Biological homeland security


Is “homeland security” only defined in terms of preventing terrorist incidents within America?
What about preventing foreign diseases from invading America?
I am referring, of course, to
the epidemic of Ebola fever currently spreading through West Africa
and, to date, nowhere else.
It seems to me to be of the greatest importance to ensure that
that threat to the health (and economy) of the American people
does not gain a foothold in the United States.

A suggestion:
Should those inspecting people boarding airplanes at American airports
for anything that might enable them to hijack the airplane
have their mission broadened to
inspecting travelers arriving in America
from locations where the Ebola virus is endemic
for signs of that virus?

Why hasn’t the U.S. closed its airports to travelers from Ebola-ravaged countries?
By Abby Phillip
Washington Post, 2014-10-01


Air travel restrictions ignore the way Ebola is transmitted:

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."

The restrictions are also redundant:

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."


[If these remarks aren't crazy, I don't know what is.
The reason to restrict air travel
is not merely
to prevent other passengers on a flight from contacting the disease,
but most importantly
to prevent people carrying the virus from entering the U.S.
Is that too hard for the "elite" to understand?

Now let us consider the point
that there is an incubation period during which an infected person
does not yet present the symptoms that he would when he becomes contagious,
but the virus is developing within him.
There are two ways to address that issue.
First, it should, in my opinion, be a highest priority
to develop a test to see whether a person is in such a state,
with the virus developing within him,
but not yet showing the external symptoms being described in the media.
Is such a test currently available?
If it is, it should be used on all people entering the U.S. from the regions of the epidemic.
If it is not, how about developing it?
Second, for the period before such a test becomes feasible to apply,
please, please, QUARANTINE people entering the U.S.
from regions where the epidemic is occurring,
quarantine them until such time has passed that,
if they were carrying the disease when they entered the U.S.,
the symptoms would be apparent.
Yes, that would be an imposition on people traveling to the U.S. from those regions.
But so too is the imposition that the entry of the disease into the U.S.
causes to the U.S. population.
And as to what that imposition is,
not only is there the fear and concern about spreading the disease,
there is the COST FACTOR of treating those who get the disease and of trying to contain it.

You know, you often read about health care decisions as being made
without the slightest regard to the costs the various choices have.
"Cost is no object, when health care is concerned."
seems to be the unspoken assumption in many cases.
But, again, please, won't somebody of importance
consider the economic costs of various options?
Which is less expensive,
quarantining those people who enter the U.S. from the regions of the epidemic
for a limited period,
or having to react to the entry of the disease into the U.S.?
In particular, does anyone know how much
the entry of the disease into Dallas in late September 2014
has cost, and how high the cost could go under various assumptions?
Yes, I know, of course, that no one can know those costs in advance,
especially since they depend so strongly on how many people were infected, etc.
But ball-park estimates can be made for various scenarios.
It would be highly informative, and I think would affect the debate and decision-making process,
if the general public could be made aware of just how high those costs could be.]

Restricting air travel will make West Africa's humanitarian crisis worse

Ebola has made access to basic resources like food, clean water and basic medical care for other ailments difficult, if not impossible to obtain. Travel restrictions, according to the World Health Organization, will only make that problem worse.

“If you try to shut down air travel and sea travel, you risk affecting to a huge extent the economy, people’s livelihoods and their ability to get around without stopping the virus from traveling,” said Gregory Hartl, a WHO spokesman. “You can’t ship goods in. Sometimes these goods are basic staples people need to survive — food and fuel.”

And in the aftermath of Ebola, the long term consequences of economic and health collapse in Liberia will be the world's burden.

"If the outbreak is not stopped now, we could be looking at hundreds of thousands of people infected, with profound political and economic and security implications for all of us," President Obama said last month. "That has profound effects on all of us, even if we are not directly contracting the disease."

[Again, ridiculous.
You can do both: Fight ebola in Africa and in America.
They are not mutually exclusive.
And stopping ebola from reaching America surely does not
prevent people from fighting it in Africa.

