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ebola-screening-455372014

By Prescott Paulin

Remember the time our government told us plastic sheeting and duct tape were enough to protect against biological agents and dirty bombs? The Obama Administration is next in line for this logic by allowing the CDC to claim “Enhanced Ebola Screening” (EES) is taking place in the United States, which debuted last week in Chicago alongside rollouts at four other major U.S. airports. Government workers carrying a firearm are more likely to receive effective training and personal protective equipment (PPE) to protect them against biological agents like Ebola, yet many of our border protection and screening agents in airports do not carry firearms . . .

This disconnect creates a gap in training and implementation of new protective measures. The latest line of Ebola logic from CDC and the White House is no more effective than putting 3 oz. limits on fluids for travelers. I just returned from Russia with a far larger bottle of Listerine in my carry-on after passing through ineffective secondary screening in Germany, bound for America

Renewed vigilance from our international partners is imperative to threat reduction, but more important is America accepting final responsibility to police her own borders, starting at every checkpoint that protects them. Restrictive logic, or isolating travelers only who have traveled into West African countries, will fail to protect us against unwitting hosts carrying the virus. Our mainstream press is failing to actively report flaws at points of entry, which reveal precisely the opportunities needed for Ebola to travel further into our nation, so I have approached TTAG in order to elevate this issue.

Three substantial problems exist in preventing Ebola entry at the U.S. border right now, and none of them are actively addressed by Centers for Disease Control and Prevention (CDC), President Obama, or his new Ebola Czar (AKA: the person to blame when mismanagement gets even deadlier). Ebola doesn’t book a one-way ticket from West Africa and stamp a passport; it finds all able-bodied carriers to exploit without consideration as to their travel origin.

Here are three problems we need to resolve IMMEDIATELY:

  • Contrary to statements that would lead you to believe otherwise, CDC is NOT on the front line screening inbound travelers at major international airports. They are in side rooms.
  • Travelers with higher statistical risk of inserting Ebola into our nation are NOT being screened, nor are they asked updated questions about their travel histories.
  • Many front line workers, including CBP agents, are not equipped with personal protective equipment (PPE) or directives about when it may be donned. Their fear breeds haste.

Before explaining how we can fix these problems, let’s address two important relevant elements: background (Context) + why you should care.

What qualifies me to observe and state discrepancies about protecting against deadly biological agents, like the Ebola virus? After serving as a Marine Corps Officer, I spent a year of my life working as a Department of Defense (DoD) contractor for Battelle, the world’s largest non-profit, independent R&D organization, and leader in defense innovation. The first assignment was to Washington Headquarters Services as an Emergency Preparedness Coordinator before transitioning into a role at the Pentagon Force Protection Agency (PFPA). I was then badged at the Department of Homeland Security (DHS) Federal Law Enforcement Training Center (FLETC) in Cheltenham, MD where we trained Pentagon Police Officers how to don Personal Protective Equipment (PPE) in order to protect themselves against CBRN threats— including biological agents like the Ebola virus. I wrote new PPE training parameters and developed a new PPE inventory management system in collaboration with our client. Our team was backed by some of the best experts in the world who compose Battelle’s impressive technical roster, and we had an unparalleled 100% agency satisfaction rating with our contract. The government needs private-public partnerships with teams like Battelle to keep an edge against rapidly evolving biological threats.

Training Police Officers to don PPE while under duress is mentally taxing because you wonder what will happen to them after they leave your classroom. There were always a handful of officers that sit idly in the early morning training session, sipping their coffee, attempting to wake up, ultimately leaving the classroom with limited learning retention. We provided them with the very best instruction we could, but for law enforcement personnel, OSHA only mandates that they receive PPE training on an annual basis.

Compare that with firearms training— Most agencies are requiring quarterly range time, though the Federal standard is just twice per year for qualification. How many of you remember safety instructions from even six months ago? One or two hours of classroom instruction simply are not enough to inspire our front line screeners to react effectively against invisible biological agents like Ebola.

