‘Cause there ain’t no cure, and there ain’t no pill for Ebola
Posted by Sappho on October 16th, 2014 filed in Africa news and blogwatch, Health and Medicine
The parody’s an old one, a bit of black humor from the days when all known Ebola outbreaks had been deadly, sure, but short term deadly, beaten back in short order in the country where they began.
I got it in Zaire, and it made me ill,
‘Cause there ain’t no cure, and there ain’t no pill for Ebola
E-BO-L-A BolaThe doctor says I’m sick, and I won’t last long,
But at least I’ll survive till the end of the song – [break off and mimic dying]
The black humor hasn’t quite been funny to me for many months now, as I’ve followed the news of the epidemic, for I have family in Senegal. Senegal’s one of the worried well countries of West Africa. Despite sharing a border with Guinea, one of the three countries hard hit by the epidemic, Senegal has stayed free, so far, of the disease, beyond one imported case. Tomorrow, WHO is expected to pronounce Senegal Ebola free, a designation that requres that
a country must pass through 42 days, with active surveillance demonstrably in place, supported by good diagnostic capacity, and with no new cases detected. Active surveillance is essential to detect chains of transmission that might otherwise remain hidden.
The period of 42 days, with active case-finding in place, is twice the maximum incubation period for Ebola virus disease and is considered by WHO as sufficient to generate confidence in a declaration that an Ebola outbreak has ended.
Trying to protect itself from Ebola, Senegal has applied a controversial closing of its border with Guinea, despite warnings from WHO that border closings are ineffective. Senegal has also, while keeping its border closed, opened a humanitarian corridor at an airport to speed aid to stricken countries.
Some other countries have applied travel restrictions, with Kenya and South Africa instituting travel restrictions for the three afflicted countries of Liberia, Guinea, and Sierra Leone, and Saudi Arabia turning down 7,000 requests for hajj visas for Ebola concerns.
Now that two nurses have caught Ebola in the US, the calls are starting for travel restrictions here. I’m seeing it from people like Rush Limbaugh and Michael Savage (whom I pretty much discount, as looking for any sort of cudgel to hit Obama), and I’m seeing it from some in The American Conservative (whom I take more seriously, as they generally strike me as people making an honest effort to reflect on policy from a perspective that sometimes differs from my own, rather than people looking to make wild claims about the treasonous motives of the Other Side).
How do I explain my mixed feelings in discussions of travel restrictions? Why I’m sympathetic with some and impatient with others? Well, I will try.
Sometimes, in discussions at Crooked Timber, I’ve heard the immigration-friendly side of the immigration debate described (by people who, like myself, take that side) as the case for “open borders.” I don’t know whether the people using those words actually go further in the “open borders” direction than I do, or whether they’re just using different words to describe a position that’s actually similar to my own, but I’ve come to the conclusion, on long reflection, that I don’t believe in anything that I would call “open borders.” Part of the reason has long been precisely the problem we’re confronting here: the spread of contagious disease. Countries are entitled to apply whatever degree of border monitoring makes rational medical sense to stop the spread of disease. But it should make rational sense. I’ll get to the “should make rational sense” part later, but for now I’ll add that there are also a few other reasons for border restrictions for which I have some sympathy: I think it’s reasonable to keep terrorists and other violent criminals out, to the degree that you can do so without draconian restrictions on the law abiding. I even think it’s reasonable to restrict the flow of immigration to what you can reasonably assimilate. We have rules and customs in this country that we want people to follow, and if, hypothetically, a flood of people who way outnumbered those already here were to come and settle here, it would be hard to assimilate the newcomers to the rules we actually want to keep.
So why do I, in most cases, find myself advocating, if not for “open borders,” for “more open borders”? Because I think that people are naturally groupish, and, being naturally groupish, tend to overestimate threats from Those Other People Over There, and so there’s a systematic bias toward restricting immigration more than is rational, that needs to be checked by an awareness of that natural groupish bias and faulty risk assessment. In the early 20th century, the target of that fear was Those Other People Over There who were of Southern European background like me, and there were eugenics based arguments about our biologically inferior intelligence and the need for immigration restrictions to keep us out. Now, a century later, our IQ scores and our social standing have risen, and we’re no longer the target. But the groupish bias remains.
