Should we shut the borders?
Well, obviously. But that little bit of common sense predates Ebola by a considerable margin. Like, the entirety of human history.
So let’s ask the question, in regards to quarantine for Ebola.
What are our goals with this infection?
1. Prevent Ebola from infecting those in the US, and/or
2. Prevent folks infected with Ebola from arriving in the US
3. Chose #1 or #2, but accomplish that goal without giving .gov power that you will regret giving, later.
Allow me to point out the underlying assumptions between Goal #1 and Goal #2. Goal #1 is less stringent, and assumes that there is some low-level amount of Ebola that is acceptable in the US. It furthermore assumes that Ebola, while deadly, is not The Pestilence That Will End The World, and that we can successfully treat patients who get it, with acceptable mortality. There is also an undercurrent of hubris and/or normalcy bias inherent in this viewpoint.
Goal #2 makes none of those assumptions.
And the real deal, folks, is that no one knows. No one has any idea if this will turn out badly or not. The best current method to start an argument in the doctor’s lounge is to assert either that Ebola is a nothing virus that will cause no harm, or that Ebola is the next Black Plague that will kill us all. We all have our beliefs and guesses, but absent the gift of prophesy, no one knows.
Currently, .gov has chosen goal #1, and the protocol is:
1. If you have symptoms, you are isolated and tested.
2. If you do not have symptoms, they don’t waste money on testing* but instead asses your risk. Assumes truthful travelers.
—Low risk: observation by state dept of health, voluntary home quarantine
—High risk: observation by state dept of health, home quarantine, but voluntary or mandatory depends on various factors.
(at this time, there is no medium risk category)
*The virus is undetectable by standard testing until at least the time of symptoms, and in some patients not until 3 days after testing. Which is why the NJ nurse’s claim that she should be released because her “ebola test is negative” demonstrates a profound ignorance of reality.
The specific changes to the protocol above depend on whether you have selected Goal #1 or Goal #2.
Some changes being considered for Goal #1 are to enforce mandatory home quarantine on any non symptomatic patient, who is from or has traveled to the most infected area.
For Goal #2, some changes being considered are to 1) either enforce mandatory quarantine on everyone who is from, or has traveled through, the most infected areas, or 2) shut down flights from that area completely. There is some noise that the quarantine should be held at some as-yet-undefined location, not at home.
Those who can think of additional changes to the above protocol are welcome to chime in, down in the comments section. Having MD after your name does not make you a Certified Galactic Intellect. That honor is reserved for old computer programmers.
I am all in favor of enforcing mandatory home quarantine on folks who are from or who have visited the affected area, at a MINIMUM; but let’s face it: this is merely a slightly gilded version of what we are already doing, with a suboptimal track record. The points of breakdown in this strategy are well known: the patient skips down and cannot be found for the health department to follow, they do not follow the quarantine rules (Ebowling!), and when the patient finally goes to the hospital, they infect other folks. The second and third degree effects cannot be predicted.
The liberal argument that folks will fly from west Africa to Europe, rest up a few days, then come to the US on a flight not obviously connected to west Africa is stupid. This implies that Europe, as a whole, would not act in the same fashion to block flights from that area. In fact, it has; only Belgium accepts flights from that area. It can’t be that hard to track all passengers from that area for the last 21 days.
If you want to enforce Goal #2 by isolation in the US, then we have a big logistical problem. Every state–or perhaps just the 5 where all those travelers will be routed–will need to set up an MSF-style isolation wing. It will need to be of sufficient quality that those monitoring the patients won’t get sick, and the patients won’t infect each other. Each camp will have to be able to accept at least 30 (that is, 150 people per day divided by the 5 different camps) patients per day, and hold them for 21 days, which works out to 630 people. And the wherewithal to feed, clothe, wash, and test them all. And survive the inevitable lawsuits and crybaby BS by entitled jerks. And it almost certainly will have to be actual brick-and-mortar buildings, not just tents, given the approaching winter. And it has to be in place, starting yesterday. And let’s face it, folks–they will put FEMA in charge of this. Or perhaps the DHS. Pick your poison.
This looks like an easy way to screw up Goal #3.
So let’s turn to Method #2, Goal #2. There will be shouts of outrage from the Left. Weeping and wailing, and gnashing of teeth. “It will make the outbreak in Africa worse!” (compared to what?) “We need to take care of the problem over there!” (most assuredly, but it does not follow that we have to import cases here.) “It will be difficult to implement, and people will slip through!” (True, true, and neither are related to whether or not we should try.)
There is an argument out there, exemplified here, that states that if we implement a travel ban, then our risk is still relatively high. This may or may not be true, but it misses the key fact: It gives us time to catch up with the OODA loop of the virus.
We need time!
Time to sort out the PPE issues and get trained. Time to determine which hospitals will take these patients. Time to set up the logistics of developing a crew of at least 18 (if not more) ICU nurses to take care of a single patient on a long term basis. Time to report on what has been done with the patients, worldwide, who have been treated with first world medicine, and try to come up with a game plan for treating them. Time, folks. Time to get the monstrous leviathan aroused.
That’s why we should shut down the border. Protection is nice but will eventually fail. The time it gives us, if used well, will be critical.
And let me leave you with this final thought, dedicated to those politicians and boot lickers that have botched everything so far:
Folly, thou conquerest, and I must yield!
Against stupidity the very gods
Themselves contend in vain. Exalted reason,
Resplendent daughter of the head divine,
Wise foundress of the system of the world,
Guide of the stars, who art thou then if thou,
Bound to the tail of folly’s uncurbed steed,
Must, vainly shrieking with the drunken crowd,
Eyes open, plunge down headlong in the abyss.
Accursed, who striveth after noble ends,
And with deliberate wisdom forms his plans!
To the fool-king belongs the world.