Public health and the hypocrisy of travel restrictions : The Ebola experience
Most countries implemented rules over the last 2 years of the pandemic to try to safeguard their population from COVID. The unelected public health intelligentsia that has been issuing marching orders since early 2020 has moved largely in lockstep around the globe. It’s worthwhile noting how completely different the current position of the public health community was prior to the coronavirus pandemic when it came to travel restrictions.
Consider what the response by the medical establishment was in 2014, when a US physician traveled back from treating patients with Ebola in Africa (a fearsome viral disease that has a 50% mortality), and subsequently fell ill with Ebola. The doctor reported being asymptomatic and walking the streets of New York for days prior to being admitted to the hospital. In response to this case, the governors of New York and New Jersey quickly enacted strict home quarantine rules. Dr. Craig Spencer, the physician who became ill from Ebola and survived took to the hallowed pages of the New England Journal of Medicine oped pages to respond. (Emphasis added)
The governors of New York and New Jersey, followed by others, enacted strict home quarantine rules without sufficiently considering the unintended side effects. The threat of quarantine may cause sick people to defer seeking treatment, and both nationals of affected countries and health care responders returning from those countries may alter their travel plans or misreport their exposure to avoid quarantine. Implementing restrictions that don't accord with the recommendations of the Centers for Disease Control and Prevention4 also undermines and erodes confidence in our ability to respond cohesively to public health crises. At times of threat to our public health, we need one pragmatic response, not 50 viewpoints that shift with the proximity of the next election. Moreover, if the U.S. public policy response undermined efforts to send more volunteers to West Africa, and thus allowed the outbreak to continue longer than it might have, we would all be culpable.
When Rick Perry, Republican governor of the state of Texas at the time, and Speaker John Boehner, Republican leader of the House called on then President Obama to institute a federal travel ban from countries with Ebola outbreaks, the response was swift. The CDC left open the possibility of travel restrictions, but felt restrictions would not “enhance our ability to stop the pandemic”
While the Centers for Disease Control and Prevention says it remains open to all effective options that will make Americans safer, "we can't have anything happening right now that slows our ability to stop the epidemic," CDC spokesman Tom Skinner said. "When some commercial flights stop going into those countries, our people are delayed going in, our people are delayed going out," Skinner said. "When we stop commercial flights in and out of the country, it does not enhance our ability to stop the epidemic."
The White House touted enhanced screening that was in place at airports, and noted that infectious disease experts they were consulting with informed them travel restrictions would be counter productive.
"Now, if we were to put in place a travel ban or a visa ban, it would provide a direct incentive for individuals seeking to travel to the United States to go underground and to seek to evade this screening and to not be candid about their travel history in order to enter the country," he said. "And that means it would be much harder for us to keep tabs on these individuals and make sure that they get the screening that's needed to protect them and to protect, more importantly, the American public."
The comments from Harvard epidemiologist John Brownstein are the most startling to read in 2022.
"You're not preventing the movement of the population anyway," said Harvard epidemologist John Brownstein. "Many of these countries have very porous borders."
And there's no evidence that travel bans have any lasting effect, he said. Brownstein co-authored a study that found that the airport closures in the eastern U.S. after 9/11 did delay the onset of flu that year, but only by two weeks.
"Ultimately these pathogens find their way around the globe," said Brownstein.
Brownstein, the Harvard epidemiologist, noted that there was no hope of stopping the Flu. Yet the entire public health establishment pivoted to stop the spread of a virus that is likely much more infectious than the flu. Nothing was off limits. They shut down the entire economy, destroyed mainstreet, kept schools closed for months, and even came up with a mask policy for toddlers in schools.
It’s hard not to unsee what obviously happened to the public health community with the arrival of the coronavirus in 2020 to US shores. Its easy to talk about appropriate policies when the people taking risks are in far-removed places across the globe. Apparently, when there’s a real possibility of contracting a novel virus at your local Starbucks, the policy position of the public health elite isn’t based on evidence or common-sense, it’s based on pure unadulterated fear. Instead of the measured, experienced voices that we needed in 2020 to quell panic, we were treated to public health leaders that were either scared, or hungry for power who abandoned their principles to amplify the panic with disastrous consequences. Whether it was playing politics or rank incompetence, it is unforgivable.
Anish Koka is a Cardiologist. Follow him on twitter @anish_koka