\n<\/p>\n
The US is imposing strict restrictions on American travelers who have been exposed in dual Ebola and hantavirus outbreaks in ways that experts say could run counter to their legal rights and affect who will volunteer in future public health crises globally.<\/p>\n
The latest restrictions highlight officials\u2019 previous rhetoric on public health measures and their attempts to contain outbreaks now, including reported opposition from the White House to Americans returning home.<\/p>\n
The US is not bringing home an American doctor sickened by Ebola and six other people with exposure to the virus. Instead, the patients and others are being moved to Germany and the Czech Republic, officials said on Wednesday.<\/p>\n
It is \u201cunlikely\u201d that there will not be more cases of US citizens and residents wishing to return from Ebola-affected regions, and \u201cit would be very concerning if Americans weren\u2019t able to\u201d, said Alexandra Phelan, an associate professor at Johns Hopkins Bloomberg School of Public Health. The unofficial policy could substantially dampen the response from volunteers to the region providing critical assistance, she said.<\/p>\n
\u201cThere is a very real likelihood that this outbreak may get much more serious, and the need for international support is going to be quite significant,\u201d Phelan said.<\/p>\n
The move follows mandatory quarantine measures in Nebraska for passengers from the MV Hondius who were exposed to Andes virus, a type of hantavirus, despite requests from some of the passengers to quarantine at home.<\/p>\n
The American Ebola patient is now hospitalized in Germany in stable condition, while the other US citizens were on their way to Germany or Czechia, Satish Pillai, the Ebola response lead at the US Centers for Disease Control and Prevention (CDC), told journalists on Wednesday. \u201cThese people, who remain asymptomatic, are being moved to ensure that they have access to the specialized care if needed,\u201d he said.<\/p>\n
When asked why these locations were chosen, instead of evacuating the Americans home as in previous outbreaks, Pillai said they were the \u201cmost expeditious\u201d options in a fast-changing situation with \u201cthe need to move quickly\u201d, adding that \u201cthese locations were chosen based on the needs that were present at that time.\u201d Czechia in particular is not known for its experience in treating viral hemorrhagic fevers, but Pillai said it had an existing relationship with the US state department and the Administration for Strategic Preparedness and Response.<\/p>\n
During the 2014-15 outbreak, Trump was outspoken about Ebola, posting frequent calls on social media for Americans who had Ebola or were exposed to the virus to be turned away. People who volunteer to help in Ebola outbreaks \u201cmust suffer the consequences\u201d, he said in August 2014.<\/p>\n
In this outbreak, the White House opposed bringing at-risk Americans home, according to reporting by the Washington Post. Pillai would not confirm in the press conference on Wednesday that the White House made this decision, instead pointing to \u201cthe conditions on the ground\u201d and \u201cthe need to rapidly mobilize\u201d.<\/p>\n
But the law on being able to return home is \u201creally simple\u201d, Phelan said. US citizens and green card holders have a legal right to return to the United States. The order on travel restrictions issued on Monday is clear that it doesn\u2019t apply to US citizens. And the US has some of the best biocontainment facilities, medical care and treatment options in the world, Phelan added. \u201cMillions of dollars have been poured into these facilities for exactly this situation.\u201d<\/p>\n
Doubt about whether health workers and other outbreak responders may return to the US could mean fewer Americans volunteer to help stop the outbreak, Phelan said.<\/p>\n
\u201cAny other indications that Americans are being prevented from returning home in some way, shape or form, would serve as disincentives to support that may be absolutely vital to the international response to this growing crisis.\u201d Phelan addded.<\/p>\n
<\/span>A passenger of the cruise ship MV Hondius, affected by a hantavirus outbreak, looks on from inside a bus in Tenerife, Spain, on 11 May.<\/span> Photograph: Hannah McKay\/Reuters<\/p>\n Craig Spencer, a doctor who contracted Ebola after volunteering in Guinea in 2014 and who was attacked online by Trump, said in an interview four years later that it was already difficult to find nurses and doctors who could take the time to volunteer \u2013 and the possibility of not returning home would mean fewer people would be able to help, the epidemic would continue, and the risks to everyone would increase with a less-controlled outbreak: \u201ca pure disaster\u201d, Spencer said.<\/p>\n When asked if this policy would deter volunteers, Pillai pointed to existing organizations in the Democratic Republic of the Congo and Uganda that \u201chave been integral in providing healthcare support\u201d already.<\/p>\n When passengers on the hantavirus-stricken cruise ship were flown back to the US, officials first ruled out the idea of mandating quarantine.<\/p>\n But now, they are requiring certain passengers to remain in the Nebraska biocontainment facility until the end of the month \u2013 even though some passengers have attempted to leave and quarantine at home.<\/p>\n \u201cThe decision was made across the leadership in the US government to have the passengers stay in Nebraska until 31 May, which marks the 21st day of their monitoring period,\u201d David Fitter, the CDC\u2019s hantavirus lead, told journalists on Tuesday. \u201cWe\u2019re constantly regarding the situation and evaluating where things are.\u201d<\/p>\n The decision reportedly came from Jay Bhattacharya, who is performing some of the duties of CDC director until the nominee is confirmed by the Senate. Angela Perryman, a 47-year-old woman who had conversations with a passenger who later died from the Andes virus, told the New York Times that she had tested negative and had no symptoms, and would like to quarantine in an Airbnb in south Florida. Another passenger, a 30-year-old man, said he would like to quarantine in New York state.<\/p>\n Bhattacharya rose to prominence by pushing back against public health measures, which he loosely terms \u201clockdowns\u201d, in the Covid pandemic. In 2023, he criticized the US Air Force Academy for quarantining cadets; two students later killed themselves. Bhattacharya highlighted the \u201charms of social isolation\u201d and said the situation was \u201ctragic\u201d.<\/p>\n \u201cAny public health measure that is imposed has to be based on reasonable scientific evidence or principles, and has to be proportionate and necessary to achieve the public health outcome,\u201d Phelan said.<\/p>\n The guiding concept in global health law is implementing \u201cthe least restrictive measure necessary to achieve the public health outcome\u201d, she added. If a measure is more restrictive than necessary, then it is infringing on personal rights.<\/p>\n Most people want to follow quarantine directions, but they may be more comfortable in their own home, where the long quarantine time may be more bearable. In public health, \u201cthe preference is to use voluntary home quarantine as the least restrictive option available,\u201d Phelan said.<\/p>\n In the case of passengers testing negative with no symptoms and a safe way to return home, \u201cI could see a reasonable judge making that conclusion,\u201d she said.<\/p>\n There is a previous case for comparison, and it goes back to the Ebola outbreak of 2014. When Kaci Hickox, a nurse who treated patients in west Africa, returned to the United States, the CDC did not require her to quarantine in a facility. But Chris Christie, the then governor of New Jersey, attempted to mandate quarantine \u2013 a move that eventually the courts rejected.<\/p>\n","protected":false},"excerpt":{"rendered":" The US is imposing strict restrictions on American travelers who have been exposed in dual Ebola and hantavirus outbreaks in ways that experts say could run counter to their legal rights and affect who will volunteer in future public health crises globally. 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