earlier thread I noted a similarity. Compare the unanimous support by the “public health community” for the self-evidently preposterous opposition to a travel ban and the perplexingly monolithic support for climate change amongst it’s relevant guild members, despite giant holes in it’s empirical evidence. I’ve just read Heather MacDonald’s excellent article in City Journal that is a companion to Dr. Rahe’s analysis. I recommend everyone read it.
I’d also point out Saudi Arabia has imposed a travel ban on the affected countries to protect people coming for the hajj – no political correctness there.
Thanks for drawing my attention to Heather MacDonald’s piece. Here is a link.
You beat me to it while I was doing my editing – thanks for posting the link.
From the start the argument has been “A travel ban would make us less safe,” and it is pronounced as if it is self-evident.
And yet no one who utters this phrase has explained how it’s logically possible.
Thanks for your comment, CW. I haven’t always agreed with Prof. Rahe’s analysis on certain issues in the past, but I think that he’s spot on in this case and AIG’s diatribe needed your sober response. I think, however, that you got the order wrong in your last sentence…right?
Yup.
Professor Smith’s question
is not only weak but dishonest. Logically, no fever (+ negative Ebola test?) should = OK to get on the plane for the USA. If there’s a fever when you are waiting to board, it’s quarantine in Africa for you.
After 21 days (or 42 days for the 98% confidence interval on the incubation period) of rigorously enforced, Nancy Snyderman proof quarantine either in Africa or Stateside after the last possible contact with contagion, you’re free to move about the country. That should work. Of course that means in real life terms it’s a 51 day, or 72 day commitment, not a 30 day one.
It’s true that Western professionals will probably be needed to help contain the epidemic in Africa, but we should do better at keeping it there.
The real problem is the lack of competence at CDC.
It’s only safe to do research on Ebola in Level IV containment facilities but (apparently per the CDC) fluid resistant but not fluid impermeable gowns, hoods, etc. were provided to the front line caregivers.
Lovely.
The president has a nominee for Surgeon General hung up in Congress because he is overly concerned with gun control and people figure he will divert resourrces from medical matters to politics.
But I have heard people say that medically, he is eminently qualified.
ISN’T HE BETTER THAN RON KLAIN!??
I think the argument should focus on what level of precautions are prudent? The canard of “this is about safety therefore x, y or z should be done, is not valid. I could say every traveler from W.A. should be killed for then we can be 100% certain, after all this is about safety. Wasn’t it about safety when we put the Japanese in camps during WW2?
I do not know, but assume it takes 2-3 weeks for a W.A. to get a visa, therefore someone who is infect who decides to come to the US for treatment would need to sneak in since they would be extremely ill prior to getting a visa. Therefore visa restrictions would not have a major effect on infected people sneaking into the country. If the number of W. Africans traveling here each week on visas is 1000 as I have seen written, then s0me sort of restrictions would be prudent. Certain people for certain reasons should be allowed, I would think 10 – 20 a week would be prudent, but this is just a guess.
As for healthcare professionals returning; the Drs. Without Borders’ protocol has been in effect for more then 9 months and has worked well. One Dr. has developed Ebola and it is unclear if he infected anyone else. This seems to me to be a prudent and effective protocol. I find it difficult to understand why someone who is concerned not about one or two cases, but a larger outbreak would not also find it prudent. We trust these professionals to be responsible when they treat us and our loved ones, I see no reason why they cannot be trusted to use reasonable caution when they return from W.A. As for the nurse from Dallas and her traveling to Cleveland, it is appears as if the instructions she was given were either faulty or unclear and after all she did not infect anyone else.
Probably not. Whatever his qualifications, in a practical sense it probably makes no difference.
President Obama nominated Vivek Murthy to be Surgeon General in November 2013.
Murthy’s nomination is said to have stalled due in large part to opposition to his views on firearms.
Since Senate rules were unilaterally changed by the Democrats to require only 50 votes to approve an appointee, Murthy could now be Surgeon General without a single Republican vote.
