On the morning of July 17, the Vermont state epidemiologist received an emergency call from a family of U.S. citizens. They had been trapped for roughly 30 hours at the U.S.-Canadian border, where they’d been stopped after trying to fly home from Kinshasa,
the capital of the Democratic Republic of Congo.
The Massachusetts family had no exposure to Ebola and had been nowhere near the site of the outbreak, which was over 1,000 miles to the northeast of Kinshasa in Ituri province. But at the U.S. border, their passports were seized, and they got scant information and little food despite having small children with them, Rolling Stone has learned. Their plight set off alarm bells from the Vermont health department to the Centers for Disease Control and Prevention.
They were not alone. This weekend, over a dozen U.S. citizens found themselves in similar straits: detained in limbo at border crossings in New York and Vermont, with little information and no way to get home, despite having had no exposure to Ebola. Elsewhere, a U.S. traveler flying into Dulles airport in Washington, D.C., was detained and routed to an airport detention facility, while another was detained in Atlanta, and was initially blocked from returning home, according to internal CDC emails, and notes and recordings of meetings obtained by Rolling Stone.
What had started as a White House priority to ensure there would be no Ebola cases on U.S. soil has turned into something different entirely: American citizens with no exposure to Ebola have effectively become Ebola detainees in their own country, sparking panicked calls between responding state health officials, CDC staff and other government agency officials.
On July 15, the CDC and Department of Homeland Security issued a new directive to include U.S. citizens in an Ebola travel restriction: anyone coming into the U.S. from the DRC would need to quarantine for 21 days in another country, or possibly be subject to a Do Not Board order that would restrict their air travel back into the U.S.
But shortly after midnight on Friday July 17, Dr. Jay Bhattacharya — who is nominally in charge of the CDC in the absence of a Senate-confirmed agency director, while also running the National Institutes of Health — plunged the CDC into chaos in pursuit of the White House’s zero-risk policy. At about 1:00 a.m., Bhattacharya “authorized the apprehension and detention of 13 people — U.S. Citizens — who came over the border by land from Canada,” according to notes from a meeting held later on Friday.
Those families — who had been placed on a Do Not Board list that restricted their air travel into the U.S., and had been trying to return home by land — were ultimately taken to Fort Drum in northern New York, where they were held for the weekend and released on Monday morning. The citizens were from states as various as Texas, New York, Colorado, Vermont, Connecticut, New Hampshire, and Massachusetts.
While the initial aim of the Do Not Board list may have been to surgically restrict potentially infected Americans from returning home until the incubation period for Ebola had passed, the result was global chaos, according to notes taken at a mid-morning CDC task force meeting on Friday, July 17: “There are requests coming from all over the world from people who are on [the Do Not Board list] and shouldn’t be. Lots of mistakes made.”
By Sunday, July 19, the CDC incident manager for the Ebola response, Satish Pilai, emailed two interagency colleagues: “I remain very concerned there will likely be continued challenges for these travelers — perhaps stemming from [Customs and Border Protection] not identifying individuals with broken itineraries or other issues that have arisen. … As you can imagine, this continues to put staff from CDC and [the Administration for Strategic Preparedness and Response] in very difficult situations as they attempt to operationalize the [U.S. government] policy decision.”
A spokesperson for the Department of Health and Human Services said that the Do Not Board list is part of an effort to “reduce the risk of Ebola importation into the United States,” and that Americans are “able to return to the United States 21 days after leaving the DRC.”
The White House did not immediately respond to a request for comment.
Senate Minority Leader Chuck Schumer, who represents New York, where some of the families trying to cross the border were detained, called out the Trump administration’s “shortsighted” cuts to USAID, which funded Ebola detection programs. “This latest incident at Fort Drum and the lack of transparency on the policy regarding Americans returning from travel is just the cherry on top of an unclear and opaque Ebola strategy,” Schumer continued in a statement. “Without an explicit chain of command, scientific quarantine plan for repatriated Americans, protocol for how to treat Americans infected or showing symptoms abroad, or clear coordination with state and local public health leaders, there are more questions than answers when considering how ready the United States is to handle the Ebola outbreak in the DRC.”
