Opinion: How to prevent the Ebola virus from entering the United States

As you’ve no doubt heard from every health official with a microphone, there is no cause for panic about the single case of Ebola virus discovered in Texas, in a Liberian man who came to visit his family. That doesn’t mean no one else will fall ill, but the disease’s chances of spreading in any significant way in this country are tiny, because our public health and medical prowess would be on the case swiftly and effectively.

Put this into perspective: About 23,000 Americans die every year of antibiotic-resistant infections, and many more die of ailments caused or exacerbated by those infections, so why are more people panicked about the Ebola case than about the rampant overuse of antibiotics that leads to such resistance?

(Speaking of antibiotic overuse, the public may have gotten a perfect example of it from the Dallas case. A man comes into the hospital with severe flu-like symptoms, tells them he’s from Liberia and is sent home with antibiotics. Of course the terrible mistake is missing all the signs that said, “Put this man in isolation and check for Ebola.” But it’s all too routine to give people with any ailment antibiotics without finding out if they have a bacterial infection; antibiotics do not treat colds or flus or any other kind of virus.)

OK, so panic isn’t called for in this case. But that doesn’t mean we should do without some more questioning than authorities seem interested in doing, concerning how a case got here despite all the early assurances that this was incredibly unlikely to happen.

Everyone knows how it got here in the literal sense. Thomas Eric Duncan wasn’t symptomatic yet, so the routine check for fever showed nothing. And, Liberian officials say, Duncan lied about whether he had had close contact with an Ebola victim recently.

But that’s how we prevent people with Ebola from reaching the United States?

We check them for fever, knowing they could be infected but just not showing it? And we ask those who really, really want to come to the United States a question that, if they answer it honestly, will keep them from coming, and expect everyone to tell the truth?

In the aftermath of the Duncan case, we’re told to take comfort because it is pretty much impossible for anyone on the plane or in the airport to have caught the disease from him because he wasn’t symptomatic and thus wasn’t contagious. Nor is Ebola easy to catch in a casual setting, as a cold would be, because it requires coming in contact with fluids of the infected person -- saliva, blood and so forth.

Nonetheless, between primary contacts and secondary contacts, we’re now at about 100 people who need to be checked, and we have family of the patient who were told to stay at home but didn’t.

So despite the assurances, something isn’t working here.

That’s especially true when you consider that people in West Africa who have been exposed to Ebola have an incentive to go to a place where they won’t come into further contact and where, if they do fall ill, they will receive a higher level of care. Duncan reportedly lives in a village where several members of his family died of Ebola. It would be understandable if escape was his motive, but no matter what, the bigger responsibility is to contain the disease.

The Centers for Disease Control and Prevention hasn’t answered my questions about why we don’t require a negative blood test for travelers arriving from one of the three West African nations most heavily hit by the virus -- especially from Liberia, where more than half the total cases and deaths have occurred. But according to an article in the New Republic, it’s because such testing would tangle things badly at the airport and would be very expensive.

It would be interesting to compare that expense over the course of a few months with the expense right now of providing medical care for Duncan, guarding his family so they don’t leave their apartment and tracking down the scores of people who might have come in contact with Duncan.

And even if the blood tests are more expensive, consider this: The United States is willing to spend $1 billion in aid to the afflicted nations, humanitarian assistance that I wholeheartedly support. But surely if we can do that, we have the money for tests to keep Ebola out of the country.

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