People are bad, at times, at risk assessment. Groupishness is part of the reason, but it’s only part. We fear the artificial more than the natural, the exotic more than the familiar.
And this gets to my first concern in the debate about border closings. Senegal’s fear really does seem rational to me. They’re right next to a country with an Ebola epidemic. They have a public health system that’s enough better than the systems of the Ebola stricken countries that people might want to leave those countries and head for Senegal (that is, I’ve read, why the one student with Ebola came to Senegal), but don’t have the infrastructure to cope with what they’d face if everyone with Ebola headed to Senegal for treatment. The rest of the world, too, probably doesn’t want Ebola in Senegal; one reason that concern rose when Ebola was imported to Senegal and Nigeria was the fact that both countries are major airport hubs. Whether or not Senegal has currently struck the right balance, with their combined border closing and humanitarian corridor, their fear is rational.
In the US, on the other hand, it seems to me that some people are falling prey to the “exotic is scarier than the familiar” bias and mistaking our risks.
For perspective, there were 20 pertussis deaths in the US in 2012 (the most reported cases since 1955), with the majority of deaths among infants less than 3 months old: http://www.cdc.gov/pertussis/outbreaks/trends.html
That was our worst year, but that one year isn’t the whole problem.
Pertussis deaths have been trending up since a low in the 1970s, because it turns out that immunity from the new acellular pertussis vaccine wears off sooner than the older whole cell pertussis vaccine: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6128a1.htm
The acellular pertussis vaccine replaced the whole cell vaccine because the whole cell vaccine had some very rare instances of serious side effects. There’s a trade off here; fewer side effects are good, of course, provided people get boosters to counteract the less durable immunity. But we have a problem. With the whole cell vaccine, the problem was that, rare though the side effects were, once herd immunity built to the point where people forgot how awful pertussis itself was, vaccination coverage among children would drop, as parents got more scared of the vaccine than the disease. With the acellular, the problem is that people need to get those booster (adults, too, should now be getting TDaP boosters).
Pertussis is just one disease where we have problems of under coverage with vaccinations. It’s endemic here in the US. It kills more people, here, than Ebola’s likely to in this country.
And that’s not getting to flu.
If we want to reduce the risk of death in this country, we need to look first at convincing the people who have decided that Vaccines Are Scary (an instance of the “artificial is scarier than natural” bias that has deadly consequences) to get their vaccinations, darn it, and get their children vaccinated. Get your flu shot. Get your children vaccinated for pertussis, and measles, and all those other illnesses (unless your particular children have a genuine contraindication). Get your daughters vaccinated against HPV, so they don’t get cervical cancer. Get all your recommended vaccines, for you and your family.
That’s one of my concerns. My other concern is that we accurately understand how far we can trust our doctors and medical experts and the CDC, and where the gaps may actually be that need to be corrected. I see some people, now that two nurses have been infected, questioning whether we can trust what we’ve been told about how easily the disease is spread. Might it, after all, be airborne?
Reality check. If Ebola were airborne, a lot more people would be sick than just those two nurses. How long did Duncan wait in that ER? And the only two people who have become sick are two people who have had abundant contact with the bodily fluids of a sick man who was producing plenty of diarrhea and vomit. That’s consistent with what we’ve been told about Ebola’s vector. Ebola’s been well studied, with plenty of peer reviewed literature. Experts agree on how it’s transmitted. And our experience of who catches it in this epidemic remains consistent with that consensus.
Unless a doctor has told you that you’ve been exposed to Ebola, if you’re in the US, you can relax about your own risk. This isn’t our tragedy. It’s West Africa’s.
The proper questions to ask, now, are ones about the protective suites, and about the protocols for removing them. Cheryl Rofer, who has used similar protective equipment for handling radiation, has a blog post about how such protective gear works, and the proper protocols for removing the suits. She also passes on a New York Times article about how lax CDC guidelines on Ebola led to poor hospital training. The New York Times compares the CDC guidelines to those used by Doctors Without Borders, which has extensive experience treating Ebola in Africa, and points out what the holes were in the guidelines. They also report that the CDC has implicitly recognized the gaps in their guidelines by issuing new ones.
The agency’s new voluntary guidelines include full-body suits covering the head and neck, supervision of the risky process of taking off protective gear, and the use of hand disinfectant as each item is removed….
