Why the US won’t treat Ebola patients at home | The Excerpt

On the Thursday, May 28, 2026, episode of The Excerpt podcast: As Ebola cases surge past 900 across Congo, Uganda, and South Sudan, the World Health Organization has declared a global health emergency. With no vaccine or treatment available, the crisis is unfolding amid historic lows in global health funding and a major shift in U.S. policy. The U.S. is now keeping suspected American cases overseas, sending some to Europe or Kenya for quarantine instead of treating them domestically. Dr. Celine Gounder, an infectious disease specialist and epidemiologist, joins USA TODAY’s The Excerpt to discuss what this means for U.S. preparedness. Dr, Gounder is also editor-at-large for public health at KFF Health News and an opinion contributor for USA TODAY.

Hit play on the player below to hear the podcast and follow along with the transcript beneath it. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text.

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Dana Taylor:

On May 16th, the World Health Organization called the Ebola outbreaks in Eastern Congo and Uganda, a global health emergency. So far, there've been over 900 suspected cases and over 200 suspected deaths in the Democratic Public of the Congo, Uganda, and South Sudan. There's no vaccine, no treatment. Behind it all is a global health funding architecture at its lowest level since 2009 with the largest single donor, the US, having walked away. A recent shift in US health policy now has the US keeping suspected American cases abroad, sending some to quarantine facilities in Europe, others to Kenya. Why can't they be treated back home? And what does that say about US preparedness for the deadly outbreak?

Hello and welcome to USA TODAY's The Excerpt. I'm Dana Taylor. Today is Thursday, May 28th, 2026. Joining me to dig into the policy shift and what it means for public health, travel restrictions and preparedness here in the US is Dr. Celine Gounder, an infectious disease specialist and epidemiologist. She's also editor at large for public health at KFF Health News and an opinion contributor for USA TODAY. Thank you so much for joining me, Dr. Gounder.

Dr. Celine Gounder:

Great to be here.

Dana Taylor:

Can you give me a clear picture of what's happening right now with this Ebola outbreak? I mentioned the dire warning from the WHO, just how serious is it?

Dr. Celine Gounder:

For those of us who've been on the ground and worked as aid workers in prior Ebola outbreaks, this current outbreak has all of the same features as the explosive West African outbreak of 2014 to 2016 and more risk factors for explosive spread. So what were the risk factors for that kind of transmission in 2014 to '16? You had urban areas affected, you had cross-border spread, you had migrant workers crossing between Guinea, Liberia, and Sierra Leone. And then you had very weak healthcare systems that really were not prepared even with the pretty basic infection control kind of measures to help prevent transmission in health facilities. So you have all of those risk factors in the current outbreak in the DRC and Uganda, but you also, in addition, have Rwandan backed armed militia in the Congo who are there trying to control natural resources. So some of what they mine in that area, those are the minerals that go into your smartphones and your EVs and other consumer electronics.

So that's created a lot of instability in the region. It's very difficult to move around. Even the baseline, it's a very difficult geography topology. But then on top of that, you have safety issues just moving around. And then on top of that, you have refugee populations in South Sudan where if you were to have Ebola spread into those populations and so far we have not, but we're very concerned that could be really catastrophic. So we're worried and we're also worried that only one in five contacts are getting appropriate contact tracing and follow-up, which means that four out of five people who had some sort of exposure, who were at risk, are not getting follow-up and each of those four out of five people could set off a new chain of transmission.

Dana Taylor:

Dr. Gounder, to date, what's the procedure been for caring for US citizens who've contracted Ebola abroad?

Dr. Celine Gounder:

In the past, it was to medevac, evacuate them to the US and we have over a dozen facilities that were special built exactly for this purpose. My friend, Craig Spencer, was hospitalized in the facility here in New York City at Bellevue Hospital. You also have Emory Hospital in Atlanta, University of Nebraska Medical Center. Those three in particular, out of the more than dozen facilities, those three have practical experience having cared for American healthcare providers who developed Ebola. And this is not an easy thing to do because you need BSL-4 level facilities, biosafety level 4 so that you don't have further transmission, but you also need to provide very high level care, intensive care sometimes, things like ventilators, dialysis. And so to do that requires really special investment and attention and practice that's very hard to stand up in an emergency.

Dana Taylor:

In looking at these specialized units, is it clear why the Trump administration is changing those procedures and sending exposed Americans to Kenya and Europe? Why would they not be treated here in the US in their home country?

Dr. Celine Gounder:

Well, what HHS has said and the administration has said is that they wanted to evacuate people to a place that was closer, that was easier to get to and so therefore to Europe or to Kenya. There were delays with the evacuation of the American doctor and his family to Germany and the other American doctor to Prague. So in that time, could they have been flown to the US for treatment? Yes. And then you have on the record that President Trump in 2014 had tweeted that no one with Ebola should come into the US and when President Obama had medical workers who were repatriated to the US for treatment here, not yet President Trump, he had called for President Obama's resignation. And so at least in the past, he is on the record as not wanting anyone, including aid workers with Ebola in the country.