However, one hour a year learning about how to protect yourself against an invisible threat is better than no training at all. Our front-line DHS Customs and Border Protection (CBP) agents are not subject to the same health protection requirements as PFPA officers, who are part of DoD, or CDC agents, which are regulated by the Department of Health and Human Services (DHHS). Nor are they subject to the same sidearms, with CBP issuing HK P2000 pistols and PFPA issuing Glock 23 pistols, though both weigh around 21 ounces and qualify for initial training at FLETC. Ultimately each agency has its own method of evaluating the OSHA PPE labor laws for 1910.132 and 1910.134, which require an initial hazard assessment to determine whether or not a specific category of employees is subject to receiving PPE.

Defining the role of a government employee, specifically as it pertains to law enforcement, is a crucial legal distinction related to who gets protected on the front lines of confronting Ebola. CBP agents that do not carry a firearm at an airport border control checkpoint but have the power to allow citizens and visitors into the US may still not meet the definition of a law enforcement agent under DHS guidelines if a department definition includes carrying a firearm.

This is important to delineate if OSHA risk assessments are unable to influence whether or not these agents receive full face piece respirators or other personal protective equipment against deadly biological agents. Officers who are actively patrolling, not sitting behind a barricade or divider, are typically considered to be more at risk of infection, whereas in an airport this logic is circumspect because the risk is coming directly to our screeners. It would be worth a FOIA inquiry to find out whether or not this is the case, since from my past observations, officers or agents who are trusted with firearms are ultimately issued the best PPE.

Trust is also an issue with training and deployment. Every competent instructor I know wants to make sure their students are best equipped to go out in the world and use the assets they are trained for. Sidearm options are as diverse as PPE options, so training to a standard is critically important. Selecting PPE is carefully considered, much like evaluating a quality sidearm.

For example, CBP supplies agents with a LEM “GLOCK style” double-strike trigger on the HK P2000, which is controversial because it reinforces/allows you to pull the trigger a second time with a shorter reset: great if you’re tackled on the ground, though many critics argue double pull creates bad habits against the “TAP / RACK / BANG” immediate action approach. That controversy is mitigated when reviewing negligent discharge (ND) stats for police officers, which suggests NDs from reholstering are a common training issue. For a GLOCK, when an agent reholsters, they assume nothing is in the trigger guard and their finger is off the trigger. If it catches, such as with loose clothing, discharging a sidearm is a real possibility. With the HK P2000, a thumb placed over back hammer makes it impossible to reholster and fire off a round. Reciprocity is built with instruction and selection: students must trust their equipment, too.

Lack of trust is inevitable within CBP ranks when trusted equipment and training doesn’t arrive. Front line Customs and Border Protection (CBP) agents are placed at greater risk because of ineffective construction at screening facilities, and lack of access to (plus proper instruction for) personal protective equipment (PPE). Further inspection reveals the lack of effective Personal Protective Barriers for its personnel. Unlike countries like Germany, Russia and Malaysia that utilize full window barriers between travelers and customs screeners, the United States has failed at Chicago O’Hare and other international points of entry to create full window barriers between CBP agents and newly returned travelers. Coughing and sneezing travelers are easily within range of spreading mucous and other airborne droplets of fluid containing the virus to CBP agents acting as screening personnel. According to a recent news article, CDC admits the virus may be susceptible to airborne transmission, spread by airborne droplets originating from coughing or mucous, with updated criteria for ebola transmission being within 3 feet.

I’ve seen agencies where inept or dysfunctional leaders are reassigned to manage warehouses, resulting in ineffective accountability and delayed movement of critical resources, which prevents front line workers from getting the PPE they need to do their job. As of last week, agents are told they don’t have an option to show up, even facing Ebola, though OSHA mandates that we provide effective PPE for front-line workers in a law enforcement capacity. In this context, our government is failing to uphold its own laws, and it’s time DHS, CBP and CDC to get on the same page in equipping agents until our contractors can catch up and give the government another boost of private-sector support and expertise. Imagine telling a police officer to arrest armed criminals without having their firearm nearby for protection… Do you think a police officer in Ferguson, MO would do it?