Or, once the nomination stalled, President Obama could have appointed someone who could attract more bipartisan support.
Clearly until very recently, it was a priority of neither President Obama, Harry Reid, nor the Democratic Party to even have a Surgeon General.
I’ll submit that even if Murthy, or a second nominee, been appointed, it is unlikely that they would have done anything differently than any other Obama appointee: advance a hard Left agenda, and dissemble in the face of the current threat posed by Ebola.
Besides, Boris Lushniak the acting Surgeon General appears equally qualified to do whatever it is the Surgeon General might be expected to do in this situation. I don’t see that we’re losing anything by not having Vivek Murthy in the top spot.
@ Black Prince- Perhaps I wasn’t as clear as I could have been. When it comes to coercing individuals or groups, our government is far more willing to coerce citizens more than non-citizens and it coerces allies more than adversaries or enemies. (When it comes to wellbeing the order seems to be reversed.)
We still have a very limited number of appropriate hospital beds; the current level of infection in the U.S.A. has IUUC taken about a quarter of them so far though Ms. Pham’s bed has now opened up again, thank God. The nine months the DWB approach has been in effect has coincided with the outbreak being in the more horizontal part of the logarithmic growth curve, which it no longer is. It was also before the number of US personnel in WA increases significantly, which it’s about to. Even so, the DWB approach let one infected person loose in a major U.S. city.
Perhaps it was prudent. Is it still?
Here is the latest Obama Aides Criticize Quarantine Rules.
Likely be a different story if there was one degree of separation between an Ebola patient and a Sidwell Friends family.
I think it’s fantastic that the three states enacting automatic quarantines are the bluest of blue states.
If that’s not a refutation of the White House’s approach, I don’t know what is.
An analogy comes to mind. On the subject of voter ID laws, those who argue that there are some elderly, black, Democrats who don’t have ID cards, isn’t the humane and sensible solution to retain the ID requirement and do everything to get all those people an ID, so they can participate in normal life?
Similarly, isn’t the way to solve the joint problems of diseased Africans coming here and nervous volunteers going there for the government to ban commercial flights but at the same time guarantee
Yes.
Yes. To date no Americans have been infected by a returning H.C. professional. In addition HC pros from other countries have returned home without problems. I wish the politicians who are hyping this held themselves to half as high a standard.
To date, yes, as far as we know . . . But Dr. Craig Spencer behaved in an irresponsible fashion. So we will have to wait and see.
Chris Christie predicts that the protocols he introduced will soon be national policy. I suspect that he is right. There is, after all, an election a week from Tuesday.
But Obama is trying to pressure Christie and Cuomo to call the whole thing off. Fat chance. Cuomo owes Obama nothing and has kept his distance now for six years, and Christie has his eye on 2016. A confrontation with the President on such an issue is for both of these men a consummation devoutly to be wished.
In the sixties, (i.e., before the age of political correctness), when I transferred from a high school in New York to one in New Jersey, I had to be tested for TB because my grandfather had been ill with it around the WWI era.
We now have Latin American children, from countries where 3%-4% have TB, flooding our border, and Obama’s response has not been to test them for diseases, but to spread them around the country, making expulsion more difficult and the spread of disease more likely.
On top of that we have a politicized NDC that opposes a travel ban of visitors from nations with Ebola outbreaks, even though Britain, France, Saudi Arabia and 24 African countries have imposed bans.
He did not behave in an irresponsible fashion. Until he began running a low grade fever, the night prior to his admission, he was living with his fiancé. When his fever began he isolated himself. Do you really think he would put his fiancé at risk? He did not act as you, who have far less knowledge than the personnel with DWB has, would like; but he followed the DWB guidelines. Unless you have more expertise in this area than the medical professionals at DWB, who have been dealing responsibly with this disease for decades, you might want to consider the remote possibility their recommendations are more prudent than yours.