Dana Taylor:

The Trump administration says they're setting up a state-of-the-art facility in Kenya through a coordinated effort with the Department of State Health and Human Services and War. What do we know about that facility and how might it compare to what exists in the US?

Dr. Celine Gounder:

We know very little, but to set up one of these facilities is not a small task and usually you do so with drills and practice and so on to make sure that the staff who work there are also going to be safe and that they won't get infected. I think there are also a lot of questions about what this will mean. Will somebody have to either recover from Ebola or die to leave that quarantine/treatment unit? What if you die? Does your body get repatriated? What happens afterwards? And for people who are making decisions about whether to volunteer to do this kind of work, those questions actually really matter. And right now Dr. Bhattacharya, who is both NIH director and has some title along the lines of acting CDC director, except he can't have that title anymore, he had sent an email to CDC staff asking them to volunteer to help staff the unit in Kenya, but what if one of them gets Ebola?

I think a lot of people are asking... They're having really difficult conversations with themselves about whether this is something they want to step up for. And I can tell you as myself as an Ebola aid worker veteran, many of my friends are Ebola veterans. We've been having these discussions ourselves. There's a lot of reticence to step up again right now.

Dana Taylor:

USA TODAY is reporting that the Centers for Disease Control and Prevention recently sent an urgent request to its employees seeking volunteers to help screen passengers arriving from the Democratic Republic of the Congo and Uganda for signs of Ebola disease. Meanwhile, the US has been expanding a list of airports that can screen passengers entering the US who've been in the affected East African areas. What does this move signal?

Dr. Celine Gounder:

There are some parallels with what was done with the 2014 to '16 outbreak, routing people who had potential exposures through specific airports where there were CDC staff. I went home through Newark Airport and upon landing, there was a customs and border patrol official who met me at the airplane, escorted me to the CDC screening site where they check my temperature. We went through a checklist of symptoms, assessed what exposures I had, if any. And then they sent me home with a flip phone, a thermometer and a diary and I was supposed to and did check in every day with the Department of Health as to my temperatures and any symptoms. And that is an appropriate way to deal with this. Ebola has a very long incubation period. It's three weeks. So the chances of catching anyone with symptoms at the time of screening are actually very low.

Many people who don't feel well would not want to board a long plane flight in that condition. But that said, the key piece is if you're going to do this, if you're really hoping that this is going to reduce transmission, keep people safe, you need to have that 21-day follow-up.

Dana Taylor:

The Trump administration invoked Title 42 public health law to restrict entry to the US. Can you explain what that law allows the government to do and who it applies to?

Dr. Celine Gounder:

Title 42 allows the federal government to implement certain restrictions, for example, around quarantine or movement for public health emergencies. The last time this was invoked was during the COVID pandemic and a couple million people were actually deported over the southern border over concerns about COVID transmission and that is despite there being active COVID transmission in the United States and those deportations really did not have any impact on transmission here. We're now seeing the Trump administration invoke Title 42 to ban people from the DRC, Uganda and Sudan from coming to the country. They're also applying this, extending that even to green card holders who may have gone overseas. The reason being that at least what they're saying is that it's less onerous if those people leave the country and then want to come back because they presumably have family overseas that they could stay with. But the way that this is being invoked is really unprecedented.

Dana Taylor:

Dr. Gounder, as I'm sure you're also aware, the DRC is playing its first World Cup game in Houston in less than three weeks. Is there a public health plan in place to handle the thousands of people who might have been to the affected areas, who'll be in close contact with millions of fans from all over the world, including Americans?

Dr. Celine Gounder:

So the DRC National Soccer Team has been in Belgium for months now. So they are not at risk for bringing Ebola over. As far as fans go with the current travel restrictions, it's going to be fairly challenging for people to be able to come into the country. But if somebody really wants to, there are ways of evading detection, whether it's traveling over land or making multiple connecting flights that can make it harder to detect whether somebody has been to these areas. I think the question of whether Ebola is a threat to the World Cup, I don't think so. What worries me about the World Cup is that we do not have a health preparedness plan in place. This is the largest mass gathering in US history. This is bigger than huge gatherings like the Hajj in the Middle East. And for an event like that, they have an incident command center. They have real-time data being fed in. They have a strategy and plans and protocols and we don't have anything like that for a much larger event involving many more cities and millions of people.

I'm not worried about Ebola spreading at the World Cup, but I am worried about something like a measles outbreak, which actually could be set off by Americans. We have pockets of undervaccination here. Another concern is MERS, which is another coronavirus, has not thankfully caused major epidemics or outbreaks like SARS and SARS-CoV-2, which caused COVID, but it is one we've had an eye on for a while. And so there are other infectious disease threats for which I am concerned we're not prepared.

Dana Taylor:

Dr. Gounder, thank you so much for taking the time to join me in The Excerpt.

Dr. Celine Gounder:

My pleasure.

Dana Taylor:

Thanks for listening to USA TODAY's The Excerpt. I'm Dana Taylor. Share your thoughts on this episode by sending a note to [email protected].