The government's failure to stop a man with tuberculosis from traveling to and from Europe is outrageous.
The authorities knew that Andrew Speaker had the drug-resistant XDR strain of tuberculosis, and border agents were told to detain him if he attempted to re-enter the country after flying to Europe.
Yet Speaker managed to fly to Canada from Prague and drive across the border into upstate New York after a security guard at the border ignored the detention order.
Now, Speaker is in isolation at a Denver hospital and Congress is demanding answers as to how he was allowed to leave the country in the first place and to later re-enter as though he were a typical tourist.
For his part, Speaker contends that he was not specifically warned against taking a commercial flight to Europe for his wedding after being diagnosed with the disease. He produced a tape purportedly of a doctor telling him he was not contagious and didn't pose a threat to anyone.
Speaker wouldn't be the first person to ever disregard a doctor's orders, but the fact that his father-in-law is a tuberculosis researcher with the National Centers for Disease Control and Prevention indicates that he may not have been responsible. Even giving him the benefit of the doubt on the first leg of his trip, the fact that he continued to fly after being told he should not bordered on criminal negligence.
But the government's missteps in this episode highlight gaps in our system that make it easier to start a pandemic. So far, Speaker's tests have shown that he's not contagious, but suppose he had been capable of infecting others with tuberculosisfi
Granted, there is no way to block someone from traveling with an infectious disease if nobody knows about it. But when someone is found to have a disease like tuberculosis, there should be better measures to restrict a patient's movements to protect the general public.
In Utah, if someone is diagnosed with active tuberculosis, the local health department is notified, and department employees will contact the patient and advise him of the risks and the need to remain isolated and take medication. The patient then signs a contract agreeing to follow doctor's orders or be forcibly isolated. A patient who refuses to sign can be involuntarily isolated. However, that involves a court hearing.
Utah does offer some carrots along with the stick to ensure the patient complies, such as providing free medication and assistance with rent or transportation as needed. Cristie Chesler, the state's tuberculosis controller, said there have been few problems with compliance, as most people do not want to endanger others.
In Speaker's case, Georgia health officials said they lacked the authority to order him to not travel. By the time the CDC got around to doing something, Speaker was already out of the country.
We have laws about people coming into the country with infectious diseases, but what about letting our own people leave when they should be isolated insteadfi It's only fair to the rest of the world to do something if we expect their citizens to not bring diseases when they visit us.
Dr. Julie Gerberding, the CDC's director, said the agency "failed to take aggressive action" to restrict Speaker's movement and bring him home under isolation conditions. But someone else should have been able to keep him from coming back into the country.
Canadian officials say that if they had they been notified that Speaker was on an American no-fly list for medical reasons, they would have stopped him at the airport and sent him to a hospital while arrangements were made to securely transport him back to America.
But that didn't happen.
U.S. border agents should have been the backstop. Instead, an agent with 18 years experience chose to ignore the warning. Speaker wasn't detained because he didn't appear sick.
Customs and Border Protection Commissioner Ralph Basham said the agency implemented new procedures to ensure that a flagged person cannot enter the country freely. We hope the new procedures include reminding border guards that they are not doctors and shouldn't ignore an order to hold someone for medical reasons if the person doesn't look sick.
The Speaker case was a comedy of errors, but it can become a tragedy if we don't learn from it and fix the system.
This story appeared in The Daily Herald on page A6.
Posted in Editorial on Saturday, June 9, 2007 11:00 pm
© Copyright 2009, Daily Herald, Provo, UT | Terms of Service and Privacy Policy