Fear of Ebola is spreading faster than the disease, and the growing paranoia in the United States is fueling calls to impose a travel ban on people coming from the three West African nations hardest-hit by the outbreak: Liberia, Guinea and Sierra Leone.
In a politically tense climate, with the Nov. 4 elections weeks away, the issue is being supercharged by partisan considerations, with prominent Republicans calling for a ban, including John Boehner, the House speaker.
But public-health officials say a travel ban would be ineffective, difficult to implement, and would not entirely prevent people in Ebola-hit countries from entering the United States.
Ultimately, health specialists said, a ban would do more harm than good because it would isolate impoverished nations that are barely able to cope with the outbreak, and possibly cut them off from the international aid workers who provide critical help to contain the disease.
Officially, the Obama administration opposes such a ban, although President Obama said Thursday, “I don’t have a philosophical objection necessarily to a travel ban if that is the thing that is going to keep the American people safe.” But he added that he was following the advice of health experts who say that “a travel ban is less effective than the measures that we are currently instituting.”
Dr. Barry Bloom, a specialist in infectious diseases and public-health professor at Harvard University said: “If one takes the big-picture view, the most important thing that can be done to protect Americans from Ebola is controlling Ebola in West Africa.”
But Ebola evokes irrational fears — the disease is extremely infectious but also tremendously hard to catch — and authorities must tackle a public-health crisis as well as manage public confidence.
One person has died in the United States from Ebola — a Liberian who flew from Monrovia to Brussels and then to Dallas. Two nurses who helped treat him at Texas Health Presbyterian Hospital contracted the disease. More than 4,500 have died in West Africa, according to the World Health Organization.
Fears of contagion spiked after one of the nurses said she had been on a domestic flight the day before she was admitted with symptoms of Ebola. That prompted some schools in Texas and Ohio to close. Authorities have since asked that staff members involved in treating Michael Eric Duncan, the Liberian who died of Ebola, avoid public spaces.
Another hospital employee, a lab supervisor who may have had contact with specimens of the virus, was found to be aboard the Carnival Magic, a cruise ship currently in waters near Belize, the U.S. State Department said Friday.
The employee and her traveling partner, who were not named, were in voluntary isolation in a cabin aboard the ship and were reported by a physician onboard to be in good health, Roger Frizzell, a spokesman from Carnival said.
On Friday, Texas Republican Gov. Rick Perry reversed himself and endorsed a temporary ban on travel from the West African countries, joining the growing chorus of more than 70 lawmakers from both parties, including Sen. Ted Cruz, R-Texas, who want Congress to reconvene before the midterm elections to vote on a ban.
Denying entry to people from Liberia, Guinea, and Sierra Leone would not stop the spread of Ebola into the United States, said Aditya Bhattacharji, an analyst at the Eurasia Group, a global political risk consultancy firm. A ban, he noted, would be impossible to implement with 100 percent effectiveness.
What would happen with U.S. citizens visiting those countries and returning home, for instance? How about dual-nationals who don’t need a visa into the United States? How about other foreign nationals who visited West Africa?
Health quarantines have a long history, going back to the bubonic plague in Venice, said Dr. Howard Markel, a professor of pediatrics and communicable diseases at the University of Michigan. But in recent decades, even with diseases that are much more contagious than Ebola, travel bans have been rejected.
A travel ban was never adopted in the 2003 SARS outbreak, which started in Asia, although it affected about 8,000 people worldwide, killing 774 of them. In that case, the World Health Organization (WHO) issued a travel advisory, Markel said.
The closest the United States has come to a travel ban was barring entry to people with HIV or AIDS in a 1987 decision during the Reagan administration. That ban, which did not apply to specific countries, was lifted by Obama.
Bhattacharji, of Eurasia Group, pointed out that after the terrorist attacks of Sept. 11, 2001, all flights in the United States were grounded for days. That measure had an unexpected consequence: it delayed the flu season by two weeks. It was the only example he could point to where travel restrictions slowed the spread of a disease.
While the prevention and screening measures in place today are not perfect, they allow public officials to track down sick travelers and understand their travel pattern. A ban might lead people to hide their tracks, making it harder to find out who they met or where they came from.
There are no direct flights from Sierra Leone, Liberia and Guinea to the United States and only a handful of international flights to Europe.
People flying out of these countries are screened before they board a plane. Health workers check their temperature and look for visible signs of illness.
Public officials acknowledge that more cases of Ebola are inevitable in the U.S., but can be managed. Last week, the Obama administration said it would increase screening measures for travelers coming from West Africa at five airports, something European countries are already doing. The five are: Washington Dulles; Chicago O’Hare; Kennedy in New York; Newark Liberty in New Jersey and Hartsfield-Jackson in Atlanta.
The enhanced screening measures are in effect for passengers arriving from Liberia, Sierra Leone and Guinea and include temperature checks and detailed questioning on arrival.
Passengers at other points of entry will continue to be screened by customs agents, who examine travelers for visible signs of illness and distribute fact sheets to those who have traveled in West African nations affected by the outbreak. In addition, the Transportation Security Administration is providing guidance to airlines on how to identify passengers who are ill.
Some African countries, such as Ivory Coast, have curtailed access to people from neighboring Ebola-afflicted nations, and sharply limited cases of the virus.
Dr. Gerald Weissmann, research professor of medicine at NYU Langone Medical Center, said he favored a travel ban on “anyone coming from Ebola-infected areas,” as documented on their passports or visas.
“The objections are very humane and very lovely,” he said. “They consider quarantines medieval, and think there’s a touch of racism in this. It may be, but I wouldn’t care if Ebola came from Sweden.”
Airlines are working closely with the Center for Disease Control and Prevention and the U.S. Department of Homeland Security to mitigate risk to the traveling public and airline employees, as they have done in the past during SARS and swine-flu outbreaks, Jean Medina, a spokeswoman for Airlines For America, the trade group for major airlines, said in an email.
Flight attendants have been trained to observe passengers for several types of illnesses, she added.
“Once someone does appear to have symptoms, airlines have had the ability to directly connect with medical experts midflight to consult on whether there is an actual concern about Ebola. This includes connecting with the CDC emergency operations center.”
Ebola spreads through direct contact with patient’s bodily fluids, such as blood or vomit. Unlike the flu, which kills tens of thousands of people each year, there is no vaccine against Ebola and there is no cure for the disease. It also has a mortality rate of about 50 percent.
That said, the risk of catching Ebola is extremely low. There is no risk of transmission from people who have been exposed to the virus but are not yet showing symptoms. Bleach solutions can kill it. The best way to contain the spread of Ebola is to avoid direct contact with people who have been contaminated.
Material from the Los Angeles Times is included in this report.