My conclusions about leadership proved accurate when memories of former training resurfaced last Thursday. I was returning from Moscow, Russia on the day CDC launched “Enhanced Ebola Screening” at Chicago O’Hare (ORD) International Airport. I spoke with nearby CBP agents who said they were fearful for their safety, and the safety of their families at home, because they had not been issued PPE or given instructions regarding when they would be allowed to don it. I was shocked to observe that changes made by DHS to the screening facilities were ultimately a step backwards from CDC’s previous engagement in the terminal. CDC staff are wholly competent and thorough in their care, but they are forced to endure challenges posed by DHS middle managers who oversee CBP customs screening checkpoints. To my surprise, CDC’s presence in the terminal had been relegated to a side room, removing initial passenger interaction.

How would I recognize the change? I’ve personally observed DHS and CDC collaboration on the screening process for viral outbreak. When I returned in June 2014 through Chicago O’Hare after visiting Malaysia for a friend’s wedding, I self-declared symptoms indicating a potential MERS-CoV viral infection. Several wedding attendees had flown Emirates Airlines through the Middle East, where the respiratory virus was emerging, and I was having respiratory issues on the flight back to America.

CBP agents casually reacted while they called a CDC screener over, allowing me to remain in close proximity to other travelers, whereas CDC’s reaction was immediately placing a mask on me as they asked a series of detailed questions, ultimately calling one of their Doctors for further evaluation. While I returned a negative result, it was still an eye-opening experience to watch the difference in responses from both CBP and CDC inside O’Hare. It also allowed me to realize how easily I could have transmitted the Middle East Respiratory Virus back into the United States without ever setting foot in the Middle East.

If the Obama Administration is truly allowed to claim that Enhanced Ebola Screening is taking place, they need to put CDC screeners at the front of the line. CDC retains qualified medical professionals who are trained to recognize and isolate travelers with symptoms of Ebola. Foisting their medical experience onto the shoulders of CBP agents is irresponsible and will only further deteriorate America’s ability to combat viral outbreak. Additionally, travelers should be allowed to voluntarily access PPE (e.g. disposable face masks) themselves prior to entering checkpoint queue lines, since they are in close proximity to other travelers and screeners.

The nomination for Ron Klain to become our Ebola Czar is a further failure because we now have an individual with no medical experience, and no additional power to affect deployment of well-trained DHHS (CDC) assets, instead reporting limited legal recommendations to two White House advisers in Homeland Security and National Security. I doubt you’ll see this lawyer walking the checkpoint lines himself to identify further problems inside airports. Our nation doesn’t need another lawyer to stir the pot— we need action, starting with boots on the ground.

Contrary to prior official statements, Customs and Border Patrol agents are NOT the first to meet passengers potentially carrying ebola when they arrive in the United States. The United States Government is allowing private security contractors at the front of these lines to direct traffic, effectively prescreening and separating International Visa Holders from United States Citizens, with further separation for American travelers who retain Global Entry trusted traveler status. CDC representatives were not stationed prior to the front entry lines to screen passengers from other flights with the intent of recognizing signs or symptoms of passengers carrying the Ebola virus.

One loophole for introducing the Ebola virus into the United States is through Trusted Traveler lanes, which greet U.S. citizens who travel frequently with less screening. These lanes should be updated to include sensors inside biometric equipment to check traveler temperature and, using technology from Theranos, could incorporate a blood sample at electronic checkpoints.

After landing Thursday at Chicago O’Hare International Airport, if you review the security footage, I was met with an empty lane whose CBP staff were not even in the booths for the Global Entry lane. There were three CPB agents standing around who casually allowed me to proceed without any additional screening. Global Entry travelers like me are at an even greater risk, statistically speaking, because they travel more frequently than other passengers who are not enrolled in Global Entry, potentially moving between other destinations undeclared on their original itinerary through foreign airlines that do not share traveler information with the United States. We are giving trusted travelers direct access into the United States without any updated security questions on kiosks that discuss travel to West Africa or potential encounters with passengers who have been in these regions. At my Global Entry kiosk, the government system recognized that I was coming from Dusseldorf, Germany but not ultimately Russia, which was my point of origin for this trip.

