What normal people can see and imagine is that three Ebola cases have severely stressed the system. Washington is scrambling, the Centers for Disease Control is embarrassed, local hospitals are rushing to learn protocols and get in all necessary equipment. Nurses groups and unions have been enraged, the public alarmed—and all this after only three cases…
How many people and professionals have been involved in the treatment, transport, tracking, monitoring, isolation and public-information aspects of the three people who became sick? Again, what if it were 300—could we fully track, treat and handle all those cases? If scores of people begin over the next few weeks going to hospital emergency rooms with Ebola, how many of their doctors, nurses, orderlies, office staffers, communications workers and technicians would continue to report to their jobs? All of them at first, then most of them. But as things became more ragged, pressured and dangerous, would they continue?…
Some critics, finally, say that a ban won’t work 100%. Let’s posit that. But if it works 78%, or 32%, isn’t it worth it?
The burden is on those who oppose a ban to make a hard, factual, coherent and concrete case. It is telling that so far they have not been able to.
The first step on a travel ban is to refuse entry to anyone from a nation with an active Ebola outbreak. This is easy to do. For people to travel internationally, they need passports. If they wish entry to the United States most must have an entry visa. There are a small number of countries whose citizens are allowed entry to the US without a visa. None of those countries are in Africa.
The next step is screening other passengers from the region both by questionnaire and by examination of passports for exit visas from affected countries.
Getting back to the case of Mr. Duncan. If a travel ban had been in effect his Liberian passport would have resulted in him not being able to board an aircraft from Monrovia in the first place as the plane would not have been flying to the US. If he had used an indirect route, his Liberian passport would have resulted in him being denied a boarding pass at any airport in the world. If,by some miracle, he did get on a flight, his Liberian passport would have resulted in him being turned back when he landed in the United States.
Will this catch 100% of the possibilities? No. But nothing will. I would submit stopping 1000+ people a week who are fleeing nations with an Ebola outbreak… and who possibly know they are infected and are seeking medical care in the US rather than in a hospital in Monrovia… is a positive start. It reduces the number of entrants. It slows their rate of travel so if they are infected they will be showing more symptoms. AND it cooperates with the international community.
CDC Director Tom Frieden has elaborated on this point. “Isolating countries won’t keep Ebola contained and away from American shores,” he said this week. “Paradoxically, it will increase the risk that Ebola will spread in those countries and to other countries.” Frieden’s point, echoed by the White House, is an important one. Sealing off West Africa, a region already drastically underprepared for this epidemic, would not only cut off lifesaving resources, but drive the epidemic underground. “People will move between countries, even when governments restrict travel and trade,” Frieden said this week. “And that kind of travel becomes almost impossible to track.”…
With hundreds of alternate routes, [Joshua Michaud] worries that some infected individuals would be sneak in through other countries or faking a visa to gain entry. “Making a full-out ban is driving people underground and if they truly want to get into the United States, they would find a way.”…
Natalie Eisenbarth, Policy & Advocacy Officer for the International Rescue Committee, says that if the goal is to protect the U.S., a travel ban is the worse possible decision. “It’s important to look at humanitarian and moral implications,” she says. “Stopping the spread of it in West Africa is in our best interest and that means getting the right people and the supplies in as fast as possible. The idea of issuing a travel ban runs against that.” On top of hindering the IRC’s ability to deliver supplies and essential medical equipment to the area; Eisenbarth says a travel ban would have a dramatic effect on people’s willingness to travel to these countries and help.
And if a travel ban were imposed, the help would be needed more than ever. The potential economic consequences that could arise from a travel ban on West Africa, says Eisenbarth, could be catastrophic. In addition to reducing trade, the ban would increase fear and suspicion of residents of this region, hindering the work of businesspeople, further sinking the economy. President of The World Bank Jim Yong Kim backed this up at a meeting of the European Union in Paris Friday. “I still don’t think the world has understood what the possible downside risk is,” said Kim. “Not just to the West African economy, but to the global economy.”
However, of the flights from West Africa to Europe and the Middle East, relatively few are from the worst-stricken countries. The flight from Monrovia to Brussels that Duncan boarded was the only transcontinental flight we could find from Liberia. There are flights to Brussels and London’s Gatwick Airport from Freetown, Sierra Leone, but flights to Paris and London-Heathrow have been suspended. Paris is the only non-African destination with a direct flight available from Conakry, Guinea, according to our search, although Turkish Airlines has announced plans to begin service to Istanbul from there soon.
In total, this represents just 18 weekly flights from Liberia, Guinea and Sierra Leone combined, nine of which are currently suspended or are not yet operating. Many of the passengers from these countries are probably connecting through busier airports like Lagos or Dakar before taking the next step on their journey.
Some of the proposals for a travel ban have suggested denying boarding to passengers on the basis of their nationality, rather than the specific route they’re flying. That might or might not be a wise thing to do, considering the epidemiological, economic and ethical implications. But for a ban to be even halfway effective, it would need to be much more sweeping than banning the handful of direct flights from West Africa to the United States. It seems unlikely that travel from Europe or the Middle East will be halted. But the next Ebola patient may be on a flight from London, not Liberia.
is his presidency in a petri dish. It’s an example already of his tendency to talk too loosely at the outset of things, so that his words come back to haunt him. There was the doctor you could keep under his health plan until, well, you couldn’t. There was the red line for Syria that he didn’t have to draw and later erased…
“If you were his parent, you’d want to shake him,” said one Democratic strategist, who questioned where Obama’s passion was and whether, even this deep into his presidency, he appreciated one of the office’s most vital functions: deploying language, bearing, symbols and ceremony to endow Americans with confidence in who’s leading them and in how they’re being led.
Right now in this country there’s a crisis of confidence, and of competence, and that’s the fertile ground in which the Ebola terror flowers. That’s the backdrop for whatever steps Obama and Frieden take from here. With the right ones, they can go a long way toward calming people who are anxious not just about Ebola but about America. I don’t even want to think about the wrong ones.
Likewise with Ebola: Of course you can find wild conspiracy theories, but the idea of a successful government cover-up — secret body bags, muzzled journalists — is basically laughable. Instead, the baseline anxiety is all about bureaucratic incompetence exacerbated by insouciance, with conservatives fearing that a liberal administration won’t be willing to go far enough — in terms of travel restrictions and quarantines — to effectively contain the disease’s spread.
Because plausible arguments have been offered for and against a travel ban, the administration’s actual response will be an interesting case study. As much as the authorities have fouled up so far, we’ve only had a few infections. If the White House continues to resist calls for more dramatic measures, and we manage to contain Ebola domestically, then the president and his appointees will look more competent and levelheaded than their critics — a result that’s all too rare these days.
But it would be welcome, and then some, to watch a competent strategy unfold that rendered that opinion obsolete.