The Doctors Without Borders guidelines are even stricter than the new C.D.C. directives in that they require full coverage of the torso, head and legs with fabrics that blood or vomit cannot soak through, along with rubber aprons, goggles or face shields, sealed wrists and rubber boots. Doctors and nurses wear two sets of gloves, including long outer ones that strap or are taped to the gown; janitors wear three sets.
As they undress in choreographed steps, Doctors Without Borders workers wash their hands with chlorine solution eight times and are sprayed with a chlorine mist. Most important, all personnel disrobe only under the eyes of a supervisor whose job is to prevent even a single misstep….
Doctors go into wards feeling fresh, he explained. But they emerge an hour later exhausted, sweating and sometimes shaking from a close call, like one he had when a patient grabbed his mask.
In the exit area, he said, “there was someone in charge whose sole focus was helping you get undressed safely.”
The old guidelines left necks uncovered, included only one layer of gloves, and did not involve sufficient supervision during the process of removing protective gear.
So, my assessment of the CDC is that there’s room for criticism, but the proper corrective comes from people with medical expertise related to Ebola, such as Doctors Without Borders. This matters when it comes to judging what border restrictions actually make sense. If the CDC and WHO and Doctors Without Borders and professional associations of doctors and nurses are all failing to call for a particular restriction, I take is as unlikely that that particular restriction is medically founded. And what are those groups saying?
The WHO’s Gregory Hartl expressed concern that “If airlines stop flying to West Africa, we can’t get the people that we need to combat this outbreak, and we can’t get the food and the fuel and other supplies that people there need to survive.”
The head of the CDC has written that
A travel ban is not the right answer. It’s simply not feasible to build a wall – virtual or real – around a community, city, or country. A travel ban would essentially quarantine the more than 22 million people that make up the combined populations of Liberia, Sierra Leone, and Guinea.
When a wildfire breaks out we don’t fence it off. We go in to extinguish it before one of the random sparks sets off another outbreak somewhere else.
We don’t want to isolate parts of the world, or people who aren’t sick, because that’s going to drive patients with Ebola underground, making it infinitely more difficult to address the outbreak.
We need to go in and extinguish this wildfire, before Ebola becomes endemic. To do that, we’re going to need more people heading to the affected countries than can be ferried on special military airplanes, and we need these countries to be able to stave off economic collapse while they fight the disease. Right now, US, UK, and French military forces are headed to West Africa to fight Ebola. Cuba has sent healthcare workers. Reversing the spread of Ebola now, in West Africa, is the right thing to do.
October 17th, 2014 at 7:13 pm
It is interesting to read another’s perspective on immigration. I certainly appreciate your nuanced position. I myself am fairly dogmatic when it comes to opposition to immigration, although I would like to think that I am open to reason on the issue.
I believe that a government’s duty, first and foremost, is to protect its citizens. I don’t think even one American life should be sacrificed on the altar of sentiment. The administration has allowed two, possibly more, American citizens to be infected with a deadly disease. Obama has failed in two ways here:
1) Non-inforcement of our immigration laws. Thomas Duncan, even if he had been perfectly healthy, should never had been allowed into the country. His admission violated federal guidelines regarding the potential for visa overstay of perspective visitors:
http://www.cis.org/vaughan/dallas-ebola-patient-was-another-visa-mistake
2) Failure to implement a travel ban imposed on the countries where the outbreak is endemic. I’ve heard the arguments against a travel ban: US medical personnel won’t be able to get back, possibly infected people will travel to other countries to get around the ban, the economy of sub-Saharan Africa would collapse. The ban would not have had to be indiscriminate. Chartered flights shuttling US medical personnel could be exempted from the ban (assuming heath professionals were required to remain and be observed in quarantine in the affected countries for at least 21 days to ensure they were not infected). The fear that infected people would travel to other countries to bypass the ban could be addressed by simple passport verification (people need to have their passports stamped when they enter or leave a country). Also, travel, especially in the affected countries, is a relatively expensive and time consuming affair, thus raising the cost of circumventing the ban. And I would prefer the economies of Africa fail to seeing even one American lose his/her life due to coming in contact with an infected foreigner.