Even with automated systems, our border patrol agents on the front lines are inadequately prepared or equipped to handle screening, and their elevated level of fear actually has the opposite effect intended: CBP agents are not being given clearly defined directives as to when they may don PPE, nor did they have access to it today when I was screened in O’Hare. Without access to PPE, CBP agents are now psychologically incentivized to let travelers move more quickly through screening lines when they come face-to-face with a traveler who is coughing or sneezing. According to them, coughing or sneezing alone isn’t enough to get CDC involved. We have some brave men and women on the front lines who are fighting a war with an enemy they cannot see, and right now their only clear choice to protect themselves (and their families at home) is to decrease their own risk by exercising their power to move travelers expeditiously through screening lines. Faster screening might seem like a logical option for agents to protect themselves, but ultimately it results in sloppy work and ineffective screening.

The same problem may cause challenges with interagency collaboration between CDC and DHS. CDC is likely making suggestions which DHS executives are taking time to review through multiple meetings, ultimately forced to struggle with limited resources, fear in their ranks, lack of prior frequent training with PPE for its personnel, lack of clearly communicated donning protocols related to biological agents like Ebola, and limitations for the interaction their own agents must commit to based on current mission demands. CBP agents and other DHS assets were never intended to make decisions requiring qualified medical personnel, yet that is the logic our government leaders are ready to apply.

It is very likely that middle management is avoiding making tough decisions, because no individual wants to get blamed for a specific action that isn’t effective enough, ultimately leading to termination or further public scrutiny. For many government middle managers, these leaders are mostly concerned with their own job security rather than bold action. Unfortunately DHS is not like the Marine Corps: Middle managers in agencies often follow only the guidelines they are issued, failing to interpret and apply ‘Commander’s Intent’ if you will, without additional implementation until they are issued further specific information. One possible result is taking no timely action following senior directives, whether due to inaction or requests for clarification, which ultimately still fails to prevent a mass outbreak of the Ebola virus. To me, that’s like standing in a convenience store as a gunman smashes the clerk’s head into the register, you’re carrying concealed, and decide you won’t intervene in this violent robbery because you don’t have enough information about the criminal you’re going to shoot. Grey areas mean life and death decision making, though, sadly, it’s commonplace for middle management to drop a ball.

Do you think President Obama or Director Frieden will know how best to protect Chicago’s Airport or any other specific facility? Typically a contractor is hired to create the isolation and protection plan for each screening location, identifying specific flaws and recommended corrective actions, but we don’t have time for a government contracting process to tell us what flaws exist and what we need to do to prevent them. CDC must quickly deploy its existing resources and get them to the front lines, ahead of DHS CBP and any of its security contractors. America has already failed its first responders in prevention efforts, deployment of PPE, and training, which has yet to be standardized. But we have not failed irreparably so long as we make rapid changes to our infrastructure and screening processes.

The United States Agency for International Development (USAID) has partnered with the White House Office of Science and Technology Policy (OSTP) to issue a Broad Agency Announcement (BAA) for awards of up to $1 million dollars to advance PPE modification in airport and security screening settings. Americans need more companies to embrace this challenge in order to combat our nation’s urgent need. While my own family business is committed to contributing resources to ensure an effective national response to the Ebola epidemic and future outbreaks, we need many more companies to contribute their time, energy and effort to help our government leaders get back on track.

What is needed:

1) Get CDC to the front lines and equip them with rock solid tools to screen people. Now.

2) Screen travelers with more statistical significance. For everyone, ask better questions.

3) Get PPE to screeners AND travelers with clear directives on HOW and WHEN to use it.