Instead, it seems that many in the "elite"
seem quite willing for ebola reach America
(As confirmation of that:
What have they done to stop ebola from reaching America?
As the facts have proven, nothing effective.),
to convince Americans that the fight against ebola is their fight,
not just the Africans.]

Federal officials cast doubt on Ebola travel ban
By Associated Press
Washington Post, 2014-10-05

Top government health officials said Sunday that they are opposed to
placing a ban on travelers from Ebola-infected countries,
warning that shutting down borders could impede efforts by aid workers
to stop the spread of the deadly virus.

The idea of a ban gained currency this past week
after the nation’s first case was diagnosed in Dallas.
Proponents have argued that it would help ensure public safety.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases,
part of the National Institutes of Health,
said a travel embargo on West African countries that are struggling with Ebola
would make it much harder for them to control the virus.

“You isolate them, you can cause unrest in the country,”
Fauci told “Fox News Sunday.”
‘’It’s conceivable that governments could fall if you just isolate them completely.”

[Many things are conceivable. But likely?
And since when is maintaining the stability of
(not terribly effective) African governments
more important than preventing an Ebola epidemic in America?]

British Airways and some other airlines have suspended flights from those countries,
and overall traffic to and from the affected areas has dropped.

Sen. Mark Kirk, an Illinois Republican, has said
the federal government should gradually halt flights to the region
to protect Americans.
Rep. Tim Murphy plans to conduct hearings on the policy this coming week.
He leads the House Energy and Commerce Subcommittee on Oversight and Investigations.

Asking travelers to report their own activities at airports
“has been a demonstrated failure,
and it is nearly impossible to retrace steps
to try and track down everyone who has been in contact with
a carrier taking multiple international flights across the globe,”
Murphy, a Pennsylvania Republican, said Friday.

Louisiana Gov. Bobby Jindal, a physician, said
the U.S. should halt flights from Ebola-stricken countries.

“The Obama administration keeps saying they won’t shut down flights.
They instead say we should listen to ‘the experts,’” Jindal said Friday.
“In fact, they said it would be counterproductive to stop these flights.
That statement defies logic.”

[This is exactly the sort of thing that has led me to mock "the elite".
Along with many other of their policies,
that benefit a few (Israelis, for example) at the expense of many.
And refusing to hold blacks accountable for their behavior.]

Tom Frieden, director of the federal Centers for Disease Control and Prevention,
said on ABC’s “This Week” that the administration
was open to practical suggestions that won’t backfire.

[I think I have made two such suggestions at the head of this post.]

“We don’t want to do something that inadvertently increases our risk
by making it harder to stop the outbreak there,
because if it spreads more widely throughout different countries in Africa,
that will be even more of a risk to us,” said Frieden,
whose agency has cautioned against non-essential travel to Liberia, Sierra Leone and Guinea.

Frieden has also noted that a ban on incoming flights
could affect Americans trying to return home from those countries.

“There are many other people who have the right to enter into this country,”
he said during a Saturday briefing.
“And we’re not going to be able to get to zero risk
no matter what we do unless and until
we control the outbreak in West Africa.”

Is it possible to "control the outbreak in West Africa"?
Under the following two possibilities:
1. The Africans abandon their disease-spreading habits, such as the hand-washing of bodies of people who die from Ebola.
2. A significant number of Africans do not abandon those habits and customs.
Finally, what is the price tag on "controlling the outbreak"?
And who must pay that price?]

An airline passenger traveling from Liberia to Dallas brought Ebola into the U.S. last month.
He is hospitalized in isolation,
and public-health officials are monitoring a few dozen people
who may have been exposed to the virus.

U.S. officials have emphasized that the United States has a modern medical system
that is far better equipped to contain an outbreak than the African countries where Ebola is currently spreading.

Airline passengers have their temperatures taken as they board planes in the outbreak zone, although those infected with Ebola can go up to 21 days before they exhibit symptoms. Passengers are also asked about contact with infected people, but that process would not be useful if a passenger lies or simply does not realize the medical condition of people they have encountered.