Previously, the CDC had used a finely honed protocol for determining whose travel should be curtailed based on a likely health risk. The system had been established following an incident in 2007, when a man known to be infected with virulent drug-resistant tuberculosis boarded an international flight from the U.S., refusing to heed U.S. public health warnings not to travel.
The current, fast-growing Ebola outbreak, now the third-worst on record, could eclipse the massive 2014 outbreak in West Africa. It was first detected in May in Ituri province in Eastern DRC, spreading in gold-mining outposts and through traditional burials, in which mourners touch the body.
So far, there are over 2,300 confirmed cases and 930 deaths, numbers that are almost certainly an undercount. There are currently no approved countermeasures, such as vaccines or treatments, for the rare Bundibugyo strain, which has a fatality rate of close to one third, which is somewhat lower than other Ebola strains. A CDC official tells Rolling Stone the outbreak is “extremely concerning” and could reach 3,000 cases within the next two weeks.
But the recent, broad use of the Do Not Board designation, coupled with Bhattacharya’s late-night detention decision, was a “wild misuse” of CDC powers, says a CDC employee familiar with the process. According to one agency official, Bhattacharya used the federal regulation 42 CFR § 70.6, which allows the CDC director to apprehend anyone “reasonably believed” to be infected with a quarantinable infectious disease.
However, according to meeting notes, CDC staff had determined all of the U.S. citizens were “assessed by CDC clinicians and all were deemed to not have had high risk exposures — these are mostly people who were only in Kinshasa.” In fact, agency staff even created a map for Bhattacharya that showed the vast distance from Kinshasa to Ituri province, to highlight the low risk. He ordered them to be detained anyway.
A spokesman for the Vermont health department confirmed that a detained family had reached out to the department on Friday, July 17, and that it alerted the CDC. “The family was screened by both the CDC and Vermont Department of Health over the weekend and were determined to be low-risk,” the spokesman said. “They are now at home and being monitored by our health department for the recommended 21-day period for all returning travelers.”
The Trump administration goal to block anyone with Ebola from being treated in the U.S. is a sharp departure from previous outbreaks. As a result of the massive 2014 Ebola outbreak in West Africa, the U.S. created a network of 13 regional pathogen treatment centers within the U.S. that collectively could treat any disease on Earth. During the Andes Hantavirus outbreak this spring on board a Dutch-flagged cruise ship, some 20 Americans were repatriated for treatment at those centers.
Nonetheless, as the Ebola outbreak worsened this spring the State Department made a deal with Kenya, in exchange for foreign aid, to allow the construction of a costly 50-bed hospital on the Laikipia air force base. There, the U.S. could isolate and treat American citizens who may have been exposed or infected while deployed at the site of the outbreak. No Kenyans would be treated there. The obvious inequity led to riots in Kenya and the deaths of three protesters, as well as a legal battle in which the Kenyan high court froze the construction. Building appears to have resumed.
This weekend, seven Americans from the disaster relief organization Samaritan’s Purse, who had been responding to the outbreak, were admitted to the facility and were in quarantine there.
Meanwhile, notes from CDC task force meetings reveal that agency staff — under pressure from the White House to execute a zero-risk strategy to keep potentially Ebola-infected Americans out of the U.S. — spent the weekend confronting a crisis situation. U.S. government employees responding to the outbreak needed to be exempt from the 21-day quarantine rule, otherwise who would deploy to help? State jurisdictions were balking at the added burden of monitoring returning Americans, more of which were expected to arrive imminently.
As the CDC struggled to implement the White House policy, there was a question of who would be blamed for the heavy-handed response. And then there was the trauma of participating in the detainment of low-risk Americans.
As notes from the July 17 meeting reflect, incident manager Satish Pilai said that “he would be sharing with CDC senior leadership the concerns of staff and the moral injury this is causing.”
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