You wrote:
People are bad, at times, at risk assessment. Groupishness is part of the reason
But people are generally pretty good at risk assessment. Groupishness is part of the reason. That is why groups continue to exist. If groupishness didn’t have some net utility, we would have evolved out of it a long time ago.
It’s endemic here in the US. It kills more people, here, than Ebola’s likely to in this country.
Hmm. That’s debatable. Pertussis killed 255 people from 2000-2012 in the US:
http://www.cdc.gov/vaccines/vpd-vac/pertussis/fs-parents.html
The Ebola threat has yet to play itself out. Not only that, there is an immigration dimension to pertussis:
http://latimesblogs.latimes.com/lanow/2010/09/new-whooping-cough-numbers-from-state-show-babies-hardest-hit-epidemic-worst-since-1955.html
So, it’s a double whammy. Tuberculosis is also on the rise, due mainly to immigration.
I have a personal stake in this one, being that my wife tested positive for the tuberculosis bacterium after visiting her sister in El Paso:
http://townhall.com/tipsheet/katiepavlich/2014/09/29/surprise-after-illegal-immigration-wave-tuberculous-plagues-el-paso-hospital-n1895083
Then there is MDR TB:
http://online.wsj.com/news/articles/SB10001424127887323293704578336283658347240
I think it’s reasonable to keep terrorists and other violent criminals out, to the degree that you can do so without draconian restrictions on the law abiding.
I disagree. I do not consider barring immigrants from entering the country to be a draconian measure. This is what countries do. If I could bar all immigrants from entering the country to prevent incidents like the Boston Marathon bombing (not to mention 9/11) then I would. I think the well being of American citizens should always take precedence over the comfort of foreigners.
I understand your sympathies toward immigrants. You are descended from immigrants and see your ancestors situation reflected in the circumstances many current immigrants find themselves in. But I would implore you to put aside you nostalgia for a moment and consider the very real negative affects of immigrants to current American citizens:
1) Wage depression – You work in the software industry. Are you going to tell me that H-1B visa holders have not depressed your wages? Technology jobs are nonetheless relatively well paying despite the wage depression. But what of non-skilled work? You know, the kind of work most black Americans are engaged in. Immigration has historically been a huge negative for American blacks. And it still is. Being that I am a black American, I am partial to black Americans and I would prefer it if well education white American citizens didn’t go out of there way, through their immigration enthusiasm, to make our row that much harder to hoe.
2) Climate change – I sense that you are the type of person who is concerned about climate change. Do you think increasing the population of the US through immigration will somehow decrease our carbon footprint?
3) Income inequality – Importing millions of poor and poorly educated immigrants yearly increases wage inequality. This is the biggest reason billionaires like Michael Bloomberg want more immigration. It means paying workers less, which is great for the holders of capital. Not so much for everyone else.
4) Resource stress – The American Southwest is currently experiencing drought conditions in good measure due to increased population levels. An increase attributable mostly to immigration.
5) Groupishness – You mentioned earlier that people are naturally groupish, yet you rather strangely only applied it to Americans. The immigrants we are currently importing are extremely clannish. And we import so many immigrants that they are able to recreate the cultures of their home countries here without having to bother even trying to assimilate.
I could go on, but I think you get my point. We are a few election cycles from the point of no return. People in some quarters rejoice at the prospect of whites becoming just another minority group in America. I certainly do not share this view.
October 18th, 2014 at 4:27 am
One thing I forgot to mention with respect to immigration generally: the finality of the “more open borders” option. With an immigration moratorium (my option), if you and other immigration supporters are right, the country would not benefit from the presence of future immigrants, but we would be no worse off for it. There would be opportunity costs associated with a moratorium (again, assuming immigration was a net benefit to the country), but the US will not crumble without immigrants. We could easily remedy the situation by opening our borders more at some point in the future. On the other hand, if the “more open borders” option were in effect, the country would, in the best case, be significantly worse off. And that situation would not be remediable. If we continue down the more open borders path and determine at some time in the future that immigration was harmful, we wouldn’t be able to change course. We would be stuck with the problems of immigration because we couldn’t then disenfrachise and deport the immigrants. The immigration debate reminds me of that old Beatles lyric from “We can work it out”:
Try to see it my way
Only time will tell
If I am right or I am wrong
While you see it your way
There’s a chance that we might
Fall apart before too long
My way being an immigration moratorium and your way being the maintenance of the current immigration status quo (we currently let in about 1 million immigrants per year into the country and have done so, more or less, for the past 30 years. Note, this figure doe not include illegal immigrants:
http://www.susps.org/overview/numbers.html)
October 18th, 2014 at 5:13 am
Here is a thought provoking article on the Ebola crisis:
http://www.weeklystandard.com/print/articles/six-reasons-panic_816387.html
October 19th, 2014 at 9:12 pm
I tend to find “don’t sacrifice even one life for X” not very practical, whether X is immigration, or nuclear power, or GMOs. Just about everything we could possibly do *might* cost at least one life, in some way or other, and sometimes the costs of getting rid of X are higher.
