Banning Air Travel Is The Wrong Response To The Ebola Outbreak

Closing down international air travel won't stop Ebola from becoming a bigger public health threat.

Ebola Virus

The revelation earlier this week that the first patient to be diagnosed with Ebola in the United States is now being treated at a Dallas area hospital has, understandably, raised public concern about the disease and whether this is just the tip of the iceberg with a disease that, because of its symptoms and fatality rate, cause a great deal of fear among the general public. Given that the patient in question, Thomas Eric Duncan, traveled to the United States by air from Liberia, with stops in Brussels and at Dulles Airport before arriving in Dallas, there has been some question raised over whether or not people who travel internationally from nations like Liberia are being properly screened, or even if they should be allowed to travel at all while this outbreak is still an issue. Some politicians, such as Ted Cruz and Rand Paul have already begun raising these concerns, with Paul going so far as to suggest that flights from Ebola stricken countries be halted until the outbreak is controlled. The White House meanwhile has said that there are no plans to impose such a ban, in no small part because Ebola is only contagious when people are symptomatic, so it should be relatively easy to quarantine people who pose a danger to travelers. This has led some on the right to draw utterly false analogies between this situation and the decision during this summer’s Gaza War to suspend flights to Israel due to the threat of Hamas rocket attacks on aircraft, a suspension that lasted for only a very short period of time.

On some level, of course, banning flights from the nations affected by Ebola seems like it might be a good idea. After all, it would seem to be the best way to make absolutely sure that the disease doesn’t spread beyond the nations where it is running rampant. As The Washington Post’s Abby Philip notes, however, such a blanket ban would be an extreme overreaction and would potentially do great harm to stopping Ebola at its source, which is the real key to stopping the disease:

Ebola can only be contracted through direct contact with a sick person’s bodily fluids. That means saliva, feces, urine, blood, vomit or semen. It isn’t transmitted through the air, so you are more likely to catch a cold on a flight than Ebola.

“It is not an optimal measure for controlling the import of Ebola virus disease,” said chief United Nations spokesperson Stephane Dujarric. “The measure does not reflect what is known about the way in which the virus passes between people.”

The U.S. has similarly spurned travel restrictions in the face of a more infectious, though less deadly, disease like Middle East Respiratory Syndrome (MERS) for similar reasons, even when sick passengers were coming to the U.S.

The State Department has warned U.S. citizens against non-essential travel to Liberia and Sierra Leone, but there are currently no plans to alter the travel warning in the wake of diagnosis, a State Department official told The Post on Wednesday.

The screening procedures at the airport in Monrovia, the Liberian capital, have been in place for months, Deborah R. Malac, the U.S. ambassador to Liberia, told The Post in a telephone interview Thursday. The CDC’s Division of Global Migration and Quarantine has worked with airport officials on screening protocols, and, Malac said, CDC officials “have confidence that everything that was supposed to have been done was done.”

If someone isn’t exhibiting symptoms of Ebola, that person is not infectious. And one of the first symptoms of Ebola is a fever. In airports in all of the affected regions and across the world, passengers coming from flights from West Africa are being screened for elevated temperatures.

If a passenger is sick or has a fever, they won’t fly. According to the CDC, “a U.S. Department of Transportation rule permits airlines to deny boarding to air travelers with serious contagious diseases that could spread during flight, including travelers with possible Ebola symptoms. This rule applies to all flights of U.S. airlines, and to direct flights (no change of planes) to or from the United States by foreign airlines.

Despite the fact that an infected passenger flew from Liberia to Dallas this month, that passenger, Duncan, was not sick — and was therefore not contagious — while he was traveling. And once people become symptomatic, they become very sick, very quickly.

In this case, it is unlikely that a sick person could go 10 days without seeking medical care, CDC Director Tom Frieden said on Tuesday.

“At this point, there is zero risk of transmission on the flight,” Frieden said. “The illness of Ebola would not have gone on for 10 days before diagnosis. He was checked for fever before getting on the flight, and there’s no reason to think that anyone on the flight that he was on would be at risk.”

This morning, the head of the CDC rejected the idea of a travel ban, arguing that it would ultimately make the rest of the world worse off:

Tom Frieden, director of the Centers for Disease Control and Prevention, on Friday said restricting travel between the U.S. and West Africa would likely “backfire” and put Americans more at risk of contracting Ebola.

Appearing on MSNBC, Frieden was asked about potentially prohibiting air travel between the U.S. and West Africa, where the Ebola outbreak is most widespread. He said that such a restriction would likely be ineffective and would make it harder for health officials to root out the virus.

“The only way we’re going to get to zero risk is by stopping the outbreak at the source” in West Africa, Frieden said.

“Even if we tried to close the border, it wouldn’t work,” the top health official added. “People have a right to return. People transiting through could come in. And it would backfire, because by isolating these countries, it’ll make it harder to help them, it will spread more there and we’d be more likely to be exposed here.”

In other words, the best way to prevent the spread of Ebola beyond west Africa isn’t to ban travel, but to screen the passengers that do travel as best as possible to determine if the are exhibiting symptoms, which would be rather obvious given how the disease manifests itself, or if they are at the point where they are beginning to become symptomatic, which apparently usually manifests itself as a fever. This is important because people become contagious when they are actually exhibiting symptoms, and not before then. Additionally, there is at least some effort being made at the international airports in these areas to screen people further by asking them whether they have been in contact with people who did or may have been exhibiting Ebola symptoms or if they came from an area where the disease is known to be at pandemic levels. The proper protocol is supposed to be that these people would be at least initially prevented from traveling abroad until they could be examined further, and perhaps even quarantined until the time when symptoms would appear has passed. For the people who pass these protocols, though, there’s really no reason to prevent them from flying since there is no real risk that they are going to infect their fellow passengers.

