When US doctor Patrick LaRochelle realized in May that he’d been exposed to Ebola in a mining town in Democratic Republic of Congo, he expected to be rushed home for treatment.
That’s what happened to him during a previous outbreak in 2018. And this time, at least three of the 13 state-of-the-art US biocontainment centers had agreed to treat him and his infected US colleague Peter Stafford.
Then the plan changed.
According to a senior administration official, once the White House heard US citizens had been exposed to the deadly virus in Congo, it delivered a clear directive: None would be coming home for treatment.
The decision to pull down the shutters flew in the face of years of investment and preparation and set the tone for a US Ebola response focused more on border controls than fighting the disease, according to more than 50 people including current and former senior administration officials, US doctors and nurses, people involved in this outbreak and previous ones, as well as public health and legal experts.
President Donald Trump’s administration instead set up a 50-bed Ebola quarantine camp for US citizens on an air force base in Kenya and doubled-down on its closed-doors policy in July with a “do-not-board” order blocking citizens from taking US-bound flights if they had been anywhere in Congo within 21 days.
The fallout from the administration’s America First closed-borders philosophy is now playing out in an Ebola outbreak that’s spreading at the fastest rate ever and has killed more than 4,000 people.
The threat of offshore treatment for exposed citizens and the 21-day policy have dramatically slowed the flow of American medical volunteers, increasing the strain on local doctors and weakening the overall response, 19 of the people said.
Trump’s shutdown of the US Agency for International Development (USAID) and withdrawal from the WHO also left a hole in the supply chain for medicines and equipment and disrupted medical work in a country almost six times the size of California.
Medical missionary LaRochelle was transported to an isolation unit in Prague in the Czech Republic. He didn’t contract the disease. Stafford went to Germany for treatment, and recovered. Both doctors said they were grateful for the US government’s help and praised their care, but were sad they weren’t flown home.
“It seems like so much is motivated by fear and by the optics, rather than a true understanding of medical risk,” LaRochelle told Reuters.
“It felt like decisions were patched together and reactive,” said the 46-year-old doctor, who has lived in Congo for 11 years with his wife, a family nurse practitioner, and their three children. “It makes me sad that we’re at that point, and there are times that I feel angry.”
Stafford said his evacuation was delayed several times for logistical reasons and when he heard he was going to Germany, he assumed it would be to a US military hospital. Instead, he went to Berlin’s Charite hospital.
“I was disappointed and certainly sad that my home country was kind of rejecting us,” Stafford told Reuters. “I would have loved to get treated in the US.”
Instead, the US State Department chipped in $50 million to the Coalition for Epidemic Preparedness Innovations, a global partnership set up in 2016 to help develop shots for pandemics and epidemics. CEPI has allocated $100 million to fund Bundibugyo vaccine research but needs another $128 million for a large-scale trial in Congo, a spokesperson said.
“This characterization of the US Ebola response overlooks the extensive work HHS and CDC are leading both at home and in Africa,” Health Department spokeswoman Emily Hilliard said in a statement. “Protecting Americans from importation and combating the outbreak at its source are both essential parts of our response.”
Kennedy didn’t receive a formal briefing on the current outbreak for weeks after it was detected in May, two people familiar with his schedule said. Hilliard said Kennedy has received regular briefings from agency experts, including the CDC, and is deeply engaged in the US response.
Kennedy’s conspicuous absence during the second worst Ebola outbreak on record left a vacuum filled in part by Secretary of State Marco Rubio, and at the outset by top White House official Stephen Miller and his team, who pushed the closed-borders strategy aggressively behind the scenes.