That’s not to say there isn’t a point where protecting the people here is more important than letting new people in, but that point can’t be set at “even one life,” because restricting immigration itself has a cost, and if the cost of immigration were really only that one life, we’d be better off spending our enforcement resources on other things, that might save more lives.
In the case of Ebola, in particular, I’m more concerned with what the Duncan case has revealed about gaps in our medical procedures. Most of us in the general population are pretty safe; nurses have some reason to complain about how things have gone so far. Some relevant links:
http://www.nbcnews.com/storyline/ebola-virus-outbreak/bioethicist-10-things-america-needs-do-about-ebola-n226771
http://www.nationalnursesunited.org/press/entry/nurses-call-on-obama-to-direct-hospitals-to-follow-highest-standards-for-be/?fb_action_ids=10153224947353356&fb_action_types=og.likes&fb_ref=.VELz29gFZYs.like
(the last one passed on to me by a friend who is a nurse and a union leader)
On immigration in general, yes, economic and environmental issues have to be taken into account. (I’ve been following David Frum on this issue, because he tends to argue his immigration restrictionist case in a way that’s more directed to what we can handle, and less about the ways in which people from a particular country are bad bets as immigrants.) So do the costs of trying to enforce any restriction (particularly high when it comes to trying to restrict people coming in from Mexico).
October 19th, 2014 at 9:23 pm
I suppose I should probably also say that it’s not just my past (my late father) that’s tied to immigration, but also my present. My younger brother met a woman when he was stationed in Chad with the Peace Corps, and married her, and a plurality of my nephews and nieces (my closest kin in the next generation) are children of that marriage.
That still doesn’t put me in favor of completely open borders; I can be happy that my father and sister-in-law were able to immigrate without thinking that we’re obliged to accept immigration without limit.
October 20th, 2014 at 6:43 pm
I think that, with respect to immigration, “even one life” should be the guiding principle for our government. No US citizen is going to lose his life because we don’t let immigrants in. On the other hand, many US citizens HAVE lost their lives due to immigration. Two Americans currently have a 50% chance of survival after contracting Ebola because….because…..because not letting in Liberians would be, in really bad taste. We can’t let protecting even one American life stop us from feeling virtuous now can we? And this really is the point isn’t it? People who advocate for increased levels of immigration don’t have to bear the direct cost of the negative effects of immigration. Before the start of Gulf War 2, I asked myself if I would be willing to sacrifice the life of one of my sons for “victory” in this war. My answer was an unequivocal no. I then asked myself if I would countenance sacrificing the life of some other American’s son for “victory” in Iraq. My answer was again no. I soon realized that I could not define “victory” in Iraq in any way that would justify the death of even one American soldier. I guess I value the lives of Americans more than I value the lives of foreigners. This does not mean I am cavalier about the lives of people in other countries. I don’t think we should go out of our way to kill people in other countries or not help out with humanitarian aid where feasible. But when it comes to iffy propositions like war or immigration (both of which are clear net negatives for the US), I am inclined to err on the side of caution, and I apply the “even one life” rule.
Like I mentioned previously, if we are wrong about the costs of the immigration status quo, there will be no “do-overs”. We won’t be able to change the demographic reality once immigration levels reach a certain point. You advocate for “more open borders” instead of “open borders” but these two approaches are effectively the same, with the latter bringing about demographic change faster than the former, but both would be inexorable and unalterable beyond a point. This is the danger. The very steep negatives that come with immigration, like climate change and resource depletion, are currently NOT being taken into account by our government. The government seems almost hostile to the interests of average Americans. Can’t we just put Americans first? What’s so wrong with that? What’s wrong with an isolationist America?