The key to a protocol like this, of course, lies in its vigorous enforcement at the point of departure, If the people screening the passengers at the airport in Monrovia, Liberia or elsewhere aren’t diligent in doing their jobs then the odds that an infected passenger is going to slip through the cracks. In the case of Mr. Duncan, one potential flaw in the screening process was revealed by the news that Duncan did not tell screeners that he had been in contact with someone with Ebola in the days prior to leaving the country, something for which the Liberians are saying they want to prosecute him at some point. However, since its apparent at this point that Duncan was not symptomatic at the time that he was leaving Liberia, it’s not clear at all that there would have been any grounds at all to delay his travel to the United States. That being said, this Dallas case strikes me as a good reason for aviation and public health authorities in the United States and elsewhere in the world to work with Liberia, the other nations affected by the Ebola outbreak, and airlines to improve the screening process even more. Perhaps their are procedures that can be added to current protocols, or perhaps its just a matter of providing additional personnel to do the screening at the airports so that individual screeners don’t have such a big workload that they’re unable to give marginal cases the attention that they might deserve, or it might be something else. In any case, it is obviously in everyone’s interest to prevent this disease spreading outside of the affected region as much as possible, and that means working at the source to prevent that.

One response to all of this, of course, is that even the best protocols in the world doesn’t necessarily prevent someone who has the Ebola virus inside them from traveling to the United States, Europe, China, or anywhere else in the world. Since there is currently no way to identify someone who is carrying the virus before they become symptomatic, this argument goes, wouldn’t the most prudent action be to simply prevent anyone from that region of the world from traveling anywhere else? As noted above, this strategy has already been adopted by some of the nations neighboring the outbreak zone, but given the fact that they are much closer to Ground Zero in the fight, it arguably makes sense for them to take that drastic course of action. As far as the rest of the world goes, though, banning international travel would cause real disruptions to international commerce and freedom of movement, and it would potentially strand westerners and others who are in those countries for one reason or another and would now find themselves with no means of getting him. So, yes, it’s possible that there might be another Timothy Duncan in the future, in the United States, or elsewhere, but the response to that isn’t to do something drastic like close off international air travel, but to make sure that public health authorities are as prepared as possible to deal with such cases if and when they arise. There already appear to be some lessons we can learn from the initial handling of the Duncan case, such as the fact that he was initially sent home from the Emergency Room largely because record keeping errors meant that doctors treating him were not aware he had recently been in Liberia. However, those minor missteps are hardly a reason to panic. Finally, as Phillips notes in the article above, we have generally not banned travel in the cases of other diseases, including diseases like MERS that are far more easily transmitted than Ebola, so it would seem to be needless overreaction to do so in this case.

Phillips points out another reason why a travel ban would be a bad idea, that it would isolate the nations where the disease is spreading and thus make it more likely that the disease will become a bigger problem there and, inevitably elsewhere in the world:

Liberia, Guinea and Sierra Leone are already economically isolated because this epidemic has spread far wider and lasted much longer than any other Ebola outbreak in history. What those countries need most now is assistance from the world.

More flight restrictions will only make it more difficult for life-saving aid and medical professionals to reach West Africa. The restrictions already in place have proved so problematic that U.S. military forces are building an “air bridge” to get health workers and medical supplies to affected areas.

“Any discontinuation of transport will affect humanitarian aid, doctors, nurses and human resources entering the country, the transfer of biological sampling and equipment for hospitals,” Daniel Menucci, a representative for the World Health Organization Travel and Transport Task Force, said in August. “All of this needs international transporting, international airlines. This will create more problems in helping the countries most affected.”

(….)

Researchers who have modeled the risk of the international spread of the Ebola virus have been clear that the longer the outbreak goes on and the bigger it is, the more likely Ebola is to spread beyond West Africa to the rest of the world.

“If the epidemic continues at this growth rate and produces more and more cases, obviously the probably increases with time,” said Alessandro Vespignani, a Northeastern University professor whose team has been updating its model of the chance of global exportation of Ebola cases. ”That means that in October, it would be 20 percent or more, and then it will grow. The probability is increasing.”

It is also the reason the U.S. has mobilized military and medical resources to aid in the fight.

“The best way to protect the U.S. is to stop the outbreak in West Africa,” Beth Bell, Director of the National Center for Emerging and Zoonotic Infectious Diseases at the CDC, said in testimony before Congress last month.

Even with some apparent successes in the fight against Ebola in nations such as Nigeria, projections for the future course of the disease are not good, and there are some concerns that the world’s response on the ground may have been too little, too late to prevent the disease from becoming an even bigger health crisis in Africa and, potentially around the world. That being said, though, it strikes me that even though this is a scary disease there ought to be some common sense applied before we decide the next step forward. As noted, Ebola is not easily transmitted between people, it is less hard to transmit than Measels, Mumps, SARS, and HIV and about as easily transmitted as Hepatitis C. While it is prudent for the CDC and public health authorities in Dallas to cast something of a wide net in following up with the people that Duncan had contact with before being diagnosed, the odds are that the vast majority of these people are unlikely to have caught the virus. This is due both to the manner in which Ebola is transmitted and the facts on the ground, including the cultural traditions in these African nations regarding the disposal of dead bodies that contribute to the spread of the disease. So, prudence and vigilance are certainly called for, and that may include beefing up the screening processes as international airports in the region. What isn’t called for, and will be counter-productive in the end, is panic, fear mongering, and the adoption of policies based on these emotions that are likely to do more harm than good

FILED UNDER: Economics and Business, Health,
Doug Mataconis
About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010. Before joining OTB, he wrote at Below The BeltwayThe Liberty Papers, and United Liberty Follow Doug on Twitter | Facebook

Comments

  1. grumpy realist says:

    Doug, you have confused two different problems: first, the contagion from an Ebola carrier not demonstrating any symptoms yet, and the validity of the screening process. Liberia and other Ebola-afflicted countries have a responsibility not just to not let people who are already contagious onto transportation mechanisms; but also a responsibility screen for people who ALREADY HAVE CAUGHT EBOLA but aren’t showing it yet.

    Given that a) people lie, and b) their screening obviously wasn’t accurate enough because this guy DID get back to Texas with Ebola, it seems the most prudent course would be to either shut down air traffic to those countries or b) hold passengers in quarantine for 21 days before allowing them to board planes. Allow mediccal transport, but I see no reason why travelers should consider they have a right to “business as usual.”

    Measles may be more contagious, but it doesn’t have a 70% death rate.

  2. Ben Wolf says:

    All available resources should be directed at halting the virus in West Africa. The further it spreads the more likely an unwelcome mutation will occur making it more peesistent/communicable.

  3. KM says:

    However, since its apparent at this point that Duncan was not symptomatic at the time that he was leaving Liberia, it’s not clear at all that there would have been any grounds at all to delay his travel to the United States.

    And therein lies the rub. When you are asking passengers questions, you are: (1) relying on their honesty and (2) assuming they have accurate knowledge. A person could be exposed and be oblivious until its too late; you cannot make the assumption that everyone is constantly vigilante and aware of the health status of those around them. Duncan pacified the questioners and with no visible evidence to the contrary, gave the go ahead.

    Instead of banning travel, I would think a quarantine on both sides of the travel would be best (length of time obviously dependent on severity of disease). A few days before and after would definitely put an infected individual in the spotlight far more readily. Yes, it’s inconvenient as hell but if you’re coming or going from a active hot zone, it’s just a reasonable precaution for you and everyone around you. It ensures you would get prompt treatment if indeed infected and help stem possible infection vectors to the general public. We think travel should be as hassle-free and speedy as possible but the reality is sometimes that’s not in the the traveler’s or public’s best interest.

  4. grumpy realist says:

    As pointed out, you can finagle your way through screening by lying and taking a lot of ibuprofen.

    Still so sure we shouldn’t shut down air travel, Doug?

  5. Mu says:

    Great screening process
    If you answer yes, you don’t get on the airplane, you get send to the open air open sewer death ward in Liberia.
    If you answer no you get on the airplane and to a country where the medical care just might give you a chance to survive.
    I wonder if anybody not named Mother Theresa would say yes.
    It’s telling that the local countries have closed the borders but the west still allows people to fly out of those countries and mingle freely with the general population. Strict quarantine has been shown to work for centuries to deal with incurable outbreaks – this is one of the situations where it’s justified.

  6. beth says:

    @grumpy realist: Not that I ever did it, but parents who can’t miss work but have a sick kid who needs to go to daycare have been doing the “give ’em some Tylenol so they don’t appear to have a fever dodge” for years. It buys you a few hours of daycare so you don’t have to call in sick for the whole day. I’m sure my daughter caught quite a few bugs because of that. I’m surprised it hasn’t been mentioned before in regards to Ebola screening.

  7. JKB says:

    Call me crazy but if you aren’t going to ban travel, then why not also institute specific medical screening on the US side of anyone who has been in an infected country in the previous 4 weeks. Low cost, low impact and layered protection.

    Or, given the decision to put the US at risk originates out of DC, simply institute a policy that any whose been in an infected area arriving in the US must spend the balance of the 3 week incubation period in the metro Washington DC area before venturing into the rest of the US. We could also include Manhattan in the holding area for media and UN personnel. This would be a good solution for aid workers and news crews who could then travel back and forth. Aviation crews could wear protective gear when entering infected countries air space and transporting people out.

  8. JKB says:

    @beth:

    They should be doing thermal surveillance in all airports. Anyone outside of normal should be investigated.

    We have the TSA, this is something useful they could do rather than their daily security theater production.

  9. In the case of Mr. Duncan, one potential flaw in the screening process was revealed by the news that Duncan did not tell screeners that he had been in contact with someone with Ebola in the days prior to leaving the country, something for which the Liberians are saying they want to prosecute him at some point.

    Perhaps Texas should prosecute him for aggravated assault.

  10. Jenos Idanian #13 says:

    Some countries are already banning travel from countries that have Ebola outbreaks.

    Ebola is already here in the United States.

    We can either be one of those countries who ban travel from infected countries, or one of those countries banned.

    And if we don’t choose soon, we may not get a choice.

    Also, as noted, a couple of pills and a lie can currently get you into the country that has the only semi-successful treatment for Ebola. in the process, you endanger a whole bunch of people with your very deadly disease, but at least you’re in the proximity of free treatment.

    By the way, has anyone figured out where that enterovirus that is currently paralyzing and killing our children came from, anyway? I’m certain that it definitely didn’t come from any of those waves and waves of illegal alien children that came across unscreened over the past few months, but it had to come from somewhere….

  11. grumpy realist says:

    It’s either we control the spread of a possible illness at the source, or we end up trying to track down peoples’ contacts later on.

    I fail to understand why we’re allowing ANYONE zipping back and forth from West Africa right now. It’s careless, it’s stupid, and it’s going to get us into a lot of trouble. IQuarantine of 21 days at the very least.

  12. Neil Hudelson says:

    So it seems conservatives have found another cause to sh*t their pants in terror.*

    *Edit: I’m not speaking as to the merits of banning travel. Just to the hysteria in some of the comments.

  13. JKB says:

    We are seeing FEMA (pre-2006) competency from the CDC, why no outcry? From the MSM? From the Hollywood types?

    I see the CDC is specifically refusing to do active US side screening of travelers. Oh, and now we have a suspected case in DC and in Georgia.

    They don’t want to ban air travel to the infected countries as it would inconvenience the CDC “researchers” in their little experiments.

  14. mannning says:

    It would seem that some are relying upon the far better practice of hygiene and medical care in the US to buffer us from Ebola infection. While that may be a significant block, without travel restrictions, we are opening ourselves to jamming our currently limited isolation capabilities with patients from several Africa nations that can rather easily slip through the local safeguards now in place, as did Patient Zero. If Patient Zero was in contact with 100 others in his few days in the US, think of the problem if 100 symptomless Africans landed here and had up to 21 days to show symptoms, and the number of our people that they could come in contact over that time. Then think of another 1,000 coming into the US in succeeding weeks, quite a few of whom carry the disease. Obviously, maximum provisions in the African nations to screen and test must be instituted, but severe limitations on travel by those that have been exposed or possibly have been exposed must be instituted as well.

  15. wr says:

    @Jenos Idanian #13: “By the way, has anyone figured out where that enterovirus that is currently paralyzing and killing our children came from, anyway? I’m certain that it definitely didn’t come from any of those waves and waves of illegal alien children that came across unscreened over the past few months, but it had to come from somewhere….”

    Shorter Jenos: “There is nothing so loathesome I won’t say, no slander so vile I won’t spread it, no baseless fear I won’t monger as long as it will get me at least 30 seconds of attention.”

  16. wr says:

    @mannning: And think of milllions!!!!! And billions!!! And what if they’re secretly sent here by Isis, and then they’ll behead us after infecting us!!!!! And then take our jobs!!!!!!!! We have to be afraid!!!!!! Very afraid!!!! Because that’s what being a Republican is all about — being so absolutely terrified of everything and anything that isn’t us we’ll cause any kinds of harm in order to make ourselves feel better!!!

    Quick — let’s all go buy guns!!!!! Then we’ll all feel good for five minutes, unless we see a black person to be scared of!!!!!

    When did you all become such cowards?

  17. Neil Hudelson says:

    @wr:

    Yeah, pretty much a spot on translation. Jenos has written some disgusting thing, but that’s definitely top for the week.

  18. Mikey says:

    My goodness, people. You’d think Ebola was the flu, smallpox, and typhoid combined.

    In reality, it’s not easily transmitted, and if the patient goes in for treatment immediately upon developing symptoms, chances of survival are quite good. It’s epidemic in West Africa because it’s hit remote villages with no provisions for treatment and because of cultural customs and superstitions there regarding interaction with the recently deceased. Neither of these factors applies to the United States.

    Also take a look at Nigeria, which was posted about here on OTB a couple days ago. 900 people exposed, 20 contracted the disease, not all died, the disease is contained, end of story. But that’s not all over the news, because if it doesn’t create fear and sensationalism, it doesn’t play.

    And talk about it “mutating to become airborne” is far more Hollywood than science. It’s vanishingly unlikely.

    It’s still a nasty disease and challenging to treat, but everyone is playing it up like the second coming of the Black Death.

  19. Gustopher says:

    If we were to ban flights from the affected countries to the US, that would just mean that they transfer in Munich or somewhere. We could then ban flights from Munich, I suppose, and eventually ban all international flights coming into the US.

    If we want/need to ban flights, we need to do it at the source. We would need the affected countries to self-quarantine. Which might mean showering them with foreign aid money.

  20. Tyrell says:

    @Stormy Dragon: Actually there could be even stronger charges, depending on how this turns out. This Mr. Duncan lied to authorities and callously gave possible exposure to a hundred or more people, including children. He might even face charges in Africa.
    Obviously there needs to be a review and probably a tightening up of procedures, regulations, and protocols. This is been the second fiasco in less than a week. There needs to be air tight restrictions on travel to and from the ebola countries.
    What is really scary is the thoughts of the state of the borders, with people rolling in here as some politicians tell them “come on in …..but don’t stop in my state”. The government can’t even protect the White House as people are climbing over the fence like it’s a neighborhood playground.
    The president needs to reassure the nation about this before some sort of panic starts.

  21. Gustopher says:

    Also, we should probably ban all air travel into or out of Texas, just to be safe. And build a wall.

  22. gVOR08 says:

    @Gustopher: Finally, a sensible suggestion.

  23. grumpy realist says:

    If everything worked perfectly, I’d be far less draconian about quarantines and keeping flights going. But we’ve already seen in our first case in the US the victim getting mistakenly released and sent back home, the information that he had just come from Africa never making it over to the doctor, and the family being left in the house with his dirty linen for several days while the disposal groups squabbled.

    Airplane crashes rarely happen because something suddenly catastrophically goes wrong. Usually it’s the end result of a chain of “oops” events. And the more possible Ebola carriers we have in Africa, the less likely we’re going to catch every single carrier coming to the US in time and get them into the hospital before infecting someone else.

    We don’t need to have that many cases of having-to-track-down-every-single-contact before the effort swamps our existing health organizations.

    So please, people. Don’t travel to West Africa to help out your families and expect to be routinely admitted back into the US.

  24. wr says:

    @Tyrell: “There needs to be air tight restrictions on travel to and from the ebola countries.”

    Okay, so let’s say someone buys a ticket from one of the “ebola countries” and flies to Amsterdam. Do we shut down all flights from Amsterdam? Because he could go from there to London on a ferry — do we shut down all flights to Britain?

    We don’t live in Gunsmoke, Chester. We live in the 21st century. Pretending otherwise is going to get us nowhere.

  25. Jeremy R says:

    @Gustopher:

    If we were to ban flights from the affected countries to the US, that would just mean that they transfer in Munich or somewhere. We could then ban flights from Munich, I suppose, and eventually ban all international flights coming into the US.

    Yup. In this particular case, Belgium:

    http://www.nola.com/health/index.ssf/2014/10/ebola_united_flight_passengers.html

    On Sept. 19, Thomas Eric Duncan flew from Liberia in the heart of western Africa’s Ebola outbreak zone to Belgium on a Brussels Airlines flight, according to Belgian officials.

    United said it believes that Duncan flew the next day on United Flight 951 from Brussels to Dulles International Airport near Washington and connected to Flight 822 from Dulles to Dallas-Fort Worth International Airport.

  26. Jenos Idanian #13 says:

    @Mikey: My goodness, people. You’d think Ebola was the flu, smallpox, and typhoid combined.

    Ebola is about 90% fatal. To spell that out in simple terms, if 10 people get infected, 9 will die. And they will die in a way that makes it very easy for those treating them to get infected unless very careful precautions are treated.

    And so far, we’re seeing some seriously gross incompetence in fighting it. Airport security didn’t flag the guy. The nurse who first treated him didn’t flag him as a possible Ebola sufferer. When he vomited on a public sidewalk, they cleaned it up with a pressure washer. They didn’t immediately isolate those who had been exposed to him, allowing more to get potentially exposed. After they were quarantined, they sent in a Red Cross volunteer with food who had NO protective gear on (bare hands, face, and wearing shorts).

    I’m feeling pessimistic towards our government and health services to contain this because so far, they’ve screwed it up repeatedly. I don’t see any reason why they’d suddenly get competent. Christ knows I hope they do, but I am not confident.

    In 2005, Senator Obama led a push to get President Bush to improve our preparation for an epidemic such as this. At that time, he was worried about avian flu (which is NOT passed human to human). Bush set up quarantine and other plans in response to this push. Then, in 2010, President Obama quietly dumped those plans and rules.

    To quote Ace of Spades, “Senator Obama and President Obama should get together some time and share ideas.” I recall quite a few times I found myself agreeing with Senator Obama, and wish he was currently in the Oval Office.

  27. wr says:

    @Jenos Idanian #13: “In 2005, Senator Obama led a push to get President Bush to improve our preparation for an epidemic such as this. At that time, he was worried about avian flu (which is NOT passed human to human). Bush set up quarantine and other plans in response to this push. Then, in 2010, President Obama quietly dumped those plans and rules.”

    Would this be after the Republicans in congress pushed through huge cuts in the CDC and NIH budgets? Sorry, Cindy Lou, but you don’t get to destroy government and then whine about how it doesn’t work. You’re on the side of the vandals, cheering the destruction at every step of the way and then trying to blame the mess on everyone who tried to stop you.

    Your mess, little girl. It’s what you wanted. Enjoy it. But do be careful of those disease ridden children who have crossed the border to infect you.

  28. Jenos Idanian #13 says:

    @Neil Hudelson: Yeah, pretty much a spot on translation. Jenos has written some disgusting thing, but that’s definitely top for the week.

    There is a correlation. Obviously, correlation does not equal causation, but it’s also true that absence of evidence is the same as evidence of absence.

    The flood of illegal alien children accepted and dispersed, mainly to cities, were given no medical screening. The outbreaks first happened in Kansas City and Chicago.

    It’s a possibility. And does anyone else remember one of the original purposes of Ellis Island?

  29. Jenos Idanian #13 says:

    @wr: Would this be after the Republicans in congress pushed through huge cuts in the CDC and NIH budgets?

    No, this was after leftist political groups criticized and complained about them. But thanks for playing, and reminding everyone just how desperately stupid you are.

    Oh, and all those screwups I cited? Kindly explain how they were the fault of “too little money,” and not “simple incompetence.” And thanks for the reminder for the left’s standard response to such failures when they are exposed — “We need more money!” “How much more?” MORE! We’ll tell you when it’s enough!”

    And it’s NEVER enough…

  30. Jenos Idanian #13 says:

    @wr: Oh, and thanks for the preview of the talking point lies we’ll be facing: “It’s the Republicans’ fault because they wouldn’t spend more and more money we don’t have! And pay no attention to all those leftists who said that Bush’s plans were EEEEVIL and demanded Obama gut them! Oh, and also please don’t notice that Obama killed them quietly, and didn’t make a stink about how the mean old Republicans were making him do it against his will!”

  31. Mikey says:

    @Jenos Idanian #13:

    Ebola is about 90% fatal. To spell that out in simple terms, if 10 people get infected, 9 will die.

    It’s 90% fatal in places where treatment is not readily available. If treatment is sought and received when symptoms first appear, fatality is about 25%.

    Look at the example of Nigeria again. 900 people exposed, 20 contracted the disease. That’s about 2%. And most of those survived because they got treatment.

    Some people sensationalize it because they want to sell newspapers, some because they just like a good scare, and some–like you–to use as a political cudgel to beat Obama with. But all of it is just bullshit because Ebola is not going to come to America and kill a bunch of people. It’s just not.

  32. Jenos Idanian #13 says:

    @Mikey: Look at the example of Nigeria again. 900 people exposed, 20 contracted the disease. That’s about 2%. And most of those survived because they got treatment.

    Let me correct your numbers there. 20 people contracted it as of September 22. As of now, 8 have died. That is a fatality rate of 40%.

    The WHO says fatality is between 25% and 90%, with 50% being a reasonable average.

    I was talking about fatality rates, not infection rates. And as I noted, there have been a LOT of people who have been exposed here in the US so far. The current estimate is about 100 people from the Texas case.

    So, using your numbers (which I do not accept, but will use here for the sake of argument), that means we can expect 2 more cases, one of which will die. And looking at how the case has been handled so far, I’ll guesstimate another 20 people exposed. (As noted, so far the handling of this has been really, really crappy. Let’s say they make it 90% better for the next round.) So we get 20 more exposures, 1 new case. (For the math-impaired, that’s based on 1st round patients exposing 100 people, 2% infected. Those expose 10 each, so that’s 20 exposed. And 2% of 20 is 0.4, which I’ll round up as Ebola is a nasty little thing, so I’ll give it the benefit of the doubt.)

    And note I’m being optimistic that we’ll get 90% better at quarantining and preventing more exposures. I have my doubts. I believe in the wisdom of “hope for the best, but prepare for the worst.”

  33. Grewgills says:

    @Jenos Idanian #13:

    Let me correct your numbers there. 20 people contracted it as of September 22. As of now, 8 have died. That is a fatality rate of 40%.

    The WHO says fatality is between 25% and 90%, with 50% being a reasonable average.

    I’ll note that is a far sight from the 90% fatality rate you came in with. The 90% is, as Mikey noted, for areas without readily available treatment like Liberia. The 25% rate is for places with ready treatment, like the United States and Western Europe. That 50% is for places that fall somewhere in the middle, like say Nigeria.
    The infection rate is low even when symptoms present and entirely absent when symptoms don’t present. Even using numbers worse than yours, we are looking at less than 20 people dead. To put this in perspective, on a typical year 9,000-45,000 people in the US die of influenza. Have you had your flue shot?
    This is this year’s bird flu, more much ado about very little.

  34. JKB says:

    @Mikey:

    First off, there is no treatment. There is palliative care for symptoms. Fluids to keep blood volume up, etc.

    The guy in Dallas caught it by helping a pregnant woman into a taxi. Not intimate contact. Six or seven others also contracted and died after contact with the same woman. It is not beyond the pale that there is a new variant that they’ve let into the US and are handling incompetently.

  35. Jenos Idanian #13 says:

    @Grewgills: I’m not confident in that 25% figure, considering how many failures there have been in the Texas case. And it keeps getting worse and worse. But yeah, I was a bit hasty on that 90% number — that is worst case.

    Consider that Ebola is a really, really nasty bug. In some ways, it’s worse than HIV. Its method of attack — uncontrolled bleeding — is ideal for spreading itself. The sicker the patient, the more virus they’re pouring out in bodily fluids. While AIDS is more fatal, people don’t become more and more dangerous as they get sicker and sicker like Ebola victims do.

    Christ, I might have to re-read Tom Clancy’s Executive Orders. One key element of the novel is weaponized Ebola, and his homework on the disease was pretty damned thorough. Say what you want about the man, he did his homework on the finer details.

  36. Mikey says:

    @Jenos Idanian #13: My numbers are from a news report that was linked right here on OTB earlier this week. 900 contacts, 20 contractions, the majority of which have survived.

    The survival percentages vary but 25% is the average with treatment of the numerous outbreaks since 1976. Yes, nearly 40 years this has been going on, and still no world-ending pandemic.

    I don’t know what it is with people like you who want a plague so damned badly. Immune to facts, dismissive of actual evidence, you just keep beating the sensationalist drum.

  37. Mikey says:

    @JKB: We already know what the variant is–it’s Zaire. Which is one of the nastier variants, but it’s nothing new, there have been half a dozen outbreaks of that one in the last 40 years.

  38. Todd says:

    Just a quick perusal through the comments so far …

    I wonder, how many of you would be outraged if a government subjected you to many of the things (mandatory quarantines with no probable cause other than your location of origin) that you are suggesting for others?

    Part of the reason why a pandemic (novel flu strain more likely) would have a decent chance of spreading in the United States … many people who are all for quarantines of others, would revolt if such a restriction was placed upon themselves.

  39. Jeremy R says:

    @Jenos Idanian #13:

    In 2005, Senator Obama led a push to get President Bush to improve our preparation for an epidemic such as this. At that time, he was worried about avian flu (which is NOT passed human to human). Bush set up quarantine and other plans in response to this push.

    You’re referring to a CDC rule proposal that was never actually adopted, meaning nothing was “set up” because of it and nothing would have gone away with its withdrawal. The proposal had been in agency comment period limbo for years during the Bush admin and then two more years under Obama (presumably because it was seen as unworkable and generally worthless). It never was more than a NPRM (notice of proposed rulemaking), meaning it never became actual federal regulation.

  40. anjin-san says:

    @JKB:

    We are seeing FEMA (pre-2006) competency from the CDC,

    Hundreds of millions of dollars have been cut from the CDC budget. You are getting the government you wanted.

    Maybe The Koch brothers and Donald Trump will step up and end the ebola threat. After all, the private sector is always the answer – right?

  41. Stonetools says:

    Conservatives have spent years hacking away at the funding of the CDC and the NIH, citing “unnecessary” studies.
    Conservatives have argued that the FDA should be abolished , saying the court system can sort out drug research and testing issues
    The Neanderthal Rifle Association has blocked the appointment of the Surgeon General because he favors scientific study of health issues like gun violence.
    Now that there is a possibility of a deadly outbreak, conservatives are all in a panic and want these agencies to perform at top efficiency. All the 2016 Republican candidates are talking about banning flights , quarantining people, and are calling on Big Gumint to “do something”.
    What I would like to do is send all these conservatives to the outbreak zone to fight the disease, but unfortunately poetic justice is not of this world.

  42. Stonetools says:

    Here’s another great way conservatives made the US ready to combat the outbreak of a deadly disease: they denied access to health care for millions of Americans by rejecting Medicaid expansion. This means that if people get sick, they’re less likely to seek treatment and more likely to remain in the community, infecting others. How’s that working out for Texas, Mr. Perry?
    Sociopathic, I tell you. And stupid too.

  43. wr says:

    @Jenos Idanian #13: Sorry, Cindy Lou. Normally it might be entertaining to demolish your standard drivel, but with your slimiing of children you have sunk so far below the standards of normal human discourse that I feel a need to shower even responding to you this way. May you enjoy your wallow in the filth you call your soul.

  44. wr says:

    @Todd: “I wonder, how many of you would be outraged if a government subjected you to many of the things (mandatory quarantines with no probable cause other than your location of origin) that you are suggesting for others?”

    Considering that these are people who scream like babies if anyone suggests they shouldn’t be able to play with semi-automatic weapons at Starbucks because they have RIGHTS RIGHTS RIGHTS and yet advocate for building concentration camps for brown children, it’s pretty clear that they have somewhat different standards for themselves and everyone else.

  45. JKB says:

    @anjin-san:

    Funny, I don’t remember that argument flying about FEMA.

    But, let’s do an audit. Let’s find out how much of the CDC budget was actually applied to, now stick with me here, Disease Control, instead of bad research for gun control or other non-disease issues.

    But the failure isn’t one of research, the CDC is failing in basic information. They weren’t prepared to even pontificate intelligently on Ebola. To offer containment procedure advisories to local health departments.

    Like did you know, Ebola is skin transmissible? So full protection is required, not just avoiding mouth, nose, eye, injury contact before washing.

    Did you know you can get the disease by just changing the sheets of an infected person? That they don’t know how long the virus can survive once dehydrated on a surface?

    What we have here is the Center for Disease Control being a total failure when it comes to even basic information on disease control.

    And we have public health departments that seem to be only good at offering birth control and VD treatments to the indigent while completely incompetent in disease outbreak control, which is why they were kept around.

    You want more money, get back on mission and quit diverting funds to trendy, political projects that aren’t core mission. No more gun control, no more soda control.

  46. Todd says:

    @JKB:

    What we have here is the Center for Disease Control being a total failure when it comes to even basic information on disease control.

    What we have here is a typical Conservative attitude that because you read something on a few of your alternative “news” sources, you are now more informed than any of the actual experts on the subject … who are of course all idiots.

