AS EBOLA REACHES U.S. SOIL, SCHUMER STATES NO NEED FOR PANIC, BUT TIGHTENING UP PROTECTIONS MUST BE ON THE TABLE; CALLS FOR FEDS TO INTENSIVELY SCREEN & TAKE TEMPERATURE OF PASSENGERS COMING FROM EBOLA HOTSPOTS, WHEN THEY ARRIVE AT U.S. AIRPORTS - ALSO PROVIDE LOCAL HOSPITALS WITH LIST OF THOSE TRAVELERS TO AVOID REPEATING DALLAS HOSPITAL MISTAKE
First, CDC Must Train Federal Airport Agents To Actively Screen Air Passengers
for Fevers & Take An Extensive CDC Health Survey on U.S. Soil For
Those Returning from West Africa– Senator Said More Safeguards Needed
In Addition To Screening in W. African Airports
Second, Since Liberia Has Second Largest Cargo Ship Industry, Schumer
Calls for Individuals Working on Ships & Entering Port of NY/NJ to
Undergo the Same Screening
Third, Schumer Proposed that CDC and CBP Make a Database Available to
Hospitals That Lists All Individuals That Have Recently Traveled to West
Africa – This Searchable, 90 Day, List Is Similar to One Already
Made Available to Law Enforcement
With Ebola now on U.S. soil, U.S. Senator Charles E. Schumer said earlier this week that while there is no need for panic, there is a real need to tighten protections for Americans at airports, ports of entry and hospitals. First, Schumer is calling on the Centers for Disease Control and Prevention (CDC) to train federal Customs and Border Protection (CBP) airport agents to actively screen air passengers for fevers upon arrival in the United States, when the traveler originated from Ebola hotspots in West Africa, through either a direct or indirect flight. Fevers are an early warning sign of Ebola, but currently individuals are only being screened in West Africa. Schumer urged that this process also require that those travelers fill out a detailed CDC health form to help detect any contact had with Ebola before they arrived in America. CDC and CBP should also conduct this intense health screening for personnel working on cargo ships at our ports of entry, particularly considering that Liberia has the second largest cargo ship fleet in the world. Experts have said almost universally that a travel ban will not work, and CDC is vehemently opposed, but checking temperature and screening on U.S. soil could well be an acceptable middle ground.
Second, Schumer urged the U.S. Department of Homeland Security (DHS) to create a database of passengers flying to and from West Africa, directly or indirectly, to be shared with local hospitals nationwide. Schumer will explain that this searchable, 90-day, database should be similar to those that are already shared with local law enforcement, and could serve as a tool for hospitals and help avoid mistakes like that in Dallas. Lastly, Schumer will call for additional CDC funds to go towards contact tracing in West Africa, which is a highly successful yet underfunded procedure abroad.
Schumer noted that the CDC has done a good job thus far in protecting Americans from the virus, including the health workers that are dealing directly with potential and confirmed Ebola cases. The CDC has said it is open to recommendations to further protect Americans from Ebola, and Schumer will send his recommendations to them.
“As the largest Ebola epidemic in history continues to spread, we need to use every precaution to help prevent everyone, both in the U.S. and in Africa, from being further infected with this deadly virus,” said Senator Schumer. “The federal government, led by the Centers for Disease Control and Prevention, has done good work thus far, but more commonsense steps at our airports, ports and hospitals should be taken to tighten up protections against the deadly virus’s spread in the United States.”
First, Schumer called on CDC personnel, in conjunction with CBP, to conduct a more comprehensive health procedure at United States’ international airports and ports, including a temperature-check and CDC-created health survey, for travelers returning from Liberia, Guinea, Sierra Leone and Nigeria, either directly, or through another secondary airport to connect, like Munich, Brussels, London, Frankfurt, and Amsterdam. The CDC has directed West African countries to conduct fever checks before people depart Ebola-affected countries, yet, individuals are not required to undergo the same rigorous health testing once landing in the United States. Currently, CBP is “passively screening” passengers per CDC guidance, which only entails visual observation to determine if a passenger appears to be ill. Screening and testing one’s temperature in the U.S. adds an extra and very reliable layer of protections. In addition, it will catch those that showed no symptoms when departing West Africa, but that developed them while in flight.
Schumer is also asking CDC and CBP to initiate a “health declaration form,” which should include an in-depth questionnaire asking specific questions about their stay in West Africa. This questionnaire could trigger further questions about their potential contact with Ebola-affected individuals, even if they do not display a fever at that time. Schumer explained that because Mr. Duncan allegedly lied on his form, it’s possible that a more in-depth and comprehensive questionnaire could both prevent further individuals from lying and/or catch individuals who may be withholding information.
Additionally, Schumer wants personnel on cargo ships from the same West African countries to be screened in the same way. Schumer noted that this would apply to ships from all of these countries, but in particular, Liberia’s cargo fleet includes 3,500 Liberian-flagged ships and is the second largest in the world.
Second, Schumer urged DHS to create a temporary database of passengers flying to and from Liberia, Guinea, Sierra Leone and Nigeria, either directly, or through another secondary airport. On a short-term, emergency basis, Schumer said that DHS should make this database available to local hospitals nationwide in the same way that the database is shared with local law enforcement. Schumer said that, the hospital-shared database should expire in 90 days, in order to protect privacy concerns. Schumer explained that a health database would allow hospitals to easily search the names of individuals in their care that raise concerns over Ebola, and would help ensure that admitted patients do not lie or omit information about their prior travels.
Third, Schumer urged that CDC to reallocate their general funds and other resources to go towards “contact tracing” abroad. Contact tracing allows officials to determine who may have been exposed to the virus and monitor those individuals. This process of ensuring containment was highly effective in containing SARS and is incredibly underfunded. Contact tracing is effective when you can locate any potential contacts and monitor them for symptoms for 21 days in the case of Ebola. According to a recent CNN article, this has proven to be extremely difficult in West African countries due to the lack of record keeping and databases where potential contacts can be found. There are also not enough people to do the work of contact tracing. This is why additional resources and funding is needed in these counties to assist with this work and the overall containment of the disease.
According to the CDC, the 2014 Ebola epidemic is the largest in history. Thus far, the virus has affected numerous countries in West Africa, including Guinea, Liberia, Nigeria and Sierra Leone. Additionally, Senegal was affected because of a travel-associated case. Overall, among Guinea, Liberia and Sierra Leon, there have been 7,157 total cases, 3,330 total deaths and 3,953 lab-confirmed cases as of October 2, 2014. In Nigeria, there have been 20 total cases, 8 total deaths and 19 lab-confirmed cases.
A copy of Schumer’s letter is below:
Dear Dr. Frieden and Commissioner Kerlikowske,
I write today to applaud the work and tireless effort you have given to
keep Americans safe in light of the recent confirmed case of Ebola in
the United States, as well as to offer additional steps that could be
taken to further address the spread of Ebola in the U.S. and abroad. As
you know, currently there are several suspected cases of Ebola in several
states. For the safety and security of the American people, I respectfully
request the Centers for Disease Control and Prevention (CDC) utilize its
resources and authority to increase the surveillance and containment of
Ebola in the U.S. and abroad. More resources are needed to accurately
detect and track this emerging virus and the appropriate agencies need
to work in concert with the CDC to ensure that Americans remain safe and healthy.
Since the emergence of Ebola in several West African countries, there
have been three confirmed cases of U.S. citizens with Ebola as well as
several other suspected cases of U.S. citizens with the virus in the US
and abroad. I applaud the CDC’s immediate response to those cases
and their continued preventive efforts in the West African countries surrounding
those that have had Ebola outbreaks. While the CDC has put significant
investment into sending supplies, training materials for detecting the
illness and volunteers overseas, I ask that CDC work with the Customs
and Border Protection (CBP) in major U.S. ports of entry to increase the
monitoring and identification of people arriving from the affected countries
both by plane and by cargo ship. In addition, due to the importance of
information gathering during any potential health epidemic, the CDC should
work with CBP to initiate a “health declaration form,” which
should include an in-depth questionnaire asking specifics about a person’s
stay in West Africa. This should be implemented for travelers returning
from Liberia, Guinea, Sierra Leone and Nigeria, either directly, or through
another secondary airport such as Munich, Brussels, London, Frankfort
and Amsterdam.
Due to the severity of Ebola symptoms, there is a great need for accurate
and immediate information to be shared with hospitals across the U.S.
The CDC has certified only 13 states whose hospitals and local health
officials are equipped to handle cases of Ebola. Therefore, I urge CDC
to work with the Department of Homeland Security (DHS) to create a database
of passengers flying to and from West Africa, directly or indirectly,
that can be shared with local hospitals nationwide. This database would
allow hospitals to confirm whether patients exhibiting symptoms have been
to one of the source countries and would ensure that physicians have the
most truthful information of a patient’s travel itinerary. It is
important that this database only contain information relevant to a person
health and travel and have an expiration date. The database should be
shared and made available to local hospitals in the same way that similar
information is shared and available to local law enforcement.
The CDC has been utilizing contact tracing to identify who has been in
contact with a person infected with Ebola, which is a crucial factor in
finding where a source of Ebola has arisen, additional people who may
need to be screened and for containment of the disease. I ask that, as
this is the largest Ebola outbreak in history and in light of the increasing
plausibility of Ebola coming to the U.S, that CDC work with other agencies
such as USAID to redirect significant funding dedicated to contact tracing
in the U.S. and in West Africa.
I believe a coordinated effort between the CDC, CBP and DHS as well as
local health departments is essential to protect the public’s health.
Thank you for your continued efforts to protect the health of all Americans,
and for your consideration of this critical and urgent request. Please
let me know if I can be of assistance.
Sincerely,
Charles E. Schumer
United States Senator