Escatlating the Ebola fight
Currently, air travelers are screened for fever as they depart Liberia, Sierra Leone or Guinea. Under new measures announced Wednesday, they will undergo these additional procedures at five major U.S. airports, including Atlanta’s:
• Have their temperature taken
• Answer questions about their health and exposure history
• Be visually assessed for signs of illness
• If they show symptoms or possible exposure to Ebola, be separated and assessed further
Air travelers from Ebola-stricken countries in West Africa will be screened for fever and other signs of the virus at five major U.S. airports, including Atlanta’s, federal health officials said Wednesday.
The announcement came hours after the first person diagnosed with Ebola in the U.S., a traveler from Liberia, died in a Texas hospital. Several infectious disease experts noted that the new measures probably would not identify someone like Thomas Eric Duncan, who had no symptoms when he arrived, as a carrier of the disease.
Still, federal officials said the temperature screening of passengers from Liberia, Guinea and Sierra Leone, which will include questions about any symptoms and whom they have been in contact with, will strengthen the country’s defenses.
“We’re stepping up protection for people coming into this country and for Americans,” said Tom Frieden, director of the Atlanta-based Centers for Disease Control.
But even Frieden acknowledged that the new measures are not a foolproof barrier. “Until this outbreak is over in Africa, we cannot get the risk to zero,” he said.
Only about 150 people travel from the three affected countries to the U.S. each day, and the five designated airports handle virtually all of them.
The screenings will begin Saturday at New York’s JFK Airport, which handles almost half those travelers. Next week the screenings will commence at Hartsfield-Jackson International Airport, Washington Dulles Airport, Newark Liberty International Airport, and Chicago O’Hare Airport.
Hartsfield-Jackson officials applauded the additional precautions.
“With growing concern over the spread of the Ebola virus, we welcome the additional screening measures announced today by the White House and the CDC,” officials said in a written statement. “We will continue to monitor this situation as it develops and take every necessary precaution to stop the spread of this disease.”
Hartsfield-Jackson has no nonstop flights from Guinea, Liberia or Sierra Leone. However, passengers could be arriving from those nations via connecting flights.
Delta operates flights from Lagos, Nigeria to Atlanta, but the Ebola outbreak has been successfully contained in Nigeria, according to the CDC.
Delta Air Lines issued a statement Wednesday saying travelers through Hartsfield should expect “no significant or noticeable” disruption of service.
But independent airline consultant Robert W. Mann said international travelers should expect some delays. Moreover, he doesn’t see the screenings as being particularly effective.
“I just think it’s a terribly wasteful process, but it’s somebody’s knee-jerk reaction,” Mann said. “… the incubation period of this disease is in excess of two weeks.”
That means travelers may still have no indication of infection until later, potentially well after they leave the airport.
That was the case with Duncan, who reportedly did not fall ill until four days after he arrived in Dallas. He had been screened for Ebola before leaving Liberia — as all passengers are in the affected countries — and had reported having no contact with anyone suspected of being infected.
Liberian officials have accused him of lying; neighbors said he had helped helped transport a pregnant woman who was convulsing and vomiting blood to various medical facilities. But his family in the U.S. said he did not know that she had Ebola.
Officials in Dallas, where Duncan died, confirmed Wednesday that a sheriff’s deputy who had been in the apartment where Duncan stayed is being tested for Ebola after complaining of feeling ill. However, the CDC said that, given his symptoms, it is unlikely that he has Ebola.
At the five designated airports, workers will scan passengers from West Africa with a hand-held, non-contact thermometer and ask them a series of questions on their health and contact history. If concerns arise, the people will be isolated and, if necessary, taken to a local hospital for further observation and testing.
The new measures represent a significant escalation in the government’s response. Last week,the CDC’s Frieden questioned the wisdom of temperature screening at U.S. airports, saying it would create a great number of “false positives,” flagging people feverish because of other illnesses. He also raised the prospect that it could slow down travel.
But pressure has been building for stronger measures, and President Obama indicated Monday his desire to increase screenings.
Ebola has become a hot campaign issue, with some Republican leaders and candidates arguing the U.S. should close its borders to people from West Africa. On Friday, the GOP-led House Committee on Homeland Security will hold a hearing at the Dallas airport on the nation’s Ebola response.
The revelation that Duncan entered the country through that airport while infected lent credibility to claims that the response has been inadequate. With Ebola threatening to join the botched Obamacare rollout and the rise of ISIL in the GOP’s roster of supposed presidential failures, the political pressure was intense, said Emory political scientist Andra Gillespie.
“The Obama administration is trying to be pre-emptive and minimize the criticism that they have mismanaged the crisis,” Gillespie said.
But that doesn’t mean the move is purely political, she said. It may serve a valid policy purpose if it merely allays the public’s spiraling fears, she said. And it may actually prevent someone infected with Ebola from entering the country and exposing dozens of people, as Duncan did.
“It’s another ounce of prevention,” she said.
Obama praised the new safety strategy.
“It will give us the ability to isolate, evaluate and monitor travelers as needed,” he said during a conference call with state and local officials. “And we’ll be able to collect any contact information that’s necessary.”
Some infectious disease researchers were skeptical, however.
“It’s really nice to see that the CDC epidemiologists are thinking about this, but there aren’t any magic ways to solve this,” said Dr. Frederick Murphy, a former CDC infectious disease researcher who in 1976 was among the first researchers in the world to help identify the Ebola virus.
Murphy is now a professor of pathology at the University of Texas Medical Branch in Galveston. He said that some studies have suggested that while fever is among the first symptoms to manifest in someone who has been exposed to Ebola, other symptoms such as stomach cramps and headache might show up first.
“If 100 percent of people are coming down with the fever first, then this model” might be effective, Murphy said.
But if the person has other symptoms not picked up by a thermometer, or the person is asymptomatic, then temperature screenings have limited use, he said. On the other hand, a fever can mean a host of things, particularly at this time of year, he said.
“We’re coming into flu season so people who have fever will show up on planes,” Murphy said.
And yet, he said, without the existence of a test that could instantly detect the virus in a person without symptoms, the new screening measures are for now the best option.
“What else could you do?” Murphy said. “If you don’t like that, have you got a better idea?”
As for questionnaires about travel history and possible exposure to Ebola, those measures are only as helpful as a passenger’s answers are truthful, said Dr. Pritish Tosh, an infectious disease physician and researcher with the Mayo Clinic.
Nevertheless, he said, “if we identify somebody early and prevent the transmission of Ebola, you don’t need to find too many of these in order for this new system to pay off.”
Ultimately, though, “to stop imported cases to the United States, we must first stop the outbreak in West Africa,” said Tosh. “That’s where most of our resources should be going right now.”
