Will “Tightening The Borders” Keep Ebola Out?

New York's Bellevue Hospital Prepares For Possible Ebola Cases

Thomas Eric Duncan, the first Ebola patient diagnosed in the US, succumbed to the virus yesterday, as the Centers for Disease Control announced that five key airports would begin screening passengers arriving from Guinea, Liberia, and Sierra Leone for signs of illness. Amanda Taub outlines the new screening protocols:

According to the CDC, over 94 percent of travelers from those three affected countries enter the US through one of the five airports that will implement the screening measures: JFK in New York City, Newark, Washington-Dulles, Chicago-O’Hare, and Atlanta. JFK, which receives more than half of those passengers, will begin screening on Saturday, October 11. Travelers will be screened at the border, immediately after they go through passport control, in a special area of the airport. Customs and Border Protection officers will take passengers’ temperatures and ask them a series of questions about their health and possible Ebola exposure.

Passengers who do not have fevers or any history of exposure to Ebola will be given information about the virus and asked to complete a temperature monitoring chart at home. Those who do have fevers or who give answers that raise concerns about possible Ebola exposure will be referred to a CDC officer in the airport, and then to public health authorities if it is determined that further monitoring is necessary.

Jonathan Cohn expects that the main benefit of these screenings will be psychological:

Experts have generally been skeptical that increased screening would make a difference, in part because the new precautions rely on candor from foreign visitors. Remember, similar screenings already take place at the points of departure in West Africa. Duncan got out of Liberia by lying and stating that he’d had no contact with an Ebola patient.

But a secondary goal of the new steps is to calm the American psyche and there’s a case for that. If it takes some extra vigilance and a quick temperature check to make the American people feel safe, and if it doesn’t divert precious resources, it’s probably a price worth payingin much the same way that security theater in the airports, following September 11, made it possible for the flying public and eventually the rest of the public to return to some form of normalcy.

And Maryn McKenna argues that emergency rooms, not airports, are the spaces we should be worrying about:

Screening passengers for fever makes it look like someone is doing something. (It’s also a surprisingly active area of engineering research; check these post-SARS papers from 2005, 2006, 2009, 2013 and this year.) But as Duncan’s case demonstrated, the critical point for “border control” of Ebola may be not the airport, but the emergency room. We already know — have known for years, in fact — that our emergency-care system is underfunded, overstressed, and asked to bear a larger burden for the health of the mass public than either hospital or outpatient care do. It is very disappointing that Duncan’s travel history was ignored in his first encounter with Texas Presbyterian — but as Texas health journalist Laura Beil pointed out on Twitter yesterday, not even slightly surprising given the churn of uninsured patients through the state’s big ERs.

Jason Millman checks in with some ER doctors:

One ER doctor in Denver, Eric Lavonas, said there was no Ebola panic yet, while another in the Bronx, Dan Murphy, said several patients came in on Tuesday fearing they were infected. Sudip Bose, an ER physician working in Chicago and Texas, said he’s seen an increase in visits after an inbound flight scare in Dallas this week. Hamad Husainy, an ER physician in Alabama, said two people who were recently hired as “scribes” to document patient visits quit those jobs because they feared being exposed to Ebola.

New York-based physician Bob Glatter said he thinks people are still being reasonable about the extremely low risk of contracting the disease in the United States. However, he thinks Ebola fears may start to pick up after Duncan’s death on Wednesday and with flu season rapidly approaching.

Pointing to a series of polls suggesting that a significant number of Americans are worried that they or their loved ones might get the disease, Waldman comments on the hysteria:

We’ve had only one case in America, and while there may be a few more like him—people who went to a place where the disease was spreading and returned before becoming symptomatic, all while evading the precautions that were in place—it won’t be more than a few. You aren’t going to get it. But fear always wins. Fear sure wins on TV, where they’re actually asking questions like “Could the virus mutate and become airborne?” And we’re all hard-wired for fear, because fear is highly adaptive from an evolutionary standpoint. The australopithecine who’s terrified of every bump in the night is the one who survives to pass on his genes.

Meanwhile, the totally-not-a-race-baiter Rush Limbaugh is telling his listeners that Barack Obama wants to let white Americans get Ebola as revenge for slavery. So of course we can all stay rational.

Meanwhile, Spanish ebola patient Teresa Romero Ramos’s dog Excalibur was put down yesterday. Barbie Latza Nadeau reports:

Despite an online petition that garnered more than 400,000 signatures and half a million tweets to try to save the dog’s life, a campaign launched by Romero’s husband Javier Limón from his quarantined quarters in the Carlos III hospital, the dog was euthanized on Wednesday evening in the couple’s apartment in suburban Madrid. Armed guards kept animal rights activists shouting “assassins” at bay.  The dog, which was never tested for the Ebola virus, was put to sleep before being removed from the locked-down apartment.  The body will be incinerated at a medical waste plant in Madrid. According to Spanish press reports, the dog’s corpse will not be tested for the virus, so no one will ever know whether or not Excalibur had the lethal disease.

Marc Champion puzzles over the outcry to save Excalibur:

I don’t remember people clashing with police to persuade their governments to do more to help stop the spread of Ebola in Africa, where more than 3,400 human beings have died from the disease. Indeed, an online petition to persuade the U.S. government to fast-track research for an Ebola drug has so far received 152,534 signatures. By that measure, we care half as much about finding a cure for Ebola as saving a dog.

Either way, Amy Davidson points out, neither mercy for Excalibur nor security theater at airports addresses the actual problem:

If it takes a dog to remind people to not be senselessly fearful in the face of a disease—not to just smother everything that’s frightening—Excalibur will have a real legacy. But that’s only true if the perspective he opens is broad: we can’t just deal with Ebola by looking at dog pictures while trying to close airports and banish images of Africa. There’s another set of scenes, the ones that we have been looking away from for months, in West Africa, where children orphaned by Ebola are fending for themselves. In Sierra Leone, gravediggers have gone on strike; it’s dangerous work, and they say that they haven’t been paid.

(Photo: A member of Bellevue’s Hospital staff wears protective clothing during a demonstration on how they would receive a suspected Ebola patient on October 8, 2014 in New York City. By Spencer Platt/Getty Images)