The Department of Homeland Security’s response to the 2014 Ebola outbreak—the deadliest in human history—lacked sufficient coordination, training, and screening of travelers arriving at US ports of entry, putting Americans at grave risk, according to a report released Wednesday by DHS’ Office of the Inspector General (OIG).
After the Centers for Disease Control and Prevention (CDC) confirmed the first case of Ebola in the US in the fall of 2014, DHS began to rapidly roll out a response plan in collaboration with other federal agencies. Within just two weeks of the first confirmed case, DHS, in coordination with CDC, began screening for Ebola at five major US airports through which 94 percent of travelers from the Ebola-stricken countries—Liberia, Sierra Leone, and Guinea—typically arrived in the US.
These airports included John F. Kennedy International Airport in New York; Washington-Dulles International Airport in Virginia; Newark Liberty International Airport in New Jersey; Chicago O’Hare International Airport in Illinois; and Hartsfield-Jackson Atlanta Airport in Georgia.
Between October 2014 and June 2015, US Customs and Border Protection (CBP), the agency responsible for Ebola screening at airports, reported screening more than 20,000 people. CBP officers reviewed travel documents, conducted health-screening interviews, and documented the temperatures of travelers identified as having been to an Ebola-affected countries in previous 21 days. Travelers who demonstrated Ebola-like symptoms were referred to CDC for additional screening.
However, the IG determined that DHS “did not ensure sufficient coordination, adequate training, and consistent screening of people arriving at US ports of entry during its response to Ebola.” Moreover, coordination between DHS, Health and Human Services, and other DHS components was inadequate.
Specifically, the IG determined that 169 passengers from Ebola-affected countries were not fully screened. CBP did not ensure these passengers had their temperatures taken or were otherwise cleared by a healthcare official.
The IG’s report stated, “As a result, some passengers with potential risk of Ebola exposure may have entered the United States without thorough screening, and the DHS workforce performing the response was not always appropriately protected.”
Although CBP claims these passengers did not pose an overt risk to the public, they did not have sufficient documentation to support this claim. “Without documentation, we cannot verify how CBP determined these 169 passengers were not a risk to public health,” the IG’s report said.
The IG also discovered that CBP officers did not always refer passengers from the Ebola-affected countries to screening. Diplomats, United Nations workers, US government officials, and other dignitaries were sometimes considered to be exempt from screening. In some cases, CBP officers released a traveler without receiving required medical clearance from CDC.
DHS concurred with the auditors’ 10 recommendations and has taken action to address them before another public health crisis hits the United States.
Pandemics pose a massive threat to human life and the economy. According to a new report from the international, independent Commission on a Global Health Risk Framework for the Future, infectious disease outbreaks that turn into epidemics or pandemics can kill millions of people and can seriously disrupt the global economy.
The Commission estimated the global expected economic loss from potential pandemics could average more than $60 billion per year. They also believe at least one pandemic will emerge over the next 100 years, with a 20 percent chance of seeing four or more.
“We have neglected this dimension of global security,” said Commission chair Peter Sands, former group chief executive officer, Standard Chartered PLC in London, and senior fellow, Mossavar-Rahmani Center for Business and Government at the Harvard Kennedy school in Cambridge, Mass. “Pandemics don’t respect national boundaries, so we have a common interest in strengthening our defenses against infectious diseases in every part of the world. Preventing and preparing for potentially catastrophic pandemics is far more effective – and ultimately, far less expensive – than reacting to them when they occur, which they will.”
Despite these predictions, nations do not adequately invest in measures to curb disease outbreaks. This has been the case in the US time and time again.
At the peak of the Ebola crisis, a DHS OIG report revealed that DHS did not adequately conduct a needs assessment prior to purchasing pandemic preparedness supplies and then did not effectively manage its stockpile of pandemic personal protective equipment and antiviral medical countermeasures.
Without conducting a needs assessment when making the purchases, DHS did not take into account that these supplies would need to be replaced. Consequently, the stockpile contained 4,982 bottles of hand sanitizer, 84 percent of which is expired. Moreover, the Transportation Security Administration’s stock of pandemic protective equipment included about 200,000 respirators beyond the 5-year usability guaranteed by the manufacturer.
The report sparked sharp criticism from public health sector and other authorities.
“The funny thing (if you can laugh at things like this) is that this DHS OIG report dings them for their inability to even prepare their own department adequately for a pandemic,” a former senior government public health preparedness official told Homeland Security Today’s Editor In Chief, Tony Kimery. “All that money, and all that preparation was supposed to be for DHS workforce protection. To the extent that they mismanaged that, someone should be taking a seriously hard look at what other failings might be expected when it comes to taking care of the entire American Public.”
Shortly after the IG issued their report, the Trust for America’s Health and the Robert Wood Johnson Foundation issued a report asserting that the Ebola crisis highlighted gaps in US Preparedness for public health emergencies.
“The Ebola outbreak demonstrated that the nation’s ability to contain a novel emerging infectious disease threat is fundamentally flawed — and makes the case for fundamental change,” the report stated.
Although Ebola has long-since faded from the headlines, the strong potential for another public health crisis to hit the US demands that the nation begin to address the serious underlying gaps in the country’s ability to handle severe infectious disease threats and control their spread.
Until the US begins to adequately invest in the prevention of a catastrophic pandemic, the nation will continue to empty its pockets only after a crisis has occurred—only then, no dollar amount will be able to save the human lives lost.