What you can do:

Call our government representatives and ask them to champion these three steps to fight Ebola.

Consider applying for a USAID grant by contributing resources and innovation to improve PPE.

When you travel, be courteous. Cover sneezes and coughs. Thank screeners for their bravery.

 

Prescott Paulin is a prior U.S. Marine Corps officer who previously served the Pentagon Force Protection Agency (PFPA) and Washington Headquarters Services (WHS) as an Emergency Preparedness Coordinator, specifically authoring recommendations to improve training protocol while concurrently training Pentagon Police Officers to properly utilize personal protective equipment (PPE) to serve and protect Americans while confronting the invisible enemies of chemical or biological agents. Paulin was badged to train law enforcement officers at the DHS Federal Law Enforcement Training Center (FLETC) in Cheltenham, MD. He currently serves 300 Below, Inc. as its International Research Consultant.

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24 COMMENTS

  1. The “screening” taking place at the airport of departure is a farce. Why would a country say “You can’t leave because you have Ebola. Stay here and we will spend hundreds of thousands per case to treat you”. More likely it would be ” This guy has Ebola. Let him travel to the US and he (she) will be their problem”

  2. What happens if someone inadvertently forgets that they have Ebola in their carry-on bag? Does the TSA have them arrested? Is there a fine or penalty?

    This is important: Ebola carriers should examine their carry-on bags for Ebola. Ebola should only be transported in checked luggage as required by TSA regulations. Then, once the Ebola carriers arrive at their final destination, they can go bowling.

    Other bowlers need not worry. The CDC will be happy to sanitize their balls.

  3. Personally, I’d rather the government just stand aside and let things be. Why? No matter what, the Obama Administrations priority is looking good in the press, not safeguarding the country. Effective containment measures-aka, locking down every international port of entry regardless of conveyance (we have ports and vehicle border checkpoints) risks accusations of racism; so, it’s more politically convenient to the DC management for the nation to suffer a mass pandemic .

    So, in that event, I’d rather we just skip the pretense and just make it clear we as a population are taking our chances and no public action will be taken to prevent this. Better to go out honestly, IMO.

  4. This is stupid. How about no regular flight out of areas that are affected by Ebola, anyone wanting to leave spends 21 days in quarantine before they jump on a plane.

    • There are no direct flights from Liberia to begin with. And that will not stop a traveler who goes to say the U.K. and infects someone there from travelling to the U.S.

      A whole lot of armchair epidemiologists and pathologists on this site.

      Including Mr. Zimmerman who continues to post outrightfalse information.

      • Missing the point, there should be NO flights out of West Africa, unless the passengers have been quarantined for 21 days.

        • Missing the point, part2 – Tom….
          Too late for quarantining just Africa. The virus is out there spreading.

  5. Another long drone about a disease and epidemic that you know nothing about. This is more partisan posturing. Ebola is not the threat to the U.S. that you fear mongers are making it out to be. It is an extremely hard virus to catch which is why only health care workers in the US are catching it. Stop contributing the MSM fear mongering, the political posturing for the upcoming elections, and the ignorance concerning this disease!

    • Ebola is so difficult to catch that even highly trained physicians wearing head-to-toe protective suits…covering every inch of skin and hair….catch it. Why worry?

      Banning travel from hot-zone areas has proven highly successful as a preventive by almost every nation in Africa. The UK, France, and Germany have all placed travel bans. Americans are not feeling panic simply because of the nature of Ebola. Rather, they panic as they realize the administration is lying about the basics of the disease, and is making travel bans sound more difficult and less useful than they are.

      The repeated statements about the impossibility of catching Ebola without touching the person and their body fluids are simply a lie. The Administration thinks a lie is fine, thinking along with Luxembourg’s Jean Claude Junker that “when things get bad, you have to lie.”

