Going from Monrovia to Belgium to New York meant enduring power outages, fever checks, Ebola questionnaires, and the hallway from hell.
- By Laurie GarrettLaurie Garrett is senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize winning science writer.
Throughout my 29-hour journey home from the West African Ebola epidemic, one question lurked in the back of my mind: How will America greet me? Will I be quarantined?
When I left the United States at the end of October, the United States was riveted with fear. Doctors Without Borders (or MSF, its French acronym) nurse Kaci Hickox had just been released from her confinement inside a tent near Newark Liberty International Airport, where she’d been placed in quarantine under orders from New Jersey Gov. Chris Christie despite her negative Ebola blood tests. Hickox had intended to merely pass through the airport, coming from Liberia with her home destination in Maine. After being released from Newark, Hickox encountered hostility in Maine as well.
Physician Craig Spencer was fighting for his life in New York’s Bellevue Hospital Center, having acquired Ebola while working for MSF in Guinea, and New York Gov. Andrew Cuomo was calling for mandatory confinement of people flying in from Liberia, Sierra Leone, and Guinea. MSF warned that restrictions placed on health-care workers threatened to undermine recruitment of personnel vitally needed for the African Ebola fight. In Washington, some members of the House and Senate were demanding cessation of visa issuances for all travelers from the hard-hit African countries; health-care workers across the United States were terrified of encountering an infected patient; and the mood across America, rife with misinformation, seemed grim. Defense Secretary Chuck Hagel ordered 21-day quarantines on all U.S. military personnel returning from Ebola duty. The Obama administration’s scheme for limiting travelers arriving from hard-hit countries to five major airports staffed with Centers for Disease Control and Prevention physicians was labeled mere "political theater."
As I planned my journey to Liberia and Sierra Leone, I was far less concerned with contracting Ebola than I was worried about the weeks of quarantine upon return. I’ve been in an Ebola epidemic before and know the viral enemy well. It was the social and political threats inside the United States that worried me, as they seemed tied to the midterm-elections atmosphere, polarized and unpredictable.
After traveling around Liberia and Sierra Leone to observe the response to the epidemic, I started my journey home on Nov. 14 at 4:30 p.m. (Monrovia time) with the long drive to Roberts International Airport. The trip on the paved two-lane road from Liberia’s capital city can be completed in an hour, but heavy traffic often doubles the journey’s duration. After 90 minutes my vehicle neared the airport’s security gates, and the sweltering heat had transformed into a tropical downpour. I lugged my bags through the rain and mud, worrying that my frustration with the security guards’ seemingly arbitrary decision that my driver be denied entry to the airport would make my temper flare, and temperature rise.
The first checkpoint (of many) was staffed by a woman dressed in protective gear from head to feet, whose instructions were barely audible through her mask. Under her watchful eyes I scrubbed my hands with bleach water and filled out a questionnaire on which I indicated that I had not attended any funerals for victims of Ebola, had not cared for Ebola-afflicted patients, and had not seen a loved one come down with the awful disease. Although I visited many Ebola treatment centers and hospitals, my job did not require that I touch anyone — and for more than two weeks I’d had no physical contact of any kind with any human being.
From there I dragged my luggage to a fever station, where more officials dressed in full body protection, goggles, and masks studied my questionnaire, administered a temperature check with a fever gun to my forehead, and asked whether I was a physician or nurse. I worried that my temperature might have elevated with all the luggage dragging, but as usual I was subnormal, 36.0 degrees Celsius (96.8 Fahrenheit). On some fever-gun checks during my stays in Liberia and Sierra Leone, my alleged temperature got as low as 33.0 Celsius (91.4 Fahrenheit), which would have indicated that I was dead and which typically prompted me to utter, "Pretty good for a corpse, no?"
The next airport checkpoint required a careful search of my luggage, as Liberia does not want animal or food products that could possibly be contaminated with the Ebola virus to be taken overseas. After that, routine baggage check and ticketing was followed by an absurdly crowded immigration and flight security experience. I was routed down a narrow hallway to a row of three passport checkpoints. Once my passport was exit-stamped, I was instructed to go back into that narrow hall and line up along the wall for standard airport carry-on and body security checks. The passageway was so narrow that it was impossible for other passengers to get to the passport windows or back in the security line without hitting me.
After weeks of careful adherence to "social distancing" — avoiding all physical contact to prevent Ebola infection — this seemed the hallway from hell. A scientist I know from the Centers for Disease Control and Prevention (CDC) was standing in the security line a few passengers behind me, and he hollered to me, "If you didn’t get Ebola during your time in Liberia, you’ll get it now!"
