Kudos to Governors Christi and Cuomo

Ebola Containment:  Lessons Learned and Lessons Ignored

Opponents to an airplane ban from the epidemic area and a 21-day pre-boarding quarantine cite the natural experiment when all air travel was barred following the 9/11 terror attacks and conclude that this experiment proves that a travel ban would fail.  As quoted in VOX Sunday October 26, 2014, “The weeks following 9/11, when people stopped getting on planes, provided influenza researchers with a natural experiment in what a travel ban might do to viral spread. They found it didn't stop influenza from moving, it only delayed flu season by a couple of weeks” and concluded that this proves that a travel ban would fail.  Opponents to a travel ban are grasping at intellectual straws to support their position.  This is a great example of poor thinking, since in fact this natural experiment provided great evidence that a ban would work and protect our citizens.  The air travel ban following 9/11 lasted 2-3 weeks, and the flu was delayed 2-3 weeks it would seem to most thinking persons that if the ban had been for longer, the flu would have been delayed longer—no??  This is not rocket science—simply common sense. 

Another misguided person was interviewed yesterday and said words to the effect that our number one priority is to facilitate medical persons travelling to and from the epidemic.  Given that this person represented the N.Y. Nurses Association this is a huge irony.  Our number one priority is to protect the people in the United States.  Given that all of the U.S. infections occurred in nurses attending a person who flew from the epidemic to Dallas, it would seem to most thinking persons that banning travel from the epidemic would be looking out for American nurses as well as non-healthcare workers! 

I am not advocating banning all travel to and from the epidemic regions, simply, when a person wants to return from the epidemic region they must be quarantined for 21 days in Africa.  After the 21 days and a negative Ebola test they can be allowed to board a plan for the U.S.  Yes, this adds 3 weeks to the burden of health care workers returning from the epidemic, but for national security it is a small and reasonable step to be taken.

The 21-day in-country quarantine must be supervised by our medical teams i.e. CDC and enforced by our military.  We have seen that even a physician can be irresponsible in this matter.  Dr. Craig Spencer treated Ebola patients and flew back to the U.S. without any in-country quarantine.  Once arriving in New York City he lived a normal life, travelled on the subway, went to a bowling ally and had close contact with several persons.  Then after a week of potentially spreading the virus he came down with a fever and was admitted to Belleview Hospital with Ebola.  Several weeks earlier Dr. Nancy Schneider, a news health person, went to the epidemic region, was around many Ebola patients, and told the world that she would self-quarantine when she returned to New Jersey.  Dr. Schneider was caught driving around long before her self-imposed 21-day quarantine was over.  Bottom line--we can’t necessarily trust physicians who should certainly know better to act responsibly.  Furthermore if we can’t trust physicians who have seen and known the horror of the Ebola infection, trusting simple questioning of passengers seems fool hardy at best and dangerously ignorant at worst.

Why don't our political leaders act?  We have been very lucky so far and hopefully we will have a run of good luck, but is this anyway to run a government?  Obama, Biden, Boehner, Senators and Congressmen/Women, why don't you do the only responsible thing and act decisively to protect us?

Kudos to Governors Christi and Cuomo more about these two courageous leaders in my next blog!

Steven Keller, Ph.D.

Professor New Jersey Medical School-Rutgers