Isolating individuals suspected of having Ebola is a cornerstone of efforts to stop its spread. But does that mean the world should try to isolate the nations where the epidemic is raging by banning travelers from those nations?
Many, if not most, Americans want that to happen. A number of politicians, especially in the Republican ranks, are sounding the call. And even a few of those directly involved in the battle to stop Ebola say the U.S. should temporarily bar travelers from Liberia, Sierra Leone and Guinea.
“Banning air travel until the world gets control of this outbreak, that’s got to be policy or the virus will spread around the world,” said Kipp Branch, director of the medicines program at MAP International. MAP is a Brunswick, Ga. nonprofit that has sent $12 million worth of protective suits and medical supplies to West Africa.
“You have to isolate it. You can’t isolate it with people coming in and out,” Branch said.
But the vast majority of federal health officials, public health experts and relief agencies say a travel ban will make matters worse, impeding efforts to control the outbreak. They say such restrictions could easily backfire, destabilizing the affected countries, sending infected people underground and raising the risk that they will find other ways to get into the U.S.
“A full-on travel ban is a bad idea,” said Dr. Martin Cetron, director of the Division on Global Migration and Quarantine at the Centers for Disease Control. “The series of cascading, unintended negative consequences would likely make matters worse.
“(Air travel) is not just the humanitarian bridge for responders and supplies that’s needed to fight the epidemic,” Cetron said. “It’s critical to prevent the economic and social collapse of affected countries, which could drive a mass exodus and refugee-style migration emergency.”
Ebola is very deadly but not very communicable. It is transmitted only through contact with the blood, vomit or other bodily fluid of a person who is infected and already showing symptoms.
But those often-repeated facts don’t appear to have calmed the fears of many Americans. In a recent NBC online survey, 58 percent of respondents said they want a ban on incoming flights from Ebola-stricken countries. Twenty percent opposed it, and the rest said they didn’t know.
Calls for a ban escalated following the death on Wednesday of the first person diagnosed with the disease in the U.S. The death of Thomas Eric Duncan, an airline passenger from Liberia, underlined the limitations of airport screening measures as well as the current treatments for the illness.
“They really need to prevent anyone from entering the country who’s been in an Ebola-affected region in the last three weeks,” said Christopher Estep on The AJC Facebook page.
Atlanta is an important player in the battle to protect the country against Ebola. The Atlanta-based CDC has deployed teams to the affected region, and Hartsfield-Jackson International Airport is among five major airports nationally that will begin taking the temperature of arriving passengers from the three West African nations.
Nonetheless, CDC Director Tom Frieden said his agency continues to oppose a travel ban.
“The problem with that approach is that it makes it extremely difficult to respond to the outbreak. It makes it hard to get health workers in because they can’t get out,” Frieden said. “If we make it harder to respond to the outbreak in West Africa, it will spread not only in those three countries but to other parts of Africa, and will ultimately increase the risk here.”
The Liberian ambassador to the United States, Jeremiah Sulunteh, said cutting off air travel would stigmatize his country, which had just begun to rebound from years of civil war. Also, he said it’s a breach of international protocol.
“The United Nations says, ‘Free movement of people’ (between countries). Help us to contain the spread, but do not isolate us,”Sulunteh told The Atlanta Journal-Constitution last week during a visit to the Carter Center.
At the same Atlanta event, the ambassador from Sierra Leone, Bockari Kortu Stevens, said travel restrictions are not the answer.
“You can stop the flights, but you can’t stop the people from coming, because people will find a way out,” Stevens said. “Even if you say, ‘Close the borders,’ people know back roads and ways to get out of the country. And remember, some have dual and even triple nationality and passports. I have two passports. There’s no way you can isolate yourself.”
If travel restrictions were in place, travelers who felt ill might be less apt to report their symptoms, said Stephen S. Morse, a Columbia University epidemiology professor.
“Once you drive it underground, it’s harder to find people,” Morse said. “It’s like the war on drugs. And look how that has gone.”
Some airlines have already discontinued or limited flights to the affected countries. Atlanta-based Delta Air Lines has stopped flying from New York to Monrovia, Liberia. British Airways, Air France and Kenya Airways have also cut flights.
Tim Shenk of the nonprofit relief group Doctors Without Borders said the scarcity of flights has already hampered relief efforts. The group has 240 international staff in West Africa.
“We need the flights to operate. That’s the bottom line,” Shenk said.
Even if ban could be effective, carrying it out would be complicated, air travel experts say. No U.S. airlines fly nonstop to or from Guinea, Sierra Leone or Liberia.
But in a globally-connected world, travelers often get to the United States by traveling through other countries. From Monrovia, a typical itinerary might take a passenger through Brussels, Paris and Washington en route to Atlanta.
U.S. Customs and Border Protection has already begun singling out passengers whose travels originated in Guinea, Liberia or Sierra Leone. They have been given given Ebola information leaflets.
Banning travel from Ebola-stricken countries would keep many people out, but some would evade it, said George Hamlin of Hamlin Transportation Consulting. “I think you could reduce the volume considerably, but people who really want to evade it probably will work pretty hard to find a way,” he said.
Nevertheless, the pressure for a travel ban persists in political circles, with several prominent Republicans and a few Democrats calling for one.
Rep. Kenny Marchant, a Texas Republican whose district includes the airport where Duncan landed, wants an immediate ban on passengers traveling from Liberia to the U.S. who are not American citizens.
“Prohibiting travel to the United States for individuals traveling from or through Liberia would greatly reduce the risk to the public,” Marchant said in a letter to House Speaker John Boehner.
Proponents of a travel ban acknowledge it may not provide airtight protection, and that some exceptions are needed. Branch, of the Georgia-based nonprofit, said emergency workers, medicine and other relief supplies would still need to get through.
He acknowledged that restrictions on air travel could double his company’s cost of sending relief supplies to Africa, but he’s willing to bear that price.
The U.S. can’t carry out a an effective ban alone, he added. Other countries would have to get on board to prevent an Ebola-infected person from hopscotching from one country to another to the U.S., he said.
“It’s going to take the world standing up and making that decision,” he said.
But some Liberians living in metro Atlanta wonder why previous epidemics in other parts of the globe haven’t sparked similar declarations.
Leo Mulbah, president of the Liberian Association of Metropolitan Atlanta, has lost members of his family in Liberia to Ebola.
“With Mad Cow disease (in Great Britain), you didn’t restrict travel; when you had bird flu in China you didn’t restrict travel, so why now?” Mulbah said. “Is it because we don’t have the economic clout and the political clout and we keep begging and begging for help? Are we not part of the community of nations?”
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