    Sometimes I regret that my brain is not wired Conservatively .. it must be wonderful to live in a world where you’re never wrong. And where If something bad happens in other people’s lives it’s due to a lack of personal responsibility. But if something bad happens in your own, it’s obviously due to either the incompetent government, or the liberally biased media. 🙂

  47. Jenos Idanian #13 says:

    @JKB: This is how the Big Government element fights back. If you don’t allow them to do EVERYTHING, then they respond by doing NOTHING. When cuts are imposed, they always make them in the way that’s the most in-your-face to the public. Remember the Parks Service during the last shutdown? They were mad they didn’t have their money, so they spent EXTRA MONEY to make goddamned sure that everyone knew they were shut down. They paid money to bring in fencing to shut down the memorials on the National Mall. They blocked off state-run scenic overlooks that dared to look at THEIR property.

    So, because we wouldn’t let Big Government politically weaponize the Centers for DISEASE Control treat guns as diseases (I guess, in a way, they do promote a rather fatal form of lead poisoning), they won’t actually put all their efforts into an actual disease that is such a potential threat.

    And that’s how it’s the NRA’s fault that we are having problems with Ebola. “It’s their fault — they hit us back!”

    As you noted, the public health system has had a string of horrible failures in handling this outbreak. In the last one I heard, a Dallas judge and two aides went into the quarantined apartment without any visible protective measures to speak with the quarantined family. If you couldn’t guess, the judge is a renowned liberal.

    Professor Reynolds has a truism I rather like: “I’ll believe that there’s a crisis when those who say there’s a crisis act like there’s a crisis.” By that principle, a whole bunch of people are telling us that this Ebola outbreak is no big deal — they are being incredibly careless and sloppy in managing it.

    Either they know something that they’re not telling, and being incredibly incompetent at keeping that a secret, or they are just incredibly, grossly incompetent. As the former implies a conspiracy that I don’t think they are competent to maintain, I’m thinking they really are that incompetent.

    And they’re supposed to be our main defense against diseases, specifically ones like Ebola.

  48. Jenos Idanian #13 says:

    @Todd: What we have here is a typical Conservative attitude that because you read something on a few of your alternative “news” sources, you are now more informed than any of the actual experts on the subject … who are of course all idiots.

    They might not be idiots, but so far they’ve done a considerable number of idiotic things. To quote myself:

    And so far, we’re seeing some seriously gross incompetence in fighting it. Airport security didn’t flag the guy. The nurse who first treated him didn’t flag him as a possible Ebola sufferer. When he vomited on a public sidewalk, they cleaned it up with a pressure washer. They didn’t immediately isolate those who had been exposed to him, allowing more to get potentially exposed. After they were quarantined, they sent in a Red Cross volunteer with food who had NO protective gear on (bare hands, face, and wearing shorts).

    Add in the judge who went in with two aides with ZERO protective gear.

    Either they’re idiots, or they’re not idiots who are acting in incredibly idiotic ways.

    We all hope they aren’t idiots, because then there’s a chance they’ll stop acting like idiots and get their shit together. But I’m not seeing too many signs to reinforce that optimism.

  49. anjin-san says:

    @JKB:

    Funny, I don’t remember that argument flying about FEMA

    The argument about FEMA was that Bush appointed a hack who had no clue what he was doing to run the agency.

  50. Jenos Idanian #13 says:

    @anjin-san: The argument about FEMA was that Bush appointed a hack who had no clue what he was doing to run the agency.

    No kidding. And he wasn’t even a good hack. A good hack wouldn’t have let Democratic NOLA Mayor Ray Nagin and Democratic Governor Kathleen Blanco shovel all their (far worse) failures off on him and FEMA.

    BTW, FEMA’s actual response to Katrina was actually pretty consistent with their responses to other prior disasters. The real problem was the complete failure at the local and state level — who are supposed to be the first responders, not FEMA.

  51. anjin-san says:

    @JKB:

    But, let’s do an audit. Let’s find out how much of the CDC budget was actually applied to, now stick with me here, Disease Control

    Ok, go find out. Here is a handy tool you can use:

    http://www.google.com

  52. Jenos Idanian #13 says:

    @anjin-san: Since you’re too lazy to actually put up anything, let me step in.

    From here.

    You’re welcome.

  53. wr says:

    @JKB: “You want more money, get back on mission and quit diverting funds to trendy, political projects that aren’t core mission. No more gun control, no more soda control.”

    And thus do the “Conservatives” continue to defend their vandalism of key parts of the government — by claiming they only slashed funding from the “unnecessary” parts and that of course they intended the core functions to continue, but those sneaky liberals messed everything up.

    This is the society you wanted. Your party slashed funding for the CDC and the NIH. And then you have the gall to lecture about the incompetence of local health departments — when the one in question is located in Texas, a state you celebrate for slashing all government spending, especially on health care.

    You made this situation. You and your ideological buddies. So don’t whine about how this isn’t what you wanted. It’s exactly what you wanted — only because you and the rest of the “conservatives” have no imagination at all, it never occurred to you that you could be a victim of your own destruction.

  54. wr says:

    Let us all remember when we’re using this Ebola victim as an excuse to bash “the government” that the government most responsible for every level of screw up here is the Texas state government — which is worshipped by righties because they refuse to spend money on, among other things, public health.

    This is the government the right wants. This is the Texas miracle. I hope you’ll all move there and enjoy it.

  55. anjin-san says:

    @JKB:

    Let’s find out how much of the CDC budget was actually applied to, now stick with me here, Disease Control, instead of bad research for gun control

    What the heck, I did the work for you:

    How much does the CDC spend on gun research? Now stick with me here – nothing:

    A 1996 law prohibits the CDC from using federal funds for studies that ‘advocate or promote gun control.’

    Until the mid-1990s, the CDC had explored a range of questions on the public health effects of firearms. In 1996, the National Rifle Association convinced key Congressional leaders to stifle federal funding for gun-violence research. At the same time, an appropriations bill killed the CDC’s annual $2.6 million budget for firearms studies.

    http://www.nbcnews.com/health/health-news/obamas-unlocking-federal-funding-ban-gun-research-yields-little-upshot-f2D11733547

    Since 1996, when a small CDC-funded study on the risks of owning a firearm ignited opposition from Republicans, the CDC’s budget for research on firearms injuries has shrunk to zero.

    Since 2007, the CDC has spent less than $100,000 a year on firearms-focused work, according to a CDC spokeswoman. The money goes not for research but for a very rough, annual estimate of the number of Americans injured by shootings.

    http://www.propublica.org/article/democrats-push-to-restart-cdc-funding-for-gun-violence-research

  56. anjin-san says:

    @Jenos Idanian #13:

    let me step in.

    That’s a 2015 budget proposal fact sheet.

    A. Do you know what year it is?
    B. Do you know the difference between a proposal and an actual budget?

  57. stonetools says:

    Is it surprising that Texas, a state with one of the worst records for public health spending, is fumbling a developing public health threat? Not to me.
    The furious spinning of Jenos and JKB on the issue would be hilarious if it wasn’t so tragic. You get the government you pay for , idiots , and when you starve the government of funds in order to give away tax cuts for billionaires, then you get inadequate public health response. It’s not hard, except for libertarian cretins who don’t understand that microbes don’t give a sh!t about right wing ideology or the right of the rich to live tax free-they infect everybody they come across.

  58. stonetools says:

    @anjin-san:

    Well, there you went and actually looked up some facts. How are Jenos and JKB ever going to be able to respond?
    BTW, there is nothing wrong at all with CDC engaging in the scientific study of gun violence and obesity-both of which are going to kill far more Americans this year than ebola. The only reason to object to it is that you fear the results of taking a scientific, data-based approach to these issues, rather than one based on moralism and right wing mythology.

  59. stonetools says:

    @JKB:

    The party that allowed 9/11, Katrina, and the 2008 financial crisis should have nothing to say about government mismanagement, now and for the foreseeable future.
    The Texas government’s response to the ebola threat is just more evidence of Republican failure to govern. What’s amazing is that the American public hasn’t yet figured out this pattern. Right wing propaganda is really remarkably effective.

  60. Jenos Idanian #13 says:

    @anjin-san: STILL better data than you offered, and it featured charts showing past expenditures.

    So I take it back. You’re NOT welcome.

  61. Jenos Idanian #13 says:

    @stonetools: The party that allowed 9/11, Katrina, and the 2008 financial crisis should have nothing to say about government mismanagement, now and for the foreseeable future.

    You’re right, but those damned Democrats won’t shut up.

    And “allowed Katrina?” Don’t tell me you’re one of those who believes in the Halliburton Hurricane Machine that Karl Rove steered into New Orleans.

  62. Anjin-San says:

    @Jenos Idanian #13:

    So, once again you are presenting a truly moronic argument, but trying to claim victory on an equally moronic technicality?

  63. Jenos Idanian #13 says:

    @stonetools: You want CDC incompetence? Here’s the director of the CDC giving conflicting information on Ebola within the space of a few minutes, actual video included.

    That’s DOCTOR Tom Frieden, head of the CDC, being interviewed by DOCTOR Sanjay Gupta of CNN, so there’s no “it was a poorly-phrased question from an ignorant journalist” excuse there. From Ace of Spades’ summary of the interview:

    The director of the CDC says that you have no fear of infection by ebola unless you are in direct contact. So, he says to Gupta, neither of us is at any risk of infecting the other just standing here, talking to each other, at a distance of a yard or so.

    The CNN anchor in the studio asks about a sneeze, and Gupta then points out that the CDC’s own guidelines state that infection is a risk in cases of either direct contact or close proximity of three feet or less with an infected person.

    The CDC guy then blathers something about taking each case individually on its own merits or something.

    This is Obama and the Gulf Coast oil spill all over again. The important thing should be to deal with the crisis now, but the left is far more interested in assigning blame first. It’s as if they refuse to deal with the crisis until they can be positive that the other side gets the blame.

    Wrong.

    Obama is the head of the Executive Branch. This is his responsibility to deal with now. We can worry about blame once this has been contained.

    Defending why the response has been so effed up thus far is WRONG. We should be focusing on making the eff-ups STOP. Instead, things keep getting effed up. Witness that idiotic judge who decided that he needed to personally speak with the quarantined people, sans protective gear, and dragged along two aides.

    You know what causes panic real good? Watching the people supposedly responsible continually effing up, while insisting that EVERYTHING WILL BE JUST FINE and IT’S NOT OUR FAULT, REALLY. And that’s what we’re getting now.

  64. Tyrell says:

    It has occurred to me that this situation will require close coordination between the CDC, Homeland Security,and the FAA. There are myriad possibilities and some can’t be foreseen. But the main goal is to control people coming in who have been in the ebola countries. That will require close inspections of passports and other procedures of course. The government should also try to keep track of US citizens who are now in the ebola countries. The president, like many of us, felt assured that CDC had all this covered and nothing like this could have happened. So I am not jumping on the president for this one.

  65. Mr. Thik says:

    First, just because a passenger does not show Ebola symptoms before he boards a plane, does not mean that he will not become sick later on that same plane or the next plane he switches to, especially on long flights around the globe.

    Second banning passenger air travel is can be done, at the same time permitting shipments of vital supplies and other official travel that can be monitored more closely. It would bring the risk of spreading down.

  66. Jenos Idanian #13 says:

    @Tyrell: So I am not jumping on the president for this one.

    I have been hammering on a similar theme for some time. A lot of the current messes aren’t Obama’s fault, but they are his responsibility.

    It can become his fault if he doesn’t step up and take on his responsibilities. And he has a chance to do so now.

  67. anjin-san says:

    @Jenos Idanian #13:

    STILL better data than you offered

    The information I presented disproved JKB’s argument.

    Do you know what “better” means?

  68. mannning says:

    @wr:

    Typical overreach by a liberal. Using up space to no good end. Disgusting!

  69. Doug says:
  70. Doug says:

    @JKB: It has been several weeks since your post and at least two medical persons have tested positive. Having said that, test at ports and airports for fevers ignores a VERY large problem. If you are Ebola positive but not yet infectious those tests are not worth a damn. Are you willing to bet that your child, your sibling, your parent, your friends won’t get infected because you want to be “fair?”

  71. honettalk says:

    One can rationalize anything.

    We cannot confine ebola to West Africa so let us maintain the conditions to unwittingly transport it? Does that make any sense?