The Public Health Enemy at the Gate

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President Donald Trump  keeps getting kicked around in court when challenges are brought against his ban on travel from seven predominantly Muslim nations. Trump says he wants to halt the flow of people who might be planning attacks. What we cannot forget is that the kind of attack he has in mind is not confined to bombs and shootings. Trump is terrified that immigrants bring diseases with them. If racism fails, public health will likely afford Trump the rationale he seeks for making it difficult for those he does not like to enter our country.

The president is a self-described germaphobe. He has doubts about vaccines. He likely does not wake up every day to thrill at the latest advances in science. This is a president who might possibly let an infectious disease do what he has so far not been able to accomplish by impugning the country or religion of immigrants he doesn’t like: provide the basis for a ban.

The threat of a pandemic is yet another avenue he could possibly embrace to create a Fortress America. He might demand more walls, quarantine stations at airports and one-way tickets home for every potential human vector — including the frail, kids and pregnant women. No one who is sick, might be sick or who can be smeared as the source of Americans getting sick would get in.

Pandemic flu, Zika, yellow fever, West Nile and a host of other maladies are likely to keep popping up over the next four years. The news media are great at stoking fear about all of them. Public officials are ill-prepared to know what to do about any of them.

This environment of panic and ignorance is right up the president’s fear-mongering alley. It is ideal for imposing the kind of ban that Trump desires without having to try to explicitly exclude Mexicans, Muslims or any other group that he and his supporters despise: See a disease emerging overseas, up go the restrictions on entry.

Think I am wrong? Remember during his campaign that Trump repugnantly and falsely argued that Mexican migrants bring “tremendous infectious disease” into the United States. During the Ebola outbreak he used his favorite mode of communication, Twitter, to argue that doctors who treat Ebola patients “are great” but shouldn’t be allowed to seek treatment back here if they get sick. “Treat them, at the highest level, over there,” he said.

There was more: “The U.S. cannot allow EBOLA infected people back. People that go to far away places to help out are great — but must suffer the consequences!” And he topped all this ill-informed armchair epidemiology by noting that “the U.S. must stop all flights from EBOLA infected countries or the plague will start and spread inside our borders.”

The health care and scientific community had better be ready to spread the facts when the next infectious disease appears and President Trump invokes microbes to close the borders.

Art Caplan heads the bioethics program at NYU. This post first appeared in the Chicago Tribune.

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