      The handbook published by the U.S. Army Medical Research Institute of Infectious Diseases, USAMRID, titled “USAMRID’s Medical Management of Biological Casualties Handbook,” is now in its seventh edition, published in 2011. On page 177 of the handbook, in a chapter discussing “Viral Hemorrhagic Fever” (VHF), a category of viruses that includes Ebola, USAMRID says: “In several instances, secondary infections among contacts and medical personnel without direct body fluid exposure have been documented. These instances have prompted concern of a rare phenomenon of aerosol transmission of infection.” Page 177 continues to specify: “Therefore, when VHF is suspected, additional infection control measures are indicated.”

  6. That nurse reminds me of Anton Chigurh – “Stand right here sir. Don’t move, please.” Whack…..

  7. Oh sure, Ebola in NYC and nothing to worry about. uh huh. Get that one from Barack Ebola?

    They shouldn’t be treating that doctor, they should flamethrower the f*cker into a crisp!

    How many people are going to die because of him?

    • You raise an excellent point.

      We should just quarantine New York City and let disease eradicate the Progressives within.

      And San Fran…

  8. Spending hundreds of millions of dollars on “enhanced” screening is absurd. Suggestions for myriad extra questions, interviews, and staffing…are pointless, and simply miss completely the nature of hemorrhagic fever spread. Early in the post the author simply assumes away the possibility of implementing travel bans. How convenient. Once that little practice is out of the way, the only practice that African nations have actually found effective, the path is open to argue for ever more domestic expenditures for useless enhanced screening.

    Hemorrhagic fevers like Ebola have a latency period during which the virus completes its initial disabling of the immune system, and then its initial infection of host cells. There is nothing you can do at an airport that will reliably identify infected travelers. Exposed people will lie, for obvious reasons.

    Our government continues to lie to the public about the possibility of non-contact close-proximity airborne transmission, as the article does note. Given that highly educated medical professionals, no less, refuse to self-isolate for twenty-one days, in NYC for example, the only effective measure will be travel bans based on airline travel records, passports, and brief interviews. More is not needed, but less would be too spare. Without the bans no other expenditure is worth the trouble.

  9. The author has good points, but does anyone act as an editor for this website? The article was somewhat rambling, made a rather curious set of references to handguns, and was too long for the point(s) he was trying to make.

    As far as Ebola being hard to catch, that is somewhat true, until the infected starts coughing, vomiting, etc. But if it ever gets into the homeless in our country, a lot of people will die.

    • I agree with the oddness of inserting fairly random comments about handguns in the post. I assumed that was done to make the post somehow suitable for TTAG. A regular reader would of course know that such firearms relevancy simply isn’t required. See, e.g. the GamerGate post, in which the relevance is merely by analogy, “things feminists hate.”

  10. that’s academia for you. most of the marines i know can get to the damn point almost immediately.
    probably a good idea not to travel much for awhile. i’ll have to cancel that junket to marburg.
    what a surprise these gov’t agencies are spending so much on ineffective programs. hopefully much ado about little.

  11. Lol..

    “These lanes should be updated to include sensors inside biometric equipment to check traveler temperature and, using technology from Theranos, could incorporate a blood sample at electronic checkpoints”

    Um yeah.. our “ebola czar” has no knowledge of medicine, and you’ve proven that you don’t either with this one sentence.

    No way in hell I’m giving the cdc / customs or the TSA my *blood* as a prerequisite to re-entering *my* country. It’s *my* country – I don’t have to kiss the TSA’s ass, grovel, beg, pledge allegiance or submit anything beyond a passport to prove that I have a *right* to enter *my* country.

    The only “right” the government has at a border is to tax the booze & cigarettes I bring in with me. Can you imagine the potential for abuse, if the government was *allowed* to take blood from travelers?

    Obviously, you’ve missed the potential for infection (for screeners and travellers) from about a *thousand* things that *aren’t* ebola by handling the blood of random travellers, as well as the potential for abuse of a nationwide dna database. You really think the government is going to pick a contractor that’s “trustworthy” & capable of drawing blood safely? One that won’t re-use needles to save $100 per day?
    Stick your totalitarian dreams in a pipe & smoke them, Prescott.

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