Universities Curtail Health Experts' Efforts to Work on Ebola in West Africa

October 21, 2014

Tulane U.
Susan McLellan, a faculty member in Tulane’s medical and public-health schools, spent two weeks treating Ebola patients in Sierra Leone in August: “I’m already extremely concerned about the inappropriate quarantine measures taken on people who pose absolutely no risk to anyone.”
Tough new restrictions on travel to Ebola-ravaged countries, including a flurry of bans announced in the past several days, by the State University of New York and other groups, have some infectious-disease experts, on campuses and off, worried.

The outbreak of the Ebola virus, which started in West Africa but has raised fears of spreading far beyond it, is the kind of global crisis they’ve spent careers tackling, and if they’re willing to climb into the trenches to fight it, they feel they should be allowed to do so. But while their employers—universities and other medical-research institutions—embrace the humanitarian mission these public-health and medical experts are advocating, they face increasing pressure to demonstrate that their campuses are safe, even if the risk that someone will return with Ebola is remote.

The result has been a series of directives and policies ranging from an all-out ban on travel to parts of West Africa to procedures intended to discourage all but a handful of crucial personnel from working there. Most policies allow exceptions for some experts battling the epidemic, but set the bar high to discourage most from trying. The number of people lining up to travel to Guinea, Liberia, or Sierra Leone is admittedly small, but that’s precisely why they shouldn’t be discouraged from doing so, some researchers say.

"It’s vitally important that the people with the knowledge and capability and willingness to fight this epidemic be able to do so," Susan McLellan, who holds joint faculty appointments in Tulane University’s medical and public-health schools, said on Monday. She spent two weeks treating Ebola patients in Sierra Leone in August and said she hadn’t heard of any efforts to restrict such travel at Tulane. "But if I did, I’d fight it," she said. "I’m already extremely concerned about the inappropriate quarantine measures taken on people who pose absolutely no risk to anyone."

The U.S. Centers for Disease Control and Prevention has issued a Level 3 travel warning, the highest alert possible, urging all U.S. residents to avoid nonessential travel to Guinea, Liberia, and Sierra Leone, the three West African countries devastated by Ebola.

The warning specifically advised universities to postpone all education-related travel to those countries.

A Travel Ban at SUNY

The State University of New York is among the groups that responded with a policy banning travel to Guinea, Liberia, and Sierra Leone, where Ebola has claimed more than 4,500 lives. SUNY’s ban applies to "all campus-related or funded activities," including study abroad and grant activity supported by the SUNY Research Foundation. Officials at the system’s largest campus, the University at Buffalo, were not aware of anyone seeking to use such grants to study in the affected countries.

The policy was outlined in a memorandum the system’s chancellor, Nancy L. Zimpher, sent to the presidents of its 64 campuses and institutes on Friday.

Craig M. Roberts, an epidemiologist at the University of Wisconsin at Madison and the American College Health Association’s point man on Ebola, said the latter group strongly supports the CDC’s travel warnings. With study abroad, it’s easy, he said. Just cancel programs. But when researchers want to take their expertise into countries where the incidence of Ebola is skyrocketing, the solution isn’t so clear.

"We’re looking into whether it’s feasible to prohibit their travel," said Mr. Roberts, who heads the association’s Emerging Public Health Threats and Emergency Response Coalition. "Even if universities withhold funding, that may not stop people. Many universities are struggling with this very issue."

‘A Major Challenge’

Now may not be a good time for public-health schools to start new programs in the Ebola-stricken countries, but researchers who are already on the ground in West Africa should be allowed to continue their work, said Tony Mazzaschi, senior director of policy and advocacy at the Association of Schools and Programs of Public Health.

"Many of our members have longstanding relationships with African countries," he said in an interview on Monday. "It’s critically important that they be able to continue working both on cures and on strengthening those areas’ ability to respond to the crisis." Among the universities with active programs, he said, are Columbia, Harvard, and Johns Hopkins Universities as well as the University of Michigan at Ann Arbor.

Columbia has taken a slightly different approach, opting to allow research to continue in Ebola-affected countries, but only after researchers get clearance from their deans and the provost. Faculty and staff members who want to go to West Africa to help fight the epidemic must lay out an evacuation plan, if needed. They must also agree to comply with safety protocols set by the CDC and other agencies.

"An essential part of Columbia’s core mission consists of connecting the knowledge and research of its students, faculty, and research staff to the search for solutions to the major challenges facing our global community," a statement posted last week reads.

"The dimensions of the Ebola outbreak and its potential threat to so many people constitute just such a major challenge," it continues. "Mindful both of the university’s service mission and of its responsibility to protect our community from the Ebola threat, the university has determined to restrict student, faculty, and staff travel to three West African countries for any purpose other than to contribute to efforts to contain and eliminate the Ebola outbreak."

The Columbia policy states that students will not receive credit or financial support for activities that involve travel to those three countries, and that student groups may not visit any of them.

Evacuation Seen as Impossible

New York University announced a similar policy on Monday, and the Johns Hopkins University issued one on Friday saying that "the potential for someone in our community to acquire Ebola and to place others in danger weighed heavily in the university’s decision to provide this guidance."

Harvard is also discouraging travel to the three countries but permitting those "in exceptional circumstances" to do so if they obtain approval from their dean and the provost, according to a statement.

Before returning to the campus, they must first be screened by the university health service, and they might be asked to stay away from the campus for 21 days, the incubation period for the virus.

The Harvard statement, released on Friday by the provost, Alan M. Garber, and the director of Harvard University Health Services, Paul Barreira, provides a stark assessment of the risks of traveling to those countries.

"Our partners operating in the region report that medical evacuation is virtually impossible," it says. "Individuals who show any signs of fever, whether they have been exposed to the disease or not, face significant challenges leaving these countries and risk being quarantined together with Ebola patients. In addition, security in this region of West Africa has deteriorated, and health risks do not appear to be diminishing. For all of these reasons, we strongly discourage travel to Sierra Leone, Guinea, and Liberia."

Harvard Global Support Services, which advises and supports Harvard employees working overseas, emphasized that "only clinicians with the highest level of readiness—personal, mental, and professional—should even consider traveling."

Stanford University’s policy "strongly advises" everyone to postpone nonessential travel to those countries.

Also on Monday, Louisiana’s governor, Bobby Jindal, issued an executive order instructing state agencies and departments to develop new policies and reporting mechanisms for faculty members, staff members, and others traveling on educational or work-related trips to the three West African countries.