I was glad to read that you support limits to immigration. What would be reasonable limits in your opinion? Would you be in favor of deporting, or otherwise strongly encouraging self-deportation, of illegal aliens? What about decreasing the level of H1-B visas issued every year? Eliminating chain-migration? Cracking down on birth tourism? What type of immigration limits would you be comfortable with?
October 20th, 2014 at 10:06 pm
While searching the various papers for updates on Ebola, I ran across this article (in German) in Der Spiegel, on what precautions are being taken in the airports of different European countries: http://www.spiegel.de/reise/aktuell/ebola-welche-flughaefen-in-europa-welche-kontrollen-durchfuehren-a-997577.html
They vary a lot. Belgium, through which Duncan passed, still has direct flights, but now has started taking temperatures of arriving passengers. (From what I’ve read, at the time Duncan traveled, all the destination and transit countries were relying on temperatures being taken at the countries of departure. So under the current rules, he would have his temperature taken again in Belgium, and again on arrival in the US. I’m not sure how much margin of safety that actually adds, though, since there’s still a 21 day incubation period. I guess it ensures that passengers really, truly don’t have a fever on the actual day of their journey, since if one checkpoint makes a mistake, another will catch it. Probably more useful than the removal of shoes we all now go through.) Germany has no direct flights; their precautions consist of a plan for what they’ll do if there’s suspicion of Ebola in a passenger in an arriving flight (which at this point would presumably be someone passing from somewhere else). The Czech Republic is instituting a questionnaire. France has 20 flights a week to Guinea (it wasn’t clear to me, though, from the article, exactly what controls France was instituting, there seemed to be something unspecified about adding to their controls on Saturday). Great Britain, which is only receiving passengers through indirect connections, is doing an Ebola screening that includes taking temperatures “among other things.”
October 20th, 2014 at 10:37 pm
“Before the start of Gulf War 2, I asked myself if I would be willing to sacrifice the life of one of my sons for “victory” in this war. My answer was an unequivocal no. I then asked myself if I would countenance sacrificing the life of some other American’s son for “victory” in Iraq. My answer was again no. I soon realized that I could not define “victory” in Iraq in any way that would justify the death of even one American soldier.”
I agree with you there. (I was baffled that so many wanted to march us into Gulf War 2, for no apparent benefit, when we were already fighting a war in Afghanistan.)
“What would be reasonable limits in your opinion?”
Any country has the right to apply reasonable screening for disease and quarantine measures for sufficient evidence of sufficiently contagious diseases, to screen out and deport violent criminals, etc. (The older Tsarnaev brother was arguably showing enough evidence already of not being a model citizen that he’d have been worth deporting, but of course there’s the problem that the list he was on was such a giant list that I can’t imagine anyone on it got particularly well checked. This seems to be a persistent problem, from one administration to the next; everyone looks suspicious in hindsight, but the system is somehow flooded with so many false leads that the real ones get missed.)
Economically, I gather that immigrants are a net gain; as with free trade, though, as with free trade (also usually a net gain in terms of the wealth of the country as a whole), there may be winners and losers. Also there may be trade offs between how far one can maximize free immigration and keep a sufficiently robust social safety net, and I believe in some degree of social safety net. Finally, there might be limits to how far human groupishness can be pushed, here, such that a given immigration level may become hard to sustain at well before the point where it would be costly in pure economic terms. I’m not sure how to weigh that factor; I figure that the way it gets factored in is that all the people who want stricter controls on immigration than I do at some point outvote me.
On the other hand, costs of immigration control, besides whatever may be foregone in terms of benefits provided by immigrants or to immigrants, include the difficulty of applying certain kinds of immigration control measures without unduly burdening legal residents (particularly legal residents who happen to resemble the immigrants that are being found and deported). Meanwhile, immigrants without legal residence can be taken advantage of by the more unscrupulous employers, so it’s not good for their numbers to simply grow indefinitely; eventually we either need to deport them or legalize them by offering them amnesty.
