Friday, October 3, 2014

Travel bans and involuntary travelers' quarantines...

Travel bans and involuntary travelers' quarantines...  Given the news and fear of Ebola recently, it's entirely predictable that there would be a rash of support for what seems like an “easy fix”, or at least, as sensible precaution: outright bans of travel to and from the three countries with significant Ebola outbreaks, and authority for the CDC to involuntarily quarantine travelers they suspect might be carriers.  Articles like this one abound.

There are significant problems with these approaches though, starting with the fact that they are completely ineffective.  “What?”, say ye – how can a ban on travel from, say, Liberia be ineffective? 

Let's start with this little inconvenient fact: there is no direct air travel between Liberia and the United States.  Anyone who wants to travel from Liberia to the United States must change planes (and usually airlines).  Most frequently this change occurs in Europe (it was Brussels for Thomas Duncan), but it could also happen in South Africa, India, or a number of other countries.  When a passenger arrives in the United States from (say) London, we don't know whether his travels originated in England, Germany, Russia, Liberia, Australia, or Japan.  You can't tell, and there are no records, unless that traveler happened to use the same airline for all the legs of his trip – and you can't even tell that.  The only travel ban that would actually work would be to close our borders to all travelers other than those explicitly tested for Ebola and found clear.  Can you imagine the impact such a total travel ban would have on the country?

Well, then, ok – how about the involuntary quarantine bit?  Surely that would help?  Consider this: Thomas Duncan was asymptomatic when he entered the U.S.  He would not have been quarantined unless it was by accident.  Then consider this: the vast majority of people quarantined under such a regime would be false positives – that is, they would be quarantined because (say) they had a high temperature, but the vast majority would have a high temperature for some reason other than Ebola.  They might have a cold, or the flu, or any one of hundreds of other illnesses – but not Ebola.  The situation would be different if there was some quick test for Ebola that could be administered at the airport – but there is no such quick test.  Millions of airline passengers would be greatly inconvenienced, and very few actual Ebola patients would be detected.  Is that a good idea?  I think not.  It smacks of security theater.

Expending effort and attention to ineffective policies like this is a waste of time and money that could be much better spent on efforts that actually work – like those currently taking place in Texas to contain the potential outbreak resulting from Thomas Duncan's unfortunate choice to travel here knowing that he'd had contact with an Ebola victim...

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