The Trump administration is setting up a quarantine and treatment facility in Kenya for Americans exposed to the Ebola outbreak in the Democratic Republic of the Congo, rather than repatriating them to the United States.
A White House official confirmed the plan, saying the Kenyan facility is intended to provide timely, high-quality care for Americans who need to leave the DRC quickly and quarantine without the hazards of a long transport back to the US.
The center will also be able to treat patients who develop Ebola, including providing critical care when required. The official added that each case would be reviewed to determine whether forward transfer for more advanced care was appropriate to maximize outcomes, but did not say whether that onward transport would be to the US or to European facilities used previously.
It was also unclear whether Americans could opt to return directly to the United States instead of going to Kenya.
US policy currently bans green card holders and certain recent travelers to the DRC, Uganda and South Sudan from entering the United States.
Public health experts expressed alarm at the decision. Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University, called the approach “shocking” and warned of serious ethical and public-health problems. She said inadequate planning for safe quarantine and prompt isolation could risk amplifying transmission, and that preventing people from coming home might discourage disclosure of exposure and drive cases underground.
Those concerns extend to staffing the response. Many Americans who volunteered for past outbreaks did so with the reassurance that they could return home for world-class care if they became ill. Without that assurance, experts say, potential volunteers may be far less likely to go.
Jeremy Konyndyk, president of Refugees International and a former USAID official involved in Ebola and Covid-19 responses, said the policy sends a message to US health workers that if they fall ill they may not be allowed to come home, which could dissuade crucial volunteer assistance. He noted that during the 2014 Ebola response the US avoided a travel ban for similar reasons, because such restrictions can be counterproductive to outbreak control.
Officials also point out that the risk associated with transporting people who are not symptomatic is very low, and that the US has extensive experience evacuating individuals exposed to or infected with Ebola and other high-consequence pathogens. Questions remain about how the new Kenyan facility will operate, how decisions about onward transfer will be made, and what options, if any, exposed Americans will have to return to the United States.