October 22nd, 2014 at 6:23 pm
Countries certainly do have the right to prevent those carrying virulent diseases from entering, but it gets complicated. How many lives must be lost before a populous becomes motivated enough to force a government to take action? The AIDS crisis could have been stopped in its tracks here in this country if the first identifiable carries (Gay men traveling back from Haiti) had been quarantined. Think about that. Over 500000 people died of AIDS in the US since 1981:
http://www.amfar.org/thirty-years-of-hiv/aids-snapshots-of-an-epidemic/
Cuba, a small poor country, DID stop AIDS in its tracks:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688320/
Ebola is much easier to get than AIDS. How many people have to die before we decide that saving American lives is more important than hurting the feeling of foreigners?
Countries also have the right to bar criminals from crossing their borders. The problem, of course, is determining which potential immigrants are criminally inclined. I think it would be proper for our government to err on the side of caution, but that is precisely what they don’t do. No immigrant has the right to come here. The well being of current American citizens should be of primary importance. You state that your impression is that immigrants are a net gain to the country, but you overlook the fact that most of the gain is captured by the immigrants themselves:
http://cis.org/immigration-and-the-american-worker-review-academic-literature
Not only that, immigrants tend to be a net fiscal drain:
http://www.heritage.org/research/reports/2013/05/the-fiscal-cost-of-unlawful-immigrants-and-amnesty-to-the-us-taxpayer
You wrote:
I figure that the way it gets factored in is that all the people who want stricter controls on immigration than I do at some point outvote me.
But this is precisely the problem. We had an immigration overhaul spearheaded in 1965 by Ted Kennedy. Kennedy actually said the following:
Our cities will not be flooded with a million immigrants annually. Under the proposed bill, the present level of immigration remains substantially the same. Secondly, the ethnic mix of this country will not be upset. Contrary to the charges in some quarters, the bill will not inundate America with immigrants from any one country or area, or the most populated and deprived nations of Africa and Asia — and in the final analysis, the ethnic pattern of immigration under the proposed measure is not expected to change as sharply as the critics seem to think.
http://cis.org/1965ImmigrationAct-MassImmigration
By the time thoughtful people like yourself determine that immigration is a problem, it will be too late. And if you are depending on opponents of immigration to win the day and stop immigration before the standard of living drops further for average Americans, think again. Did opponents of the Iraq War win the day? No they did not. Did the war have enthusiastic bi-partisan support? Yes it did. Did opponents of the bank bailout, a policy that the overwhelming majority of the American people opposed, win the day? No, we did not. The bailout also had enthusiastic bi-partisan support. Our votes seem to matter less with each election cycle. And note, the weakening of the vote is made worse by immigration, because immigrants are less politically active, generally less well informed than native Americans and have a tendency to identify with central governments.
include the difficulty of applying certain kinds of immigration control measures without unduly burdening legal residents
And how might legal immigrants be unduly burdened? By requiring that they keep their green cards or visas on them at all times to prove that they are in the country legally? They are required to do this already by law. The law is just rarely enforced. Again, I don’t see why the comfort of immigrants should take precedence over the well-being of Americans.
October 22nd, 2014 at 6:36 pm
eventually we either need to deport them or legalize them by offering them amnesty.
I think you are wrong on both counts. We passed a massive amnesty (which most Americans opposed at the time, btw) in 1986. That was supposed to be the last one, but yet here we are. That amnesty was a complete failure:
http://www.newsworks.org/index.php/local/brandywine-to-broad/61505-immigration-reforms-flaws-revealed-in-the-1986-amnesty
And we wouldn’t need to deport all immigrants. We would only have to give illegal aliens the impression that we were serious about enforcing our immigration laws by deporting a significant portion of them. We could also do other things to encourage self-deportation like:
1) Taxing remittances.
2) Cracking down on employers who hire illegals.
3) Cracking down on landlords who rent to illegals.
4) Deny medical and educational benefits to illegals.
Theses four policy measures would do the trick. Heck, there was a drastic slowdown in illegal immigration after 9/11 without us doing anything except posting a few soldiers at our southern border.
October 23rd, 2014 at 3:10 am
Enterovirus D-68 is another example where my “even one life” principal should have been in effect:
http://news.investors.com/ibd-editorials/101714-722387-enterovirus-outbreak-illegal-alien-kids.htm
What could we possibly gain by letting in thousands of illegal aliens children, a significant portion of whom are infected with contagious diseases? Average citizens do not benefit from this. In fact we are clearly hurt by it.