Should the U.S limit travel to protect Americans from Ebola?

Fears about the spread of the deadly Ebola virus have led many Americans to push for closing the country’s borders to travelers from West Africa, ground zero of the outbreak.

U.S. House Republicans are demanding that President Barack Obama impose new travel restrictions, a step the president continues to resist. Obama said yesterday that “a flat-out travel ban is not the way to go” because current screening measures at airports are sufficient.

Politicians continue to weigh in — as midterm elections loom in November — with Republicans criticizing the administration’s response to Ebola and Democrats aiming to shore up public confidence in the nation’s ability to prevent an outbreak here at home.

Health officials continue to stress that the risk in the U.S. remains very low.

U.S. Sen. Susan Collins sent a letter to the president calling for stronger action against Ebola, including restricting travel to the U.S. from most affected countries to essential personnel such as health care and aid workers.

U.S. Sen. Angus King said in a statement that a blanket ban would hamper aid workers’ efforts to combat the epidemic and encourage people to leave their countries by untraceable methods. He left the door open to reconsidering travel restrictions for tourists traveling from affected countries.

Rep. Mike Michaud argued a travel ban would prove ineffective unless every country participated, urging Obama to press the World Health Organization to require screenings at all international points of arrival across the globe. 

Health experts fiercely debate whether a travel ban would limit the outbreak’s spread beyond Guinea, Liberia and Sierra Leone, where more than 4,000 people have died from the virus.

Dr. August Valenti, an infectious disease specialist at Maine Medical Center in Portland, thinks a limited travel ban makes sense. He doesn’t favor banning all travel, which would prevent health care workers from reaching Ebola-stricken patients, he told me on Monday.

“If I were the head of the CDC, I would have recommended that to the president right off the bat,” he said, speaking of his personal opinion and not on behalf of the hospital. “Let’s limit exposures in the United States, let’s restrict visas, let’s let only healthcare people in there, and let’s get control of it that way.”

Maine Med grabbed the Ebola spotlight earlier this week, after confirming that the hospital isolated a patient at low risk of infection at the request of state and federal health officials. The patient had a fever and reported recent travel to a “region of concern,” but multiple tests confirmed the patient was not infected with the virus.

Maine has not had any confirmed cases of the disease.

Meanwhile, about 150 people a day are traveling in and out of West Africa, Valenti said.

“To let people electively go back and forth into West Africa I think is a mistake,” he said.

The key to stopping Ebola in its tracks is focusing public health resources at the heart of the outbreak, Valenti said.

“We should bring our fight to where the epidemic is. In other words bring the fight to the fire  … You don’t want even a spark here and now we’ve had a spark,” he said.

Valenti’s well aware that plenty of reputable infectious disease experts disagree with him.

Their reasons are well summarized in this Vox article, which explains that travel bans are more about easing the public’s fears than securing public health. U.S. CDC Director Tom Frieden has noted that even if the government restricts travel, determined individuals will still find a way to cross borders, but we’ll have no way to track their movements.

Even closing the borders with exceptions for health care and aid workers poses problems, the Vox article states. “Responses to humanitarian crises are not well-organized affairs. They’re chaos. A bureaucratic regime that systematically screens who can go in and out of affected countries would only slow down or make impossible the much-needed relief.”








There are three reasons why it’s a crazy idea. The first is that it just won’t work. In CDC Director Tom Freiden’s words, “Even when governments restrict travel and trade, people in affected countries still find a way to move and it is even harder to track them systematically.” In other words, determined people will find a way to cross borders anyway, but unlike at airports, we can’t track their movements.

The second is that it would actually make stopping the outbreak in West Africa more difficult. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said, “To completely seal off and don’t let planes in or out of the West African countries involved, then you could paradoxically make things much worse in the sense that you can’t get supplies in, you can’t get help in, you can’t get the kinds of things in there that we need to contain the epidemic.” 

Some have suggested a half-measure: close borders allowing exceptions for doctors, aid workers, and medical supplies only. The problem with this idea is that responses to humanitarian crises are not well-organized affairs. They’re chaos. A bureaucratic regime that systematically screens who can go in and out of affected countries would only slow down or make impossible the much-needed relief. Plus, many aid workers — like reserve staff for Doctors Without Borders — would be responsible for booking their own tickets to get to the affected region. How would they do this then? And how long would it take to get them over there? 

The third reason closing borders is nuts is that it will devastate the economies of West Africa and further destroy the limited health systems there. The World Bank already estimates this outbreak could cost West African economies up to $33 billion. That’s a lot for any country, but especially when you’re talking about some of the world’s poorest. World Health Organization director Margaret Chan reminded us that 90 percent of any outbreak’s economic costs “come from irrational and disorganized efforts of the public to avoid infection.”


Jackie Farwell

About Jackie Farwell

I'm the health editor for the Bangor Daily News, a Bangor native, a UMaine grad, and a weekend crossword warrior. I never get sick of writing about Maine people, geeking out over health care data, and finding new ways to help you stay well. I live in Gorham with my husband Nick and our hound dog Riley.