On Edge Over Ebola

Navarro College is not accepting any new applications from students residing in Africa – all of Africa, not just those five countries on the continent with confirmed cases of the Ebola virus. 

The Texas community college made the news cycles last week for sending rejection letters to Nigerian applicants that said "Navarro College is not accepting international students from countries with confirmed Ebola cases." Navarro initially apologized for “misinformation” provided to prospective international students, but later, Dewayne Gragg, the college’s vice president of access and accountability, issued an updated statement saying that administrators believe it to be the responsible course to postpone recruitment “in those nations that the Center for Disease Control and the U.S. State Department have identified as at risk.... We are eager to resume accepting student applicants from these countries as soon as possible.”

In an interview Gragg clarified that non-African countries with Ebola cases – which would include Spain and, yes, the United States (where Texas has been ground zero) – are not encompassed by the new application policy. By contrast, he said that the college’s policy is to return new applications from any African country. 

Asked why the policy is so broad as to include prospective students in African countries without any Ebola cases, Gragg said the interview was getting into territory that isn’t relevant, but added, “We have made this decision based on what we feel is best for the safety of our students.”

“It wasn’t an easy decision, and yes we were probably one of the first if not the first to make a decision like that," Gragg said. “We know that all the data says that it’s highly unlikely that we would admit somebody who would come to this school [with Ebola], but on the other hand we also know that if we did admit somebody who had Ebola and they came to this school we’d be 100 percent wrong and for the safety of our students and our faculty and our community we chose not to take the chance."

Federal health guidance does not recommend restrictions on enrolling Africans generally but instead advises risk assessments and monitoring for those who have recently returned to the U.S. from Ebola-affected countries. 

“Over all, colleges and universities are on the low end of risk,” said Craig M. Roberts, an epidemiologist for the University of Wisconsin at Madison’s University Health Services and a clinical assistant professor of population health sciences. Roberts, who is also chair of the American College Health Association’s Emerging Public Health Threats and Emergency Response Coalition, noted that about 36,000 people have entered the U.S. in the last six months from the three African nations at the center of the outbreak – Guinea, Liberia, and Sierra Leone – and only about 300 of them were college students.

That’s not to say colleges aren’t preparing for a potential crisis: Roberts had two Ebola-related meetings on campus Friday afternoon, and he expected much the same was true for administrators and medical officials on campuses across the country. The American College Health Association created a new web resource on Ebola preparedness last week. The aforementioned guidance for colleges from the federal Centers for Disease Control and Prevention issued earlier in the academic year recommended suspending travel to Guinea, Liberia and Sierra Leone, and suggested risk assessments and health monitoring for students and faculty members who have been to countries with active Ebola outbreaks in the last 21 days (the virus’s incubation period). The CDC did not recommend that colleges isolate or quarantine faculty, students or staff based on travel history alone. 

“Because we’re outpatient clinics, what we’re telling our members to do is prepare for not an outbreak of Ebola on your campus – that’s pretty unlikely – but to prepare for a single case or, what’s even more likely, a threat of a case, which is what happened at Yale this week,” said Roberts. (A doctoral student in Yale University’s School of Public Health who had recently returned from Liberia was hospitalized with a fever, but tests for Ebola were negative.)

Asked about an admissions ban like Navarro’s, Roberts said, “I don’t see any public health or medical reason to do that.” More broadly, he said he does worry about hysteria among individuals with no known exposure to Ebola or recent travel to areas of the outbreak, as well as the possibility of discrimination against individuals from affected countries -- or, even worse, all of Africa.

“Many of us have seen this with AIDS and HIV in the '80s, people coming in wanting to get a HIV test because they shook hands with a gay person. It’s bizarre, but it happens.”

Allan E. Goodman, president and chief executive officer of the Institute for International Education, said that universities have a long history of successfully managing public health crises from influenza to severe acute respiratory syndrome (SARS) to gun violence to natural disasters. “Colleges and universities have the opportunity to be a model practitioner of good public health practices and demonstrate to America and the world that we can have international students and we can have international programs and we can have international admissions if we’re just prudent about how we do it,” he said.

The range of university responses to the SARS outbreak, which was centered in Asia in 2003, may offer the closest historical precedent to the current Ebola outbreak.  As the Los Angeles Times reported at the time, the University of California at Berkeley initially closed its summer programs to new students from China, Hong Kong, Singapore, and Taiwan before modifying its decision and letting a limited number of students from SARS-affected countries enroll. The Berkeley ban, which came under criticism, was unusual, however: responses of other universities ranged from canceling study abroad programs to discouraging parents of foreign students from attending commencement ceremonies to conducting health screenings of students from SARS-affected countries, as was reported in articles in The New York Times and The Philadelphia Inquirer.

Within the last week, Kent State University announced it had asked three employees who are relatives of a Dallas-based nurse infected with Ebola, Amber Joy Vinson, to remain off campus for 21 days and self-monitor their health according to the CDC’s protocols (Vinson, who assisted in the treatment of Ebola victim Thomas Eric Duncan, had flown to Ohio to visit family prior to becoming ill). The University of Texas at Austin announced on Friday that a student who had shared a flight with Vinson would be staying home from class and away from campus activities. And, as WAFB Channel 9 reported, a Louisiana State University employee who was in Liberia training police on how to respond to the Ebola crisis, was asked not to return to campus for three weeks. The local health department said that the employee, whom it had interviewed, had not had contact with individuals infected with Ebola.  

In responding to the Ebola outbreak, colleges and universities are balancing recommended public health practices with the concerns of an anxious or even in cases panicked public. When Syracuse University’s  S.I. Newhouse School of Public Communications rescinded a speaking invitation to a three-time Pulitzer Prize-winning photojournalist who recently traveled to Liberia in response to a student concern, the institution found itself thrust into “the middle of the national conversation about the Ebola virus and the irrational fears about how it is spread,” as Dean Lorraine Branham wrote in a statement. Syracuse disinvited Michel duCille, of The Washington Post, even though he had been symptom-free and back in the U.S. for more than 21 days, the upper end of the incubation period identified by the CDC.

In an interview with the News Photographer, duCille described the Syracuse decision as alarmist and unbefitting a journalism school.  "I am disappointed in the level of journalism at Syracuse, and I am angry that they missed a great teaching opportunity. Instead they have decided to jump in with the mass hysteria,” he said. 

The Washington Post also published a commentary on the subject with the tongue-in-cheek headline, "Syracuse University bravely saves students from exposure to journalism."

In her statement, Branham acknowledged not only that duCille had been symptom-free in the U.S. for 21 days, but also that he had visited the CDC earlier in the week and had been on Capitol Hill covering the hearings on Ebola.

“If it were just about me, that would have been good enough, given what I had read about the disease and how it is spread, and the fact that he had gone 21 days without symptoms. However, I knew that might not be good enough for many others in our community. And just yesterday, according to a report published in the Washington Post, new data now raises questions about whether or not 21 days is long enough to rule out Ebola,” Branham said in a statement issued on Friday. 

“I have a responsibility to faculty, staff and most importantly, our students – and their parents. While I don’t want to contribute to the fears about the disease, I believed we needed to exercise due caution. I also knew at least one student was already worried about his visit and that those concerns would quickly spread to other students (and then their parents), as well as staff and faculty. We did not want to create a panic.”