While the risk of an Ebola outbreak in the state is low, the Department of Transportation says it has an action plan already in place.
Since last weekend, West Hawaii Today has received several calls from residents upset about a rumored DOT policy to divert all planes carrying passengers displaying potential symptoms of the deadly virus to Kona International Airport. DOT Public Information Officer Caroline Sluyter and Dr. James Ireland, the state airports’ medical director, dismissed the rumor, saying the claim was untrue.
Instead, Sluyter and Ireland emphasized the policies and procedures Hawaii has maintained for nearly a decade to detect, stop and react quickly to infectious and deadly viruses that may be introduced by travelers. Ireland reassured the public that such diseases are always being looked for. He also expressed confidence in the readiness of airport staff statewide to immediately respond should a disease-related situation arise.
Hawaii was the first state to establish such enhanced airport surveillance in 2005, which was then in response to concerns about avian influenza and Severe Acute Respiratory Syndrome, or SARS. The program was initiated through a memorandum of understanding between DOT, the state Department of Health, U.S. Centers for Disease Control, and Healthcare Association of Hawaii, Ireland added.
“Hawaii’s airports system has protocols in place for infectious disease and we are continually working with our partners at the state Department of Health, the airlines and Centers for Disease Control to update the protocols for Ebola and other infectious diseases,” Sluyter said. “As a reminder, there are no direct flights from West Africa into Hawaii. The CDC has set up new, more stringent screenings at five mainland airports that receive the majority of passengers from that region.”
The five international airports — New York’s JFK, Washington-Dulles, Newark, Chicago-O’Hare, and Atlanta — doing more stringent entry screenings received more than 94 percent of travelers from the Ebola-affected nations of Guinea, Liberia and Sierra Leone. That screening includes the Department of Homeland Security’s Customs & Board Protection personnel escorting travelers from Ebola-affected nations to an area to be observed for signs of illness and questioning about health and exposure, as well as trained medical staff taking their temperature with a noncontact thermometer. Those travelers with possible exposure, fever or symptoms are evaluated by a CDC quarantine station public health officer, who takes temperatures again and makes an assessment to determine if further evaluation or monitoring is required.
Ireland stressed Hawaii gets very few travelers from Africa, and while the risk of Ebola in the state is “very low, extremely low,” it’s not zero. Nevertheless, he said DOT and its partners are staying informed about the virus, following the recommendations and changes from the CDC, as well as reviewing protocols and closely coordinating to ensure preparedness and the safety of everyone involved.
In Hawaii, procedures begin prior to the plane’s arrival. If a flight crew notices someone ill and exhibiting potential symptoms of an infectious disease, the airport is notified before landing.
Federal law already requires pilots of international flights arriving to the U.S. to report before arrival any death or illnesses among passengers or crew to the CDC Quarantine Station at or nearest to the airport of arrival. Pilots of interstate flights are also required to report a suspected case of contagious disease among passengers or crew members before arrival to the local health authority with jurisdiction for the arrival airport.
People often come in ill on planes and it doesn’t mean that they have Ebola. There are a number of illnesses with similar symptoms, including flu, malaria and typhoid. Still, it’s important ill travelers are properly assessed by those trained to detect infectious diseases and that their travel history evaluated, Ireland said. Red flags for Ebola include fever and recent travel to West Africa or areas experiencing an outbreak, he added.
Travel history is particularly key, and DOT works quickly with the airline to obtain such information before the plane arrives. An ill passenger may be asked questions such as “Where have you been in the last month?” or “Have you been in Africa or come in contact with someone who has?” If you’re an international passenger, the Customs & Border Protection will know where you originated from or if you traveled through West Africa, Ireland said.
Upon landing, airport emergency personnel, such as a firefighter or paramedic, responds by boarding the plane in proper protective equipment and assesses the patient. That emergency responder relays vital signs, medical history and travel history to a CDC officer. If that traveler is believed to have an infectious disease, he is quarantined, as well as the others on the plane, Ireland said.
Besides airports and DOT, health officials are also on heightened alert. “We’re motivated by a sincere want to assure public safety and the best level of care,” said Toby Clairmont, director of the Healthcare Association’s Emergency Services Division. “There’s also an abundance of caution, detail and vigilance to protect our home.”
For months, the state DOH, Healthcare Association of Hawaii and hospitals have built and reviewed procedures and agreements to respond to and protect the public should Ebola or a suspected case be encountered, Clairmont said.
“We have been watching these events unfold, communicating with each other, and actively planning well ahead and before most people here were even talking about Ebola,” he said. “We have policies, plans, resources and expertise all in place, and it’s something we’ve been working on since June.”
Resources include stockpiles of protective gear and equipment, mobile isolation units for transportation, as well as thousands of health care workers and trained volunteers ready to take action, Clairmont said.
Like the airports, DOH and the hospitals also have an action plan for infectious diseases because of previous outbreak concerns about SARS and bird flu. However, DOH, along with the health care community and other partners, plans “soon” to jointly release its updated Ebola response strategy, which includes training, drills and “secret shopper” exercises to test protocols, to the public. There will also be briefing with the Legislature’s health committees next week, Clairmont said.
For more information about Ebola and the outbreak response, visit cdc.gov/vhf/ebola.