The Public Health Enemy at the Gate

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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6 replies »

  1. “a proponent of immigration restriction”, your words, are not the same as one that wishes to permanently ban all immigration. You should know that. …And yes, I know enough about your “immigration policies” to know that you do not stand for a total permanent ban of all immigration, so don’t wrap yourself in self rightous indignation. Instead learn to moderate your accusatory statements so they reflect the truth rather than what you want to be true when promoting your ideology.

    Without question Sessions is not a racist and the poor article relying upon an even poorer article doesn’t demonstrate Sessions to be a racist. You have a tendency to overstate your case and end up on the wrong side of the truth.

  2. “…Senator Jeff Sessions, Donald Trump’s nominee to run the Justice Department, once praised a 1924 immigration law whose chief author in the House once declared was intended to end “indiscriminate acceptance of all races.”

    Sessions has long been a proponent of immigration restriction, and was one of the first to back Trump’s call on a ban on Muslims entering the United States during the primary.

    During an October 2015 radio interview with Stephen Bannon of Breitbart, now a top adviser to the president-elect, Sessions praised the 1924 law…”


    Sessions is a racist xenophobe who advocates reducing the “foreign-born” population in the U.S. His ELEVEN anti-immigration Senate votes are a matter of public record.

    BTW, you don’t know squat about my “immigration policies.” Clod.

  3. “He’s against even legal immigration. ”

    That is a very broad statement, but the real quesiton is whether he is against all immigration and to date I have found nothing demonstrating that. He doesn’t agree with your immigration policies, but that doesn’t make him anti immigration.

  4. “He has doubts about vaccines. ”

    A little skepticism is a good idea, but more correctly the President worries about so many antigens being given at the same time. That is a question many have. If I remember correctly his son Barron is being vaccinated but at a slower pace.

    “tremendous infectious disease” into the United States.”

    Do you know where multi-drug resistant Tuberculosis comes from? Tuberculosis was almost completely wiped out in the US.

  5. Our public health people actually did a pretty job with the Ebola threat. They certainly took a lot of grief as efforts were made to discredit them, but mostly I hope, as a way to try to discredit the Obama administration. I would hope that with ownership of the presidency that the right would be willing to listen to advice from those with expertise in the area. Guess we will see. As a marker I would suggest that if the current administration makes any movement towards the anti-vaxxers, anything more than just the words Trump has offered in the past, then they likely do use these issues towards their political ends.


  6. Don’t give Trump AG Jeff Sessions any more ideas. He already wants foreign-born people out of the U.S. He’s against even legal immigration. In a 2015 paper he argued that we should “reduce the foreign-born population,” mostly because they “take jobs away from native-born Americans” (Just ask the REAL “native-born,” I guess). As a Senator he voted ELEVEN times against every immigration reform bill that came up for vote.