During the three hours in the ticketed passengers’ waiting area, all electrical power for the airport shut down twice. The only lights were glowing cell-phone screens. Passengers stumbled over one another in the pitch darkness, and I turned on my bright Kindle screen to ward people away from sitting on me or stumbling over my feet.
By 9:30 p.m. I was aboard the Brussels Airlines flight from Monrovia to Belgium. Passengers took comfort in air-conditioning, electric lights, and clean water. Most of the World Health Organization, humanitarian aid, and CDC passengers seated around me were talking about their concerns over what might greet them when they reached their respective destinations. Brussels was merely a transit point for all of us — Brussels Air is the last commercial flier servicing the Ebola-hit countries, and its flight crews are the only ones in the world today willing to make the twice-weekly journeys in and out of Liberia, Guinea, and Sierra Leone. Most of the World Health Organization passengers were returning to the agency’s Geneva headquarters and faced no Swiss issues such as quarantine. The CDC folks heading to Atlanta were also fortunate, as the state of Georgia ruled out the sorts of quarantine measures like the ones Christie had ordered for Hickox and Cuomo claimed were needed in New York.
During the flight we were given another health questionnaire asking the same sorts of things I had previously been asked in Monrovia, only this time for Belgian authorities. The form was accompanied by a flier with photos showing how to properly submit to a fever-gun check– a seemingly absurd thing to give a planeload of people who had been undergoing dozens of fever checks per day throughout their time amid the epidemic.
The plane landed at a dark, remote terminal of Brussels Airport at 5:30 in the morning on Nov. 15, and we were greeted by a quartet of cheery officials dressed in matching bright blue jumpsuits, matching latex gloves, and masks. It was the first color-coordinated, fashionable Ebola protection outfit I’d ever seen. I submitted my completed questionnaire, had my fever checked again (this time 36.3 Celsius, or 97.3 Fahrenheit), and began the more-than-a-mile hike through the otherwise empty terminal to the main, inhabited portion of the airport.
After a six-hour layover, I boarded the sold-out Saturday afternoon flight to New York, seated in the economy section alongside a fellow American traveling from Copenhagen to New York. We discussed the epidemic, and she seemed indifferent to the extremely-remote-to-zero possibility I was infected with the virus. Seven hours later, as the flight approached JFK International Airport, I felt a small knot in my stomach — nervous tension about the threat of quarantine.
At immigration I swiped my passport through the scanner, and the receipt had a large X across it. An official wearing a mask and gloves directed me to a special line, and I soon recognized passengers from the original Liberian leg of the journey — 25 of us. One by one we approached the immigration official, who politely asked whether we had been in Liberia. Once we so affirmed, he led each of us to a special office located some 200 yards away.
Masked-and-gloved U.S. customs officials had me fill out yet another questionnaire, asking pretty much the same questions I’d answered in Monrovia and Brussels. They noted my seat number on the flight, gave me another fever-gun check (this time in Fahrenheit, 96.5 degrees) and asked me to wait. The holding room was arranged to prevent airborne transmission, with passengers seated about six feet away from officers at all times — a precaution that seemed ridiculous given that Ebola is absolutely not capable of airborne transmission. A customs official asked for a detailed home address and contact information. And 10 minutes later I was greeted by a CDC care ambassador who provided me a pamphlet describing Ebola symptoms, a log book for 21 days, a thermometer, and a cell phone. (The cell phone is an inexpensive, pre-smartphone model, and we were told to keep it with us at all times for the 21-day period.)
I just completed my daily check-in call with New York City’s health department. Every midday for three weeks, somebody from the health department will call me on the CDC-issued cell phone and ask what time I took my temperature last night and this morning, what were the results, and did I have any symptoms to report? I am not under quarantine of any kind, though the health department caller always asks that I remain in New York City. Today’s caller added that I should not leave the state for Thanksgiving.
The hysteria that dominated America’s view of Ebola and the open disdain for travelers from the hard-hit region that was the norm when I left the United States in late October have yielded to what seems a very rational, smart way of keeping track of returnees. Although the CDC told me I am "free to go about life normally," I am still keeping my social distance and working from home simply to keep others calm. I shop for groceries, take long bike rides and walks, and continue my Council on Foreign Relations daily work, as per normal — except that it is from my home office.
Is it cynical of me to conclude that the hysteria yielded to rationality because the midterm elections have passed? Such a conclusion would imply that politicians manipulated the public’s Ebola fear to obtain votes. Surely American leaders wouldn’t stoop to such fear-mongering for votes, would they?