White House response to hantavirus and Ebola contrasts with COVID criticisms

Global Health

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The administration imposed mandatory federal quarantine orders on two American passengers from the cruise ship hit by the hantavirus, wants round-the-clock guards for some U.S. passengers quarantining at home, banned people from countries where Ebola is spreading from entering the U.S, and blocked Americans who catch Ebola from returning to the country for treatment.

"They have spent so much time talking about not having the government impose on peoples individual decisions and individual movement, touted individual choice over public health, and argued that individual freedom trumps public health guidance," says Dr. Ashish Jha, a senior fellow at Harvard University who served as President Biden's COVID-19 Response Coordinator. "And yet, in response to the hantavirus and Ebola, this administration has chosen to impose very draconian and extreme public health measures."

Stringent restrictions criticized as an overreaction

The administration, and some outside experts, defend the steps as necessary to protect the American public. Critics say the aggressive measures are uncalled for and counterproductive, and worry that similar tactics would be imposed more widely if any kind of outbreak actually occurs in the U.S.

"It's very concerning about what overreaction we may see," says James Hodge, a public health law professor at Arizona State University. "How far will this government go to contain an outbreak?"

The actions are surprising to some because of the administration's criticisms of lockdowns, mask mandates, vaccine requirements and other measures imposed during the pandemic. In addition, federal health officials frequently cite "health freedom" or "medical freedom" in announcing new policies, such as questioning vaccines and making unproven remedies such as peptides more easily available. The health freedom movement calls for leaving more medical decisions up to individuals.

"Health freedom is about giving people more choices," Jha says. "That's certainly not been consistent with the actions they've been taking."

The first controversial measure involved some of the passengers aboard the Dutch cruise ship hit by the hantavirus that claimed three lives. Federal officials initially said passengers flown from the ship to a federally funded quarantine unit in Omaha, Neb., were being kept there voluntarily. But the administration then took a very rare step: imposing mandatory federal quarantine orders on two of the passengers who wanted to quarantine at home like some other passengers.

"That's heavy-handed. And really quite unnecessary," Hodge says.

Given the virus doesn't appear to spread very easily from one person to another, the passengers could quarantine at home without posing a danger to the community, Hodge and others say. Passengers who left the ship early on were allowed to do that.

Next, the federal government said passengers leaving the federal quarantine unit in Nebraska could finish their quarantines at home only if they were subject to round-the-clock monitoring by their local health departments.

"They're taking a lot of steps that many would view as very authoritarian, very over-the-top," Hodge says.

Travel bans could undermine care

In the meantime, the Ebola crisis erupted in Africa— triggering two controversial reactions by the Trump administration. First, the administration banned anyone from countries with Ebola outbreaks from entering the U.S. even though the World Health Organization opposes such bans.

But even more surprising to many public health and infectious disease experts, federal officials also barred U.S. citizens helping fight Ebola from coming home to get treated if necessary. Instead, the administration has been sending Americans to Europe for treatment and wants to open a facility for exposed people in Kenya.

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"It's completely stunning that we would not allow Americans to return to the United States," says Jennifer Nuzzo, who runs Brown University's Pandemic Center. "We have specialized, taxpayer-built units that exist solely for this purpose: to provide life-saving care to people who may be exposed to deadly diseases while they are doing important public health work."

Tough immigration stance echoed in public health response

In some ways, the tactics mirror the administration's immigration crackdown, says Lawrence Gostin, a public health law professor at Georgetown.

"The administration is conflating its immigration policy with public health guidance and expertise," Gostin says. "We're seeing a real overkill that's trampling the civil liberties of American citizens."

Similarly, the Trump administration invoked a public health regulation during the pandemic to quickly expel migrants and asylum-seekers at the U.S.-Mexico border to prevent the spread of the virus.

Gostin calls the administration's actions "political theater."

"The administration is trying to look tough," Gostin says. "And that's just no way to deal with an infectious disease that really doesn't know borders. We need to use science and public health rather than political theater and overkill."

The tactics could backfire by discouraging other countries from reporting outbreaks early, undermining public trust, and driving exposed and infected people into hiding instead of cooperating with public health authorities, Gostin and others say. That increases the chances people will bring dangerous infections into the country and spread the pathogens, experts say. The best way to protect Americans is to stop outbreaks at the source, according to Gostin and other public health experts.

"A lot of times there's unintended consequences that work against you when you set up travel bans like this," says Dr. Martin Cetron, former director of the division of global migration and quarantine at the Centers for Disease Control and Prevention. "The restrictions can drive people underground."

Department of Health and Human Services spokesman Andrew Nixon said in an email that the administration was mounting an "aggressive" response. But said the restrictions were "targeted" and aimed at "protecting the health and safety of the American people."

But the aggressive tactics are raising fears about how the administration will respond if an outbreak of hantavirus, Ebola or some other pathogen erupts in the U.S.

"Should we start having some outbreaks in the United States, it could be deeply problematic," says Wendy Parmet, a public health law professor at Northeastern University.

Other public health experts, however, defend the administration's response to the hantavirus, given the strain of the virus involved in the cruise ship outbreak can spread from person to person and can be deadly.

"These are judgment calls. I'm not going to second-guess it," says Dr. Robert Redfield, a visiting fellow at the Heritage Foundation, a conservative think tank. Redfield also ran the Centers for Disease Control and Prevention during the first Trump administration.

Redfield says the Ebola travel ban is also reasonable, though he disagrees with the decision to keep Americans who need treatment from returning to the U.S. "They should be able to come back," Redfield says. "Your likelihood of survival if you do get Ebola will be directly linked to the quality of care that you get."