Trump administration officials on Thursday said Americans exposed to Ebola during the current outbreak in the Congo will be sent to a newly constructed facility at an air base in Kenya, instead of returning them to the U.S. The officials said it was the best option to expedite their care.
The decision is a break from past practice during prior Ebola outbreaks when Americans were brought home for care. An American doctor who cared for Ebola patients during the 2014 epidemic in west Africa, Craig Spencer, and was treated in New York City after returning home and developing symptoms, has already said the decision to send U.S. citizens to Kenya amounted to abandoning “our responsibility for our own.”
At this point, there is no one at the Kenyan facility. One American doctor infected with the disease after treating an Ebola patient in the Congo’s Ituri province, the epicenter of the outbreak, is in Berlin. One of his colleagues is in Prague, though he does not have symptoms.
Administration officials said any Americans moved to Kenya due to exposure to the lethal hemorrhagic fever will mostly quarantine there. They will ultimately be transported to Europe if they become sick.
Secretary of State Marco Rubio suggested Wednesday at a Cabinet meeting that U.S. borders were closed to anyone with Ebola.
“We cannot and will not allow any cases of Ebola to enter the United States,” Rubio said.
At a briefing Thursday, one of the senior administration officials, all of whom spoke to reporters only after they agreed not to use the officials’ names, insisted the decision to send Americans to Kenya was based purely on what was best for their health. “These decisions were made to make sure we provide the best care, optimize what can be done for our American citizens who are overseas,” the official said.
Because the approach is a departure from previous Ebola outbreaks, it has sparked pushback from doctors, public health advocates and career diplomats, who argue that the United States has over a dozen of the best facilities in the world to care for people with Ebola and should not deny its citizens, some of whom are responding to the outbreak, that lifesaving treatment.
The American Foreign Service Association, the labor union representing career diplomats, protested the decision Wednesday after the New York Times reported it, stating that its members exposed to Ebola had a “right to come home.”
The senior administration official said they were “certainly not aware of any political factors” that played into the decision. “We felt it was better to transport these individuals to closer institutions, incredibly high-quality tertiary care institutions, as opposed to facing a very long transit time back to the United States.”
Spencer, a physician who treated patients in Guinea in 2014 and later came down with the disease, wrote on Substack that the administration had misplaced priorities. “The administration has said its number one priority is keeping Ebola out of America, and its number two priority is ending the outbreak in central Africa. Nowhere on that list are the Americans we are asking to step up and respond,” he wrote.
President Donald Trump has not weighed in, but during the 2014 Ebola outbreak — which by the time it ended in 2016 was the most deadly of more than 30 Ebola outbreaks since the 1970s, with more than 11,000 killed — said the United States could not allow people infected with the virus to return.
“People that go to far away places to help out are great-but must suffer the consequences!” Trump wrote on Twitter at the time.
So far over 1,000 people are suspected to have contracted Ebola in the current outbreak. The strain that is spreading, called Bundibugyo, is rare and there are no licensed treatments or vaccines. Nearly 250 people are thought to have already died from the virus, according to the Africa Centres for Disease Control and Prevention, the public health agency of the African Union. The outbreak is already the third largest on record and public health officials fear it had been spreading for months before it was discovered earlier this month.
Tests for the Bundibugyo strain are harder to come by, which contributed to its late detection. Some who work in the region also blame foreign aid cutbacks by the U.S. and other wealthy nations. Rubio has blamed the World Health Organization, the United Nations agency in charge of responding to epidemics, for catching the outbreak late. But Tedros Adhanom Ghebreyesus, the WHO director-general, has pushed back, saying that it’s up to countries to detect and report outbreaks, not the WHO.
Beyond helping Americans in the Ebola-affected region, which includes the Democratic Republic of the Congo and Uganda, where several people have come down with the disease, and South Sudan, which abuts Ituri Province, the administration has also implemented airport screenings for Americans returning from the area and restricted travel to the U.S. for people who aren’t American citizens, one of the officials said.
“Obviously, we want to make sure that Americans on the ground there as quickly and efficiently get the care they need,” the official said, “but obviously beyond that, the administration is also … taking a broad swath of other actions to ensure that Americans in the United States don’t contract disease, so these two things aren’t mutually exclusive at all.”
The Kenyan facility will be located at the U.S. ally’s Laikipia Air Base, in the center of the country about 125 miles north of the capital, Nairobi. There will be 50 available beds beginning on Friday to quarantine Americans exposed to Ebola. The president of Kenya, William Ruto, has approved the plan, a third senior administration official said, and the U.K. is in talks with the U.S. about joint access to the facility.
Thirty U.S. health care specialists in the Commissioned Corps of the U.S. Public Health Service trained to deploy around the world to stop the spread of disease will staff the facility. The officers headed to Kenya, some of whom responded to the 2014-2016 Ebola outbreak, trained for three days at Joint Base Andrews in Maryland, officials said, and will continue training once on the ground.
“This is an incredibly high level of care. We’ll be training an additional cadre of officers on the upcoming weekend, who will then be able to depart to the Kenya facility next week,” the first senior administration official said.
The U.S. is also transporting three isolation units that could house people who become symptomatic or test positive for Ebola, each able to accommodate four people, the official said. There will also be two biocontainment units, each able to hold two patients, with the goal of caring for people who show symptoms or test positive on the base temporarily until they can be flown to Europe for higher-quality care.
Where in Europe has not been determined, officials said, describing it both as a current negotiation between the Centers for Disease Control and Prevention, State Department and other countries, as well as a case-by-case medical decision.
“Medical professionals on the ground in Kenya will decide when transportation should be initiated, so they will make that on an individual person-to-person decision, it won’t be a cookie cutter approach,” the first official said.
Officials did not have an estimate for how many Americans, if any, would need to quarantine or seek treatment in Kenya. So far, the one U.S. doctor who has contracted Ebola, Peter Stafford, who works with the Christian missionary group Serge, is recovering at Berlin’s Charité Hospital. His colleague Patrick LaRochelle is being monitored at Prague’s Bulovka University Hospital.
A German government official told POLITICO that Germany agreed to a U.S. request to treat Stafford because of German experience in treating Ebola patients in the past and because “the flight time to Germany is significantly shorter, so treatment could begin much more quickly here.”
Hans von der Burchard in Berlin, Germany, contributed to this report.
