US to send Americans exposed to Ebola to makeshift hospital in Kenya

The Trump administration is planning to send Americans exposed to Ebola to a quarantine facility in central Kenya that the U.S. military has been directed to stand up within a week, according to two people familiar with the matter who, like others in this article, spoke on the condition of anonymity to discuss sensitive deliberations.

The planned field hospital would house Americans exposed to the virus in the growing outbreak in the Congo to keep them safely isolated in biocontainment units that the government would transport from the United States, the people said. There is an active discussion about what happens to people who test positive, they said.

The initial plan is to have a 50-bed unit within a week and the potential to expand to 250 beds later, one of the people said. U.S. personnel are expected to receive prefabricated medical facilities that are easily transported by truck and airplane.

The facility in Kenya is being set up through a coordinated effort with the departments of State, Health and Human Services and Defense, according to an administration official in an email, who spoke on the condition of anonymity because of ground rules set by the administration.

“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 U.S.,” the official said. “Time is of the essence for Ebola patients, and this facility will enable Americans in the region who contract Ebola to receive lifesaving care as quickly as possible without 12-plus hours of medevac flight time.”

Workers there should be able to fully care for someone with the deadly disease, including those needing critical care, the official said, but will evaluate whether a patient needs to be transported for more advanced care.

Infectious-disease physicians who have cared for Ebola patients say it is critical to assess patients and act quickly because an infection can progress within days to multi-organ failure.

There is no approved vaccine or therapeutic for this strain, the Bundibugyo virus.

Members of the U.S. Public Health Service have already begun training at Joint Base Andrews in Maryland to staff the Kenya facility, according to two people familiar with the response. One person expressed concern that the training period was only three days, which experts say is not sufficient.

During a White House Cabinet meeting Wednesday, Secretary of State Marco Rubio reiterated that the No. 1 priority of U.S. foreign policy is to protect the American people.

“We cannot and will not allow any cases of Ebola to enter the United States, and so we’re very — the State Department and other agencies represented here, the Centers of Disease Control, HHS, others — are working very, very hard to contain this crisis to the countries where it’s currently located, particularly the Democratic Republic of the Congo,” he said.

Infectious-disease and public health experts and American officials involved in previous outbreaks say the best way to protect Americans at home is to contain outbreaks at their origin.

Rubio said the United States has “surged assistance to make sure that that is being contained there, obviously multiple agencies involved here are also very involved in tracking people, just to make sure that nobody comes into this country that has Ebola and creates a problem for us.” He added: “And we feel like we’ve got good efforts in place to do that, and Americans should feel sure that the president and his administration is doing everything we can to protect them on that front.”

The Kenyan government has approved the plan to construct a facility on their air base, but the U.S. was still awaiting permission to bring patients as of Wednesday, according to a U.S. official familiar with the process. U.S. officials are also negotiating with U.K. and Kenyan counterparts to potentially support their citizens, the official said.

The Wall Street Journal first reported the plan to send Americans exposed to Ebola to Kenya.

The American Foreign Service Association on Wednesday urged the State Department to authorize the departure of U.S. diplomats and family members from Congo, Uganda and South Sudan because of Ebola concerns.

In a statement, the union said the move was justified by the opening of treatment facilities in Kenya, calling it a “sharp departure” from previous outbreak procedures. The union said Americans exposed during earlier Ebola outbreaks were evacuated to specialized treatment centers in the United States. Those facilities remain available, it said.

U.S. Foreign Service officers were in the region “because the U.S. government sent them,” the statement said, and they should have “the right to come home.”

Nahid Bhadelia, who directs Boston University’s Center on Emerging Infectious Diseases and has cared for Ebola patients in multiple deployments to outbreaks, said that establishing a makeshift quarantine hospital overseas carries some risks.

“My biggest concern would be that you cannot re-create the same quality of care or training among health care staff at an ad hoc center that you would at any of the well-trained and established hospitals that the U.S. has set up since 2014 to take care of these types of patients,” Bhadelia said. “I’m also concerned what this does is effectively discourage Americans and American organizations from working in the area if they know it will be difficult for them to come back in case of an emergency.”

Bhadelia said that caring for these kinds of patients “requires [that] health care workers are trained repeatedly to safely use personal protective equipment, to make sure they don’t contaminate themselves as they remove their equipment,” adding that if they become ill with the disease, staff “would need to be able to provide ICU-level care.”

The plans are emerging as Congo confronts a fast-growing outbreak of the rare Bundibugyo strain, which has also spread into Uganda. The World Health Organization has declared the outbreak a public health emergency of international concern. WHO and partner agencies reported more than 900 suspected cases and more than 220 suspected deaths in Congo and Uganda as of May 26.

The administration’s Kenya quarantine plan also reflects White House officials’ resistance to bringing Ebola-exposed or infected Americans back to the United States, according to people familiar with the discussions. The Washington Post previously reported that White House officials did not allow an American doctor infected with Ebola in Congo to return to the United States for treatment, pushing instead for his evacuation to Germany. Another doctor working for the same missionary nonprofit was evacuated to Prague.

The administration’s plans come amid heightened concern over Ebola exposure and preparedness.

The U.S. field hospital is in Laikipia County in central Kenya, an area known for its large ranches, wildlife conservancies and significant expatriate population. The location has an air base and barracks that could provide housing. The region also hosts the British Army Training Unit Kenya, one of the United Kingdom’s largest military installations in Africa.

Kenya’s Minister for Health Aden Duale did not respond to The Post’s request for comment but in a press release, he acknowledged ongoing discussions between the two governments in regard to Ebola response in the region.

He touted the country’s health system, citing the fact that between 2014 and 2016, Kenya sent over 100 volunteer health workers to contain an Ebola outbreak that killed more than 11,000 people in Guinea, Sierra Leone and Liberia.

Duale’s statement said “any arrangements regarding international health cooperation will be guided by Kenya’s national laws, public health regulations, biosafety and biosecurity standards.”

News of the quarantine unit sparked intense debate on social media in Kenya, especially after the U.S. imposed a temporary 30-day suspension on entry for all non-U.S. citizens who have been in Congo, including Kenyans.

Miguna Miguna, a Kenyan lawyer, wrote on X that bringing Americans who are exposed to Ebola constituted an act of “high treason” and that the move should be “opposed, resisted and overturned.” He wrote: “No Ifs or Buts.” Nduru Karanja, another Kenyan, responded to the X post saying the move was not diplomacy but risked “exposing millions of citizens to potential catastrophe.”

Rael Ombuor reported from Nairobi. Natalie Allison contributed to this report.