Politics & Policy

The Travel Ban

It may not be medically necessary or even advisable, but it is psychologically necessary.

In my 2005 book, False Alarm: The Truth about the Epidemic of Fear, I wrote about fear guides — mentors or leaders who could help us manage worry and learn to see health risks in perspective. Unfortunately, these guides are lacking in the current Ebola crisis, and the public is in panic freefall, with no apparent solution in sight.

During the plague years in Europe, care providers were required to take a holiday after their last contact. Nowadays, Ebola care givers are allowed to get on planes.​

The public distrust of our health-care system and fear that it cannot protect us from Ebola have grown with each new headlines. First, Thomas Eric Duncan slipped through our system for screening international travelers and made his way to Dallas, and then he was wrongly discharged from Texas Health Presbyterian Hospital. This was an isolated case, but it sent the public the message that our hospitals aren’t ready. Next, two health-care workers who treated Duncan developed Ebola, despite protective garb, sending the message that the CDC wasn’t involved enough despite the agency’s reassurances.

There is the also inherent difficulty involved in screening passengers who have come in contact with Ebola, don’t want to admit it, and aren’t yet showing symptoms. In any case, the American public has generalized from these Dallas cases to a distrust of our public-health officials.

Sadly, it has reached the point where we will not feel safe unless we ban travel to and from Liberia, Sierra Leone, and Guinea. The reason this is a sad moment is that there is a good chance it could interfere with the flow of health care and resources to and from these countries. Not only that, but, historically, when a country suffering from a growing epidemic has felt cut off from the rest of the world, the fear quotient has risen, and people afraid of the contagion have attempted to flee. Unfortunately, when people hastily attempt to escape imposed restrictions, they tend to take fewer precautions, which increases their chances of catching the dreaded disease.

But first and foremost, although we are members of the world health community, we must worry about our own public psyche here in the United States. If our leaders can’t give us a sense that we are protected, we must achieve it by imposing a ban.

I realize this isn’t strictly a medical argument. There are millions of cases of malaria in West Africa every year, and the accompanying risk of malaria’s coming here by plane is far greater than for Ebola — there are close to 2,000 cases of malaria reported here per year. Though malaria isn’t contagious, treating these people costs our health-care system millions. Ebola, by comparison, is very difficult to transmit, but since it is an emerging infectious disease it is important that we prevent it from gaining a foothold here if at all possible. Fruit bats, dogs, and non-human primates can carry it and spread it.

I’m not convinced medically — I don’t believe that a travel ban against the Ebola-afflicted countries in West Africa will be particularly effective, it may even be counterproductive, and it certainly isn’t coming from the strongest side of what being an American means. But as fear of Ebola and fear of our leaders’ ineptitude grows, I think we must have a ban to patch our battered national psyche.

— Marc Siegel, M.D., is an internist practicing in New York City, the author of The Inner Pulse, and a member of the Fox News Medical A-Team.


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