International student mobility and the Ebola outbreak

The Ebola outbreak began in Guinea in March this year and in the months following it spread to three other countries: Liberia, Sierra Leone, and Nigeria. Isolated cases have appeared since in Africa and elsewhere. On the strength of an effective public health response, however, Nigeria has recently been declared Ebola-free. The epidemic has accelerated quickly otherwise and the World Health Organization (WHO) has declared a global health emergency. Treatments are uncertain and experimental in the best of circumstances. In the overburdened health systems of the most-afflicted countries in West Africa, treatment is scant indeed and the toll is rising. The WHO reports 9,936 confirmed cases as of 19 October and 4,877 deaths, numbers that are widely considered to be underreported. The Centers for Disease Control and Prevention (CDC), meanwhile, projects that Ebola cases in Liberia are currently doubling every 15-20 days and every 30-40 days in Sierra Leone and Guinea. By some estimates, as many as 20,000 people will be infected by early November and the mortality rate is high, on the order of 70% of confirmed cases. No wonder then that the very word Ebola can trigger fear, and that public health officials and governments are seized with the need to put sound protocols and policies in place to respond. No wonder either that the issue arises in the context of international education, raising new questions for institutions and schools and demanding an effective and measured response. The result, as The Chronicle of Higher Education recently put it, is that educators must perform a “delicate dance" and strike a balance between taking precautions and overreacting.

An abundance of caution

Many institutions are now considering what measures they will take in response to Ebola. Some are encouraging students or staff who have travelled from West Africa to monitor their health closely. Others are introducing travel bans for faculty and staff to prevent travel to affected countries. Spurred by three confirmed Ebola cases in the Dallas area, and, on 24 October, another confirmed case in New York City, some US institutions have been quick to act in response to even the possibility of contact with the disease.

• In mid-October, a public health doctoral student at Yale University, recently returned from Liberia, was isolated in hospital with fever symptoms. The student later tested negative for the disease.
• Kent State University asked three staff members who had possibly been exposed to stay off campus and monitor their health for 21 days, widely considered to be the maximum incubation period for the virus.
• Students at California’s Southwestern College were evacuated and quarantined for several hours after rumours spread that a student had been in contact with someone with Ebola-like symptoms. (The claim was soon disproved and the quarantine lifted.)
• Syracuse University and the University of Georgia have both recently cancelled speaking appearances by journalists who had returned from Liberia.
• Oregon’s Jesuit High School cancelled a school visit by a group of African student leaders.
• Dallas-area Navarro College rejected applications from Nigerian students, saying that the community college was “not accepting international students from countries with confirmed Ebola cases,” though they have since cited other reasons for the rejections.

Testing commitment

Fear of Ebola is testing commitment to internationalisation, and international mobility in particular, at some institutions. “For now, the greatest immediate effect on international academic exchange from the Ebola crisis will probably be a slowdown in the flow of students from the United States and other countries to West Africa,” says the Washington Post. "Now academic visits have been suspended as US authorities are warning against all nonessential travel to Liberia, Guinea and Sierra Leone.” According to the Institute of International Education (IIE), in the 2011/12 academic year, 3,126 students from the US went to West Africa to study (e.g., 2,190 to Ghana, 122 to Sierra Leone, 83 to Liberia, 23 to Nigeria, and 4 to Guinea). The IIE also reports that in 2012/13, there were 14,452 students from 17 West African nations enrolled at US colleges and universities, with the largest numbers as follows:

• Nigeria (7,316);
• Ghana (2,863);
• Ivory Coast (980);
• Liberia (172);
• Sierra Leone (123);
• Guinea (79).

Countering fear with facts

A recent item in Wired magazine explains, “Ebola is very unlikely to be a problem or cause a major outbreak [in the US]. One of the main reasons is that it is not as easily transmitted as other diseases. It does not travel through the air like influenza - to be infected you must come into contact with fluids from an infected person.” Other key facts:

• The time between contact with an infected person and the time that Ebola symptoms first appear ranges from two to 21 days.
• As a public health advisory from the British government adds, “Any persons arriving… from any of the affected countries, and who are free of symptoms, are not infectious and there should be no restrictions on their education or normal activities.”

Expert advice

A number of public health bodies have now issued official recommendations or requirements with respect to Ebola. The British government has released specific guidance for education institutions and advises that the risk of Ebola arriving in the UK is low. The UK bulletin also provides detailed advice with respect to monitoring and responding to any Ebola-like symptoms. Similarly, the CDC has issued specific guidance for institutions in the US. As in the UK, the CDC does not recommend restrictions on enrolling or hosting African students but does advise “risk assessments and monitoring for those who have recently returned to the US from Ebola-affected countries.” The CDC also recommends the suspension of travel to Guinea, Liberia, and Sierra Leone, but, in keeping with the British recommendations on this point, the CDC does not consider it necessary that colleges isolate or quarantine students or staff based on travel history alone. More broadly, the CDC has now introduced an active monitoring programme, though which anyone recently returned from Guinea, Liberia, or Sierra Leone will be required to undergo mandatory temperature checks for 21 days after returning to the US. While so far avoiding an outright travel ban to affected countries, the CDC has also recommended against non-essential travel to the most-afflicted countries. A number of institutions, however, have imposed bans on staff or student travel to West Africa.