The 50-bed unit was set to open Friday, but a Kenyan court late Thursday temporarily suspended the plan after a lawsuit argued the site could endanger public health. The next hearing is scheduled for Tuesday.
“The facility is designed to provide access to high-quality care for Americans who would need to quickly get out of DRC and quarantine without the risks of a lengthy transport back to the US,” a Trump administration official said in a statement. “Treatment capabilities at the facility are expected to be able to care for the full-spectrum of Ebola Virus Disease, including critical care needs, though each case will be evaluated for forward transport for more advanced care as appropriate in order to maximize patient outcomes.”
But experts warn a facility capable of offering the same intensity and quality of care as US hospitals would take millions of dollars and months to establish. Medical professionals and nonprofits are also concerned the policy would deter humanitarian aid workers from volunteering in affected areas because of uncertainty about the level of care they’ll receive.
“Mortality rates for Americans who were promptly evacuated from West Africa was zero,” said Frankfurter, who is considering volunteering in this outbreak. “People are going to get sick by caring for patients, and with this, you don’t really know. It will definitely influence my decision [to volunteer].”
The policy is a reversal from how past presidential administrations, including President Obama’s administration in 2014, have responded to outbreaks. Previously, Americans who contracted the virus while working in Africa were evacuated to the United States, and those coming back from working in affected areas were able to quarantine at home.
This month, the Trump administration evacuated an American doctor and six other Americans to Germany and the Czech Republic. The administration has also barred from entry to the United States immigrants and legal permanent residents who had recently been in the DRC, Uganda, or South Sudan.
During a White House Cabinet meeting this week, Secretary of State Marco Rubio said the administration “cannot and will not allow any cases of Ebola to enter the United States” in an effort to protect Americans.
Since officials in the DRC announced the outbreak May 15, suspected cases have grown to more than 1,000, and suspected deaths surpassed 240. Cases are concentrated in the DRC and have also been reported in neighboring Uganda.
Workers from the Uganda Red Cross Society evacuate the body of a suspected Ebola victim in Kampala, Uganda on May 26.BADRU KATUMBA/AFP via Getty Images
The current outbreak is caused by a rare virus strain called Bundibugyo, which differs from the Zaire strain that was spreading during the 2014 and 2018 outbreaks. There’s no vaccine or known treatment for this strain of the virus, said Dr. Adam Levine, a professor of emergency medicine and international and public affairs at Brown University.
“In many ways, it sets us back to really where I was in August of 2014 when I responded to the Zaire Ebola outbreak in Liberia, before we had an effective treatment or vaccine for it,” said Levine, who was part of the team that developed a vaccine and the first treatment for the Zaire strain.
Levine, who was deployed to Liberia to help research and treat the virus by the nonprofit International Medical Corps in 2014, said the US government set up a high-functioning Ebola treatment center in Liberia during the 2014 outbreak. The center, known as the Monrovia Medical Unit, treated international health care workers, including Americans, and local health officials.
“Location is not necessarily the most important question … you can build a US-level ICU in Kenya or Liberia if you want to,” Levine said. “But that [Monrovia Medical Unit] took months to construct … it’s not something you can set up in a few days or weeks.”
In addition to the millions of dollars and months of planning required to establish a similar unit, training health care workers to safely treat Ebola patients takes time, said Dr. Nahid Bhadelia, the director of Boston University’s Center on Emerging Infectious Diseases.
The Trump administration is training for three days members of the US Public Health Service to staff the facility, according to The New York Times. The same agency staffed the MMU in 2014.
Bhadelia, who treated Ebola patients in Sierra Leone during the West African outbreak, was an instructor for a CDC course that taught US health care workers how to care for Ebola patients.
“It requires a lot in addition to training — it requires a lot of experience,” Bhadelia said. “You need to repeat it over and over again.”
That’s one of the biggest drawbacks to building a new facility instead of using the United States’ 13 existing centers equipped and trained to treat patients with Ebola and other infectious diseases, Bhadelia said. The government has spent millions of dollars building and maintaining these biocontainment facilities, which were federally designated as Regional Emerging Special Pathogen Treatment Centers after the 2014 outbreak, Levine said.
Massachusetts General Hospital is the designated RESPTC serving New England.
“The benefit is that the staff there has been trained for a very, very long time,” Bhadelia said. “The standard of care would be higher … [the health care workers here] have gone through so much training versus somebody who might be learning this now.”
Bhadelia said there has never been a secondary transmission from an Ebola patient treated in a Regional Emerging Special Pathogen Treatment Center. But if the Kenyan facility is not carefully managed, a lack of personal protective equipment and safety protocols could lead to infections.
“It’s not a rational response,” Frankfurter said. “There’s no evidence that you’re reducing any sort of risk by [sending Americans to Kenya].”
Dr. John Welch, senior director of clinical systems at the Boston-based Partners in Health, said the lack of guarantee that clinicians would be brought to the United States for treatment could be a “huge deterrent” for aid workers.
“It’s quite a prospect to say, ‘I will go to Africa and take care of Ebola patients,’” he said. “What those clinicians need to know is that if they become sick themselves, they’ve got access to high quality care.”
While most care for Ebola patients will be provided by local health officials in Africa, more international volunteers could mean getting the virus under control quicker, Bhadelia said. Global health officials have noted the outbreak of the virus is outpacing the response.
“You’re hearing from everybody that we are behind in this response,” Bhadelia said. “It will need a lot more people from all over the world to help to support our DRC colleagues, who are excellent at doing this.”
Emily Spatz can be reached at emily.spatz@globe.com. Follow her on X @emilymspatz.