In his campaign to unseat Senator Mark Udall, Republican challenger Cory Gardner has called for a travel ban from the West African countries hit hardest by the recent Ebola outbreak. In doing so, he’s ignoring a strong consensus among public health experts on how best to deal with outbreaks of this kind.
A press release on the congressman’s website quotes him as saying, “A travel ban would help contain the virus and prevent it from being introduced in new places, as we’ve already seen happen in the United States.”
However, several studies on the subject indicate that this strategy would be ineffective, and potentially counterproductive.
“For every complex problem, there’s a solution that’s quick, simple, and wrong,” wrote Tom Frieden, Director of the Centers for Disease Control and Prevention, in an op-ed for FoxNews.com. “A travel ban is not the right answer.”
Frieden summarizes the current consensus among public health experts in the piece, arguing that a travel ban would hinder U.S. health officials’ ability to track and monitor potentially infected individuals, and hurt efforts to stop the virus’ spread at its source in Guinea, Sierra Leone, and Liberia. Instead, the C.D.C. has instituted a screening process for incoming travelers from the region, allowing health officials to identify, track, monitor, and, in some cases, isolate at-risk individuals.
Dr. Joseph Amon, an epidemiologist and Director of the Health and Human Rights Division at Human Rights Watch, agrees with the C.D.C.’s current strategy.
“A travel ban is not an effective approach,” he said in an interview with CU News Corps. “There is a clear scientific consensus on the issue of travel restrictions for Ebola.”
Amon was the lead author of a 2008 study on travel restrictions implemented by more than 60 countries in the wake of the HIV/AIDS epidemic. HIV is a useful comparison because, like Ebola, it is not airborne and spreads primarily through bodily fluids.
The researchers found that travel restrictions did not protect public health, and negatively impacted HIV prevention and treatment efforts. “Governments should repeal these laws and policies, and instead devote legislative attention and national resources to comprehensive HIV prevention, care, and treatment programmes serving citizens and non-citizens alike,” they recommended.
Even before Amon’s study, a 1989 review concluded, “The rapidity and extent of HIV spread in any country is primarily determined not by HIV-infected travellers but by the risk-producing activities of its citizens, regardless of whether HIV is introduced by foreign travellers or returning nationals.” The authors found travel restrictions to be “inherently, and often by design, ineffective, impractical, costly, harmful, and may be discriminatory.”
“Banning everyone who has been in a country with Ebola is far too broad and indiscriminate,” said Amon. He believes that such travel restrictions could trigger backlashes from other countries, and points out that ebola-free Rwanda is now screening American travelers for the disease. Amon also worries that travel restrictions could prevent American health workers from returning to the U.S., hurting efforts to stop Ebola in West Africa.
“The question for Ebola really isn’t, will travel restrictions prevent people who are infectious from traveling?” said Amon. “It is, what is the cost of restricting all travel from these countries in order to limit the small number of people who may eventually be infectious but who are currently asymptomatic?”
The current best practice for stemming outbreaks of this kind is called “contact-tracing,” and has been credited as the biggest factor in Nigeria and Senegal’s successful campaigns to stop the virus’ spread. Both countries were recently declared Ebola-free by the World Health Organization, yet neither implemented a travel ban. This allowed health officials to track and monitor incoming travelers from Sierra Leone, Guinea, and Liberia. When a case is found, health officials identify individuals that had contact with the infected individual, monitoring, and sometimes isolating, them until they have been asymptomatic for 21 days. The same practice is being used in Dallas, Texas, where 51 people who had contact with Ebola victim Thomas Eric Duncan were recently cleared.
“We know how to stop Ebola: by isolating and treating patients, tracing and monitoring their contacts, and breaking the chains of transmission,” wrote Frieden in his FoxNews.com op-ed.
While Gardner’s intentions may be good, his claim that a travel ban would help contain the virus and prevent it from being introduced in new places is misleading, and in clear contrast with the scientific consensus on the issue.
“It’s as if you were in a burning house, in your room, and you start putting wet towels under the door to keep the smoke from coming in,” World Bank President Jim Kim told reporters earlier this month. “That is not an effective strategy. We’ve got to get back to putting out the fire.”
Outbreak Distribution Map: Centers for Disease Control and Prevention