Epidemiologist: Stop the flights now
By David Dausey October 6 at 12:24 PM
David Dausey, a Yale-trained epidemiologist who works on controlling pandemics, is dean of the School of Health Professions and Public Health at Mercyhurst University in Erie, Pennsylvania.
Washington Post, 2014-10-06
Infected men and women may not be contagious on the plane,
but they could wreak havoc when they arrive.

[Well, duh!
I may not be "a Yale-trained epidemiologist who works on controlling pandemics",
but that's something I figured out back on September 5.]


Bodily fluids including vomit spread Ebola, and [Thomas Eric] Duncan —
who presented himself to a Dallas hospital only to be misdiagnosed and sent home —
vomited on the sidewalk outside of his home.
It took days before a properly trained Hazmat crew was sent to the apartment to clean it.
The human errors in this single case highlight why it is urgent that
we ban all commercial flights from the impacted countries
until the outbreak is contained.

Individuals who suspect they have been exposed to Ebola
and have the means to travel to the United States
have every reason to get on a plane to the United States as soon as possible.
If they stay in Africa,
the probability that they will survive the illness if they have it is quite low.
If they make it to the United States,
they can expect to receive the best medical care the world can provide,
and they will have a much higher probability of survival.
[Congratulations, American citizens.
You have the opportunity to pay for health care for practically everyone in Africa.
Aren't you lucky!
Nancy Pelosi and the Democratic Party must be besides themselves with glee
at this opportunity to provide health care for Africans
and bankrupt the United States.]

So they are motivated to lie about their exposure status
(wouldn’t you, in their shoes?)
to airlines and public health officials
and travel to the United States.

The incubation period for Ebola is up to 21 days,
so a person could get on a plane the day he or she is exposed
and spend three weeks in the United States before exhibiting symptoms.
Then he or she could potentially infect any number of people here
before the disease is properly diagnosed,
and they are isolated or quarantined.

Top U.S. government health officials have spoken strongly against
creating a travel ban
(though members of Congress increasingly disagree).
They say restricting flights will also restrict aid to affected countries
and will increase the amount of ongoing unrest.
But commercial airlines are not the only ways
for the United States to send aid and aid workers.
The United States has the most advanced military in the entire world;
we can transport people and supplies without commercial carriers.

[Not only that.
The need is to restrict arrivals from the region of the epidemic,
not flights to that region.
How sleazy it is when those arguing against restricting flights
fail to note that possibility.]

The Ebola outbreak in West Africa has been compared to a war zone.
The disease is now being viewed as a national security threat
on par with nuclear weapons.
The United States has committed nearly 4,000 troops to impacted countries.
It’s time to take security precautions that align with
the gravity of the threat.
That means doing whatever it takes to keep infected people from coming here.

Again, to make that point is precisely why I created this post
back on September 5.]

Leading Republicans press for limits on travel to prevent spread of Ebola
By Sean Sullivan
Washington Post, 2014-10-06

[Democrats, you are really amazing.
Can you not see that this is a vital issue for the health of all Americans?
Evidently not.
One may suspect that the reason is pressure from a critical part of the Democratic coalition,
African-American voters.
Why else would Democrats oppose restricting flights?
Certainly the argument that "it would hinder the fight against Ebola in Africa"
is not valid,
as the restrictions could only apply to flights from the affected regions,
not flights to them, presumably carrying help for Africa.

Again, note that even this is a partisan issue.]


Sen. Jerry Moran (R-Kan.) and Rep. Frank Wolf (R-Va.) wrote Obama a letter Monday asking him

to appoint a "single, senior advisor
who will be responsible for
coordinating all U.S. agencies and policies
involving the international and domestic response to Ebola.

They suggested Obama bring in
former George W. Bush administration officials
Colin Powell, Robert Gates and Mike Leavitt
to "assist with this serious challenge."

[Obviously, a great idea.]