Residents of the St. Paul Bridget neighborhood take a man suspected of carrying the Ebola virus to a clinic, in Monrovia, Liberia.

Residents of the St. Paul Bridget neighborhood take a man suspected of carrying the Ebola virus to a clinic, in Monrovia, Liberia. Jerome Delay/AP

The CDC Is Relying on People To Tell the Truth About Contact with Ebola

The CDC’s proposed thermal screenings provide a fictional sense of security, according to both border protection officials and health experts. By Patrick Tucker

People traveling to the United States from West Africa through five of the nation’s busiest airports could now face temperature screening and enhanced questioning.

The additional screenings at New York’s JFK Airport this weekend and then Washington, D.C.’s Dulles Airport, Chicago’s O’Hare, as well as Atlanta and Newark shortly after will consist of questions about where the traveler has been prior to or in addition to temperature taking. “If a traveler has a fever or other symptoms or has been exposed to Ebola, [Customs and Border Patrol] will refer to CDC to further evaluate the traveler,” according to a CDC statement.

Prior to leaving Liberia, Thomas Eric Duncan, the Liberian man who was diagnosed with Ebola in Dallas on Sept. 30, filled out a questionnaire in which he denied that he had any contact with someone suffering from the virus, according to The Washington Post. Duncan died Wednesday in Dallas from the disease.

“These additional questions may have identified him after arrival in the United States,” CDC Director Dr. Thomas Frieden told reporters during a press conference on Wednesday.

The problem isn’t the questions, though. It’s the answers.

“We’re asking for their honesty and it turns out that [Duncan] was carrying someone that had Ebola and he lied. At least that’s what the news is reporting. We’re relying on people to tell the truth,” a Department of Homeland Security official told Defense One.

We’re relying on people to tell the truth.
Department of Homeland Security official

The second screening ramp up will take the form of thermal or temperature screenings, which will be taken via what the CDC described as  "a non-contact" and "FDA-approved" thermometer.

It’s part of the CDC’s effort to keep further cases of Ebola from showing up in neighborhoods around the country. However, even border security officials have expressed serious doubt about how effective the proposed screening enhancements will be in catching Ebola at airport checkpoints.

“By doing enhanced entry screening at five U.S. airports, we will evaluate over 94 percent of travelers from the affected countries. Our staff at all airports remain trained and ready to respond to any reports of ill travelers, and our robust public health system is prepared to respond and assist,” the CDC said in a statement.

Frieden said about 150 people per day come to the United States from countries where Ebola outbreaks have been spotted, a number he called “manageable” in terms of additional screening.

He also acknowledged that the enhanced procedures would yield even more false positives. They will, he said “find people with fever… who don’t have Ebola.”

The CDC has subjected more than 36,000 individuals to additional screenings in the past few months but just 77 people presented with a fever or other obvious indicator illness and none of those individuals, it turns out, actually had Ebola.

“Most of those had malaria,” Frieden said. 

Frieden said the additional screening procedures represented a “layered” approach. “I want to emphasize that this is stepping up protection,” he said and acknowledged that additional false positive would likely arise.

The thermal screenings will also miss some people who have Ebola, if history is any indication. 

The thermal screenings will also miss some people who have Ebola, if history is any indication. Duncan was reportedly subjected to a thermal screening in Liberia when he left the country, but he was not presenting a fever at the time and did not become sick until four days after. Someone with Ebola can have the illness for as long as 21 days before presenting symptoms, like fever, that might be detectable at an airport checkpoint. 

 “We’re checking for temperature but the problem is, as we saw with the guy in Texas, he didn’t have a temperature when he came through,” the Homeland Security official pointed out.

Frieden reiterated a point he’s been making repeatedly; that the best way to contain the Ebola spread is to fight it in Africa.

The CDC recently said that as many as 1.4 million cases of Ebola might be diagnosed by January of 2015. "As long as the disease continues to spread in Africa we can’t make the risk zero here," according to Freiden.