Yeah, right, he followed DWB guidelines. He no doubt followed DWB guidelines while in West Africa as well. But, gosh and golly, he came down with Ebola nonetheless. Now how could that happen if they really, really know all about Ebola?
Someone who is really responsible would presume that Doctors Without Borders might have underestimated the problem. I do, indeed, have far less knowledge than Dr. Spencer does. But I do know this. The medical professionals do not know very much about these matters. A slew of DWB personnel have come down with Ebola and died since this outbreak began. How, pray tell, did that happen? It is pretty obvious that one should be more careful than they were — which, liberal jim, is precisely what I have been urging. Sometimes it is a good idea not to trust those who claim expertise. They often know less than they want us to think they know.
Do you trust the climate scientists who tell us that the sky is falling . . . er . . . that there is a global warming crisis? Will you tell me, “You might want to consider the remote possibility their recommendations are more prudent than yours?” Perhaps you will.
When one errs, should one not err on the side of caution? Dr. Spencer did not do that.
If the DWB recommendations permit a person from an Ebola endemic area to go around New York City with symptoms of Ebola, maybe it’s time the DWB recommendations are re-evaluated.
In other news, according to the New York Times:
Two things that interest me about the statement
Does this mean Americans will be actually be protected, or merely reassured they are protected?
“Ready in days” awesome. How many hundreds of millions of dollars have we been spending for decades so that a policy about a problem we’ve known about for years, and that has been at the front of public debate for months can be ready days from now? How many days? “Days” is likely an Obama administration term of art for “when, but only if, the political pressure becomes unbearable.” Curious the policy which will be become “ready in days” only surfaced when governors of four states (as of this moment) decided to act independently.
Meanwhile according to CNN Nurse Hickox is complaining “To put me in prison is just inhumane” CNN also reports Hickox is in a tent, with no shower or flushable toilet. Not what she signed up for, but life happens. Tomorrow my son leaves for Liberia as part of the 101st Airborne’s mission to set up HQ command & for the military we’re deploying mainly so President Obama can pretend to be doing something. Odds are he’ll be in a tent and using porta potties for a lot longer than 27 days (no word right now on showers). Not what he signed up for either, but so far he’s doing it without complaint.
Put this in the memory file: When we have an epidemic of some infectious disease in the United States – this is a question of when and not if – let us remember the present debate about utility of quarantines and their possible untoward effects (hurting the economy, delivering aid, etc.) when it comes to applying them to non-citizens in other countries.
When it comes to quarantining cities, counties or states within the US itself, none of this will be considered relevant. Our esteemed government will do it to us, its
subjectscitizens without a second thought. Does anybody doubt this based on the overwhelming evidence of our government’s mounting willingness to coerce citizens?The bottom line is that Dems won’t defend America because they don’t believe she deserves to be defended. Thos of us who are skeptical of the sincerity of Libs wonder just how far this don’t do anything pose goes.
Would they support having immigrant kids with Enterovirus 68 in their own young children’s schools? When if their own kids get it it can paralyze them? If OK in the school, how about boarding a homeless immigrant kid with Enterovirus 68 in your own home? How about bunking in in your kid’s bedroom?
Cool with all that?
Didn’t think so. Liberalism is for thee, not for me.
But these people get away with getting into high office and taking an oath to the Consitution while their whole purpose of being in public life is to traduce the Constitution.
Libs are divorced from the human condition. They think America just happened and no matter how many roots they chop out, will continue to stand. The Democratic Party stands for destroying America.
Another suggestion. That the US set up central quarantine areas in one or more of the affected countries. All volunteer aid workers would enter and exit through those camps to control the flow to the United States. HHS, State and DOD to coordinate, and provide the transport. Those returning would be quarantined in the area for 30 days with no patient contact. During that time they could be used to educate and give advise to locals via telemedicine facilities, and instruct the incoming volunteers with the knowledge gained during their “tour of duty”. The last might help those aid workers who chaff at the quarantine as they could still be doing productive work. Nothing is foolproof, some people might still leak into the US, but the risk reduction would be tremendous.