Biden’s Half Measures on Ebola Put the United States at Risk

The Centers for Disease Control and Prevention (CDC) issued an order on Tuesday detailing new public health measures in response to outbreaks of Ebola in Guinea and the Democratic Republic of the Congo (DRC). The order follows a CDC statement just one week earlier that called the threat “extremely low” and prescribed minimal precautions.

The CDC order states that Ebola “can spread quickly between close contacts and within healthcare settings, often with high case fatality rates, and with substantial disruption and strain on healthcare services and broader socioeconomic impacts.” Further, the order states the CDC director has determined that travelers arriving in the United States from the DRC and Guinea “are at risk of exposure to [Ebola].” This contrasts with CDC’s original statement on February 26, which observed, “The outbreaks are centered in remote areas of these countries. The risk of Ebola to the United States is extremely low.”

Ebola outbreaks in the DRC are not uncommon. The country declared the end of its 10th and 11th outbreaks in June and November 2020, respectively. The outbreak in Guinea is its first since 2014–2016, when the largest Ebola outbreak in history resulted in more than 28,000 cases and more than 11,000 deaths and spread to neighboring Sierra Leone and Liberia. Infected travelers also brought Ebola to Mali, Nigeria, and Senegal.

There is a vaccine for this strain of Ebola, which could be used to limit exposure for healthcare workers. But both outbreaks – which occurred independently – are in remote areas of Guinea and the DRC, complicating response activities. Both populations also have a history of vaccine hesitancy. As the CDC notes, air travel can transport people who “may have been exposed to a communicable disease, anywhere across the globe in less than 24 hours,” and “there is a potential for spread within the affected countries and to surrounding countries in both West Africa and Central/East Africa.”

The CDC’s action mirrors the Obama administration’s response to the 2014–2016 West African Ebola outbreak. The new measures transfer all passengers from Guinea and the DRC to six airports to allow for the collection of accurate contact tracing information.

Average daily passenger rates from the DRC (27) and Guinea (33) to the United States are low. However, given that Ebola has an incubation period of two to 21 days, a passenger may not be experiencing symptoms by the time he or she travels to the United States. That is exactly what happened in September 2014, when a traveler from West Africa became ill with Ebola after arrival and died in a Dallas hospital. Two nurses who cared for the patient contracted Ebola and recovered.

The CDC’s rapidly evolving threat assessment makes it challenging to assess the utility of the new public health measures. The CDC order also lacks details on who will follow up with these passengers. Public health professionals are already overwhelmed with the COVID-19 response, which could cause these passengers to fall through the cracks. A simpler solution is a temporary travel ban on passengers returning from Guinea or the DRC, which would prevent the spread of Ebola within the United States. Returning American citizens and permanent residents would be allowed to travel to the United States but should be subject to a 21-day quarantine monitored by state and local health departments.

Addressing two Ebola outbreaks is daunting for public health officials and is especially challenging during a global pandemic. The Biden administration should clarify its assessment of the Ebola threat’s severity and consider measures such as a mandatory quarantine and travel ban.

Anthony Ruggiero is a senior fellow at the Foundation for Defense of Democracies (FDD). He previously served in the U.S. government for more than 19 years, most recently as senior director for counterproliferation and biodefense at the National Security Council, where he chaired senior U.S. government meetings on the U.S. response to the Ebola outbreaks in the DRC (2019–2021). For more analysis from Anthony and FDD, please subscribe HERE. Follow Anthony on Twitter @NatSecAnthony. Follow FDD on Twitter @FDD. FDD is a Washington, DC-based, nonpartisan research institute focusing on national security and foreign policy.