Enhanced entry screening for the Ebola virus began at Washington-Dulles International Airport on Thursday, along with four other airports, in an attempt by the Centers for Disease Control to thwart the spread of Ebola into the United States.
University Professor Lawrence Gostin, who specializes in global health law, criticized the efficacy of the screenings on Minnesota Public Radio on Oct. 8. Gostin also directs the O’Neill Institute for National and Global Health Law and was the Founding O’Neill Chair in Global Health Law.
“I think that what the CDC has done for airport screening is reasonable and the most moderate they could have done. It’s well targeted, and I think it’s a very measured response,” Gostin told The Hoya. “But will it work? Probably not.”
Ebola screenings began at New York’s John F. Kennedy International Airport Saturday, and Chicago’s O’Hare International, Newark Liberty International and Atlanta’s Hartsfield-Jackson International joined them Thursday.
There have been eight cases of Ebola in the United States. Thomas Eric Duncan, the first reported Ebola patient in the United States, left Liberia on Sept. 19 on a Brussels Airline jet to Belgium. From there, he flew to Dulles International, and spent three hours there on a layover, before flying into Dallas. Duncan died Oct. 8.
“We work to continuously increase the safety of Americans,” CDC Director Tom Frieden said in a press release last Wednesday. “We believe these new measures will further protect the health of Americans, understanding that nothing we can do will get us to absolute zero risk until we end the Ebola epidemic in West Africa.”
These five airports account for over 94 percent of travellers from the Ebola-impacted countries of Liberia, Sierra Leone and Guinea. Travellers from the affected countries will be taken aside to a separate screening area, where trained staff from Customs and Border Patrol will check them for signs of sickness.
These travellers will also be questioned about any potential exposure to the virus, and any indication of Ebola-like symptoms or possible encounters with the disease will result in transfer to a quarantined area for further evaluation.
Gostin cited the historical failings of fever monitoring, particularly during the severe acute respiratory syndrome, or SARS, outbreak of 2002 to 2003, as precedent for the failure of screenings. The SARS outbreak started in southern China and spread to infect individuals in 37 other countries, including the United States. Hundreds of thousands of travellers were monitored and not a single SARS case was found.
He said that it is possible that symptoms resembling Ebola may result in false positives, wasting resources that could otherwise be used to combat the real threat.
“I’m afraid that this will distract a lot of resources and attention from the real problem,” Gostin said. “This could burden the CDC, as well as state and local health departments and emergency rooms.”
John Kraemer (LAW ’08), professor of health systems administration at Georgetown and a Scholar at the O’Neill Institute for National and Global Health Law, was also skeptical of airport screening.
“That sort of assessment will not catch every potential case. People will still be asymptomatic and in the incubation period at the time they go through screening,” he said.
In addition to screenings, House Republicans also called for a travel ban from West Africa in an Energy and Commerce Committee hearing on Ebola Thursday.
Gostin vigorously disagreed with a travel ban, arguing that it would prevent aid from reaching the affected countries.
“I think a travel ban would make us much more at risk. What it would do is exacerbate the epidemic in West Africa, and the more that that epidemic rages out of control, the more risk there is of international spread,” Gostin said.
Kraemer, who also opposed a travel ban, admitted that despite its potential inefficacies, airport screening was one of the best available options.
“A travel ban would be highly counterproductive, and something like biologic screening would be logistically very difficult,” he said. “Airport screening is essentially the best option available under the circumstances.”
Instead of focusing on prevention within the United States, Gostin said that it is essential that the government increase the scope of its response in West Africa, which he criticized as inadequate.
“The surest way to prevent cases in the United States is to root out infection at the source,” he said. “It’s been a very flawed and failed effort in West Africa.”
Kraemer echoed this sentiment, emphasizing the far more serious epidemic in Africa.
“Everybody should be allocating significantly more resources to control the outbreak in Liberia, Sierra Leone and Guinea,” he said. “In the United States, Ebola may kill a very small number of people. It is quickly becoming catastrophic in those countries.”
The much-publicized death of Thomas Eric Duncan at Presbyterian Hospital of Dallas, as well as the failure of the hospital to ensure the safety of staff and other patients, has led many to criticize the United States’ ability to handle Ebola. Most hospitals are ill-equipped for controlling the disease and are susceptible to breaches in protocol.
“Dallas exposed a soft underbelly of American vulnerability in our health system,” Gostin said. “We’ve cut our funding for the CDC, we’ve cut our funding for state and local health departments and we have enormous deficiency in our response capabilities.”
Despite this seemingly grim outlook, Kraemer said that Ebola does not pose a significant threat to the United States.
“The likelihood of significant community transmission is very small,” Kraemer said. “You don’t see significant outbreaks of Ebola anyplace that has a functioning health care system.”
