Representatives Push for Travel Ban at Ebola Hearing
The issue of travel bans dominated a congressional panel on Ebola on Thursday, as members of the House Subcommittee on Oversight and Investigations pressed officials on why travel restrictions were not in place for passengers coming from the affected countries in West Africa.
The hearing came as the World Health Organization predicted that the death toll from the virus would rise above 4,500 people in West Africa, with infections topping 9,000.
The panel consisted of officials from the Centers for Disease Control and Prevention, the National Institutes of Health and the Department of Homeland Security, among other agencies, who testified on the government’s response to the disease so far.
The primary focus of the hearing was the handling of the first domestically diagnosed case of Ebola. Thomas Eric Duncan, a Liberian, became the first person to be diagnosed with the disease in America on Sept. 30. He died on Oct. 8, in a hospital in Dallas, Texas. In the weeks following his death, two health care workers responsible for his care — Nina Pham and Amber Joy Vinson — were both confirmed to be infected with Ebola.
Opening the hearing, Subcommittee Chairman Tim Murphy (R-Penn.) asked, “Why was the CDC slow to deploy first response teams?” In a statement released earlier in the day, Murphy said, “There is no room for error when it comes to Ebola.”
“It would be an understatement to say that the response to the first U.S. patient of Ebola has been mismanaged,” Ranking Member Diana DeGette (D-Colo.) said during the hearing.
“Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes,” Dr. Daniel Varga, the chief clinical officer and senior executive vice president for Texas Health Resources, said in his testimony. “We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry.”
The CDC updated its protocol for hospitals dealing with Ebola cases on Tuesday, following the infections in Dallas. The new guidelines, which remain voluntary, suggest using suits that would cover a health care worker from head to toe and also recommend that a supervisor oversee the proper removal of protective gear.
President Barack Obama on Wednesday directed the CDC to put together Ebola rapid response teams to dispatch to local hospitals in case of infections.
Among those testifying on Thursday were Dr. Thomas Frieden, director of the CDC, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at NIH, Dr. Luciana Borio, assistant commissioner of counterterrorism policy at the Food and Drug Administration, and John P. Wagner, acting assistant commissioner at the Office of Field Operations, Customs and Border Protection at the Department of Homeland Security.
Frieden’s opening testimony focused on the measures already taken in the U.S., including airport screening, and CDC officials involved in the response in West Africa. Frieden said the CDC’s top priority was to protect Americans.
Fauci, director of NIAID, focused on the ongoing research into therapeutics and vaccines, including research into more accurate diagnostic tools for Ebola. He also confirmed that one of the infected health workers, Nina Pham, would be moved to a unit at NIH for “state-of-the-art care.”
Several representatives questioned the officials about why travel restrictions had not been put in place, saying their constituents were pushing for travel bans from countries stricken with Ebola.
Frieden defended the CDC’s opposition to the travel ban, saying such travelers could easily be screened and tracked. “Currently, we have detailed locating information,” Frieden said, adding that a travel ban would mean losing a lot of the tracking information now available. When Chairman Murphy pressed him further, Frieden said, “We will consider any options to better protect Americans.”
Fauci also opposed a travel ban, agreeing with Rep. Henry Waxman (D-Calif.) that such a ban would exacerbate the Ebola outbreak in West Africa.
Frieden later clarified that a travel ban would make it much harder to screen, locate and track travelers coming in from West Africa. When asked about the issue again, he said it was important to keep in mind that many of those flying from West Africa were American citizens, traveling with U.S. passports.
Reps. Marsha Blackburn (R-Tenn.) and Billy Long (R-Mont.) also voiced their support for travel bans, bringing up the matter of the “porous” southern border of the U.S. posing a threat to Border Patrol officials.
Rep. Steve Scalise (R-La.) pushed Frieden on whether travel bans were brought up in discussions between the CDC and the White House. Frieden replied, “I cannot speak for the White House.” Scalise then suggested the U.S. suspend visas to the countries stricken with Ebola, to which Frieden replied, “The CDC does not issue visas.”
Change in Guidelines
Rep. Bruce Braley (D-Iowa) pressed Frieden on whether the Dallas case had prompted any changes in guidelines. Frieden said the three areas of focus were now on 1) rapid diagnosis, 2) tracing and monitoring of those who came in contact with a patient for 21 days and 3) quarantining those who were infected.
Rep. Jan Schakowsky (D-Ill.) asked Frieden how the two nurses in contact with Duncan became infected. Frieden said that while the Texas hospital was waiting for confirmation on Duncan’s illness, there was “some variability” in the use of personal protective equipment. Asked how health care workers could better protect themselves, Frieden said, “Think Ebola” in cases that showed Ebola symptoms and a travel history that included Africa.
Rep. Phil Gingrey (R-Ga.) brought up the issue of the CDC’s standards, asking whether the agency’s guidelines for personal protective equipment met “international standards” put in place by organizations working in West Africa. Frieden said, “There is no single right answer,” adding that the CDC’s current guidelines conformed to recommendations from WHO. The CDC’s current guidelines can be found here.
Vaccines and Diagnostics
Fauci said the NIH was collaborating on developing vaccines with GlaxoSmithKline and NewLink Genetics so they could move toward trials. One vaccine proved “favorable” in animal trials, he said. Vaccine candidates would begin clinical testing in 2015.
On the matter of diagnosis, Frieden said there was currently no way to test someone for Ebola before they showed symptoms. “We can’t even find tiny amounts of it in people’s bodies until they get sick,” Frieden said in response to Rep. John Yarmuth (D-Ky.). He later added that the U.S. Navy had one test in development.
Last week, FRONTLINE sent 200 copies of the documentary Ebola Outbreak at the CDC’s request to help the agency train health workers battling the disease in West Africa. You can watch the film below.
Watch our documentary, “Ebola Outbreak”: