Friday, June 01, 2007

The TB Flight Scare and Border Control Needs A Wakeup

If you're placed on a no-fly list, you shouldn't be allowed to fly. Period. There are good reasons for being placed on such lists. And if you're not allowed to fly, it should also mean that you shouldn't be allowed to cross into the US from the Mexican or Canadian side either.

Andrew Speaker was a wanted man because of his potential to expose people to a very rare and dangerous form of tuberculosis that is extremely drug resistant.

Yet, the border guard at the US/Canada border allowed him to enter, despite very specific instructions to detain him.
A globe-trotting Atlanta lawyer with a dangerous strain of tuberculosis was allowed back into the United States by a border inspector who disregarded a computer warning to stop him and don protective gear, officials said yesterday.

The inspector has been removed from border duty.

The unidentified inspector said he is not a doctor but the infected man seemed perfectly healthy and that he thought the warning was merely "discretionary," officials briefed on the case told the Associated Press. They spoke on the condition of anonymity because the matter is still under investigation.

Andrew Speaker, 31, was quarantined May 25, a day after he was allowed to pass through the border crossing at Champlain, N.Y., along the Canadian border.
For all those folks who think that border control isn't an important issue, this should be a wakeup call. What if Speaker wasn't a potential carrier of a deadly disease, but a terrorist bringing in WMD or was plotting terrorist attacks within the country with conventional means? They would just as surely made in into the country.

Border control in the US is a joke, and the Speaker incident is yet more proof that Congress, the Administration, and the various federal agencies responsible for border control and national security do not take border control seriously enough.

Proponents of the immigration bill are more than willing to call those who oppose the bill racists (or worse), and yet this is a clear sign that the bill does not even manage to improve existing border control and enforcement.

As Kim at Wizbang notes, there was no additional training required of the border agent who allowed Speaker to enter the country. There was no discretion in the matter. The computer listed him as a threat and that Speaker should be taken into custody and treated as a biohazard. Yet, the agent chose to ignore it. This agent should be fired, not assigned to a desk.

For his part, Speaker says that he was told that he wasn't a risk to others.

Time Magazine has it right:
It might seem that after the threats of bioterrorism, and after the spread of HIV and SARS in recent decades, public health officials would be better prepared — and more coordinated — when it comes to dealing with nasty bugs that hitch rides from country to country in often unsuspecting plane travelers. But this latest TB scare illustrates that the system still has a long way to go to be able to deal effectively with such health crises.

On May 25, 31-year old Andrew Speaker disobeyed CDC officials when they contacted him during his trip in Rome and asked that he remain in the city until special transport could be arranged. It was then that an official for the U.S. health agency informed him that his TB was not only resistant to multiple drugs, as he had initially been told before he left for Europe, but was also considered "extensively resistant" to drugs (XDR), meaning most first-line and second-line drug treatments might be ineffective.

At that point, he told the Atlanta Journal Constitution, he decided to bypass the CDC's efforts to find care and transport for him and instead returned to the U.S,. via Prague and Montreal. He came back, he said, so he could get the best treatment for his condition. According to new reports, Speaker's father-in-law is himself a microbiologist at the CDC.

Should the CDC have moved more quickly and issued a more unequivocal order for Speaker not to travel? "We try to balance individual freedoms with the public good, and that depends on a covenant of trust," says Dr. Martin Cetron, CDC's director of global migration and quarantine. "There were several communications between my staff and individuals in Rome, begging him to stay put and not travel while we worked on options for him."
The system is broken, but Time doesn't go far enough. This lapse shows the failings of not only the public health system, but border security and air security as well.

I understand that there are civil liberty concerns as well, and that Speaker's civil rights need to be respected, but the general public needs to be safeguarded as well. The government failed on both accounts.

Others covering the issues:
Sensible Mom slams Speaker for gross negligence.

Dave Schuler at Outside the Beltway and Glittering Eye thinks that we're not taking public health seriously enough.

The wire reports are finally catching up with the real issues involved here - the legal and public health concerns, and how they interact.

No comments: