June 1 - A group of U.S. healthcare officials, among them individuals who previously served at the Centers for Disease Control and Prevention, has urged Congress not to adopt a proposed policy to treat Americans who have been exposed to Ebola in Kenya or in European Union nations.
The officials - infectious disease physician Krutika Kuppalli, emergency physicians Debra Houry and Craig Spencer, and epidemiologist Anne Schuchat - set out their concerns in an open letter. They said the proposal would mark a break from the long-established practice of medical repatriation and would create significant clinical risks.
"This policy raises profound clinical, ethical, operational, and legal concerns," the letter said.
The writers also warned that the policy could discourage healthcare workers from deploying to outbreak zones and could undermine broader global response efforts. They emphasized operational trade-offs, arguing that channeling resources into improvised quarantine, isolation and treatment capacity overseas would detract from efforts to control the outbreak where it began.
"At a time when outbreak response efforts are already strained, this is a dangerous precedent. We are equally concerned about the diversion of resources toward establishing ad hoc quarantine, isolation and treatment infrastructure overseas rather than directing urgently needed resources toward controlling the outbreak at its source."
Last week, U.S. authorities announced plans to establish a facility in Kenya to quarantine U.S. citizens who had been exposed to Ebola. Officials said they would not repatriate those individuals to U.S. soil if they developed symptoms; instead, symptomatic people would be transferred to a third country. The move aligns with the current administration's objective of keeping Ebola cases off U.S. territory.
The proposal to route Americans exposed in the eastern Democratic Republic of Congo and Uganda to Kenya has met resistance within Kenya. A number of Kenyans have opposed the plan, and a Kenyan court issued a temporary suspension of efforts to establish the quarantine facility after a lawsuit contended that the planned site could pose a danger to public health.
The signatories and the court action together underscore a debate over how best to manage the intersection of national policy, individual patient care, and international outbreak control.