A government that built hospitals to treat its own soldiers from Ebola now plans to send infected Americans to a facility it has not yet finished constructing in Kenya.

"When Americans will need us most, the US government plans to send them to a hospital it is standing up from scratch in Kenya. I find it incredibly difficult to believe that we can stand up a facility in the next few weeks with the staff, the supplies, and the experience we have built over the past decade in more than a dozen hospitals across the US."

— Dr. Craig Spencer, professor of public health at Brown University, who contracted Ebola in 2014 while treating patients in West Africa

The New York Times reported on Tuesday that the Trump administration has abandoned decades of established protocol for handling Americans exposed to deadly pathogens overseas: instead of bringing them home to state-of-the-art quarantine and treatment facilities, the White House plans to send them to Kenya.

Several dozen Public Health Service officers are currently being trained to deploy to East Africa. Their mission is not merely to monitor Americans who have been in contact with Ebola patients during the current outbreak in the Democratic Republic of Congo. According to three people familiar with the administration's plans, these officers will now be responsible for treating infected Americans as well.

The reversal marks a dramatic departure from every previous American response to an Ebola emergency. During the 2014 West Africa outbreak, the United States built more than a dozen specialized treatment hospitals across the country. When Dr. Spencer contracted Ebola while working with Doctors Without Borders in Sierra Leone, he was flown home and treated at Bellevue Hospital in New York City, where he survived. He has since become one of the most vocal critics of the current plan.

Translation: the United States spent a decade and millions of dollars building world-class Ebola infrastructure, then decided to ship its citizens abroad anyway.

The strain currently spreading through Ituri Province in the DRC is caused by the Bundibugyo virus, one of six species in the Ebolavirus genus. Unlike the Zaire ebolavirus that dominated previous outbreaks, the Bundibugyo strain has no FDA-approved vaccine or treatment. The CDC confirmed this in an alert issued on May 19: "There is currently no Food and Drug Administration-licensed or authorized vaccine to protect against Bundibugyo virus infection."

The WHO declared the outbreak a public health emergency of international concern on May 17. As of that week, suspected cases had reached at least 906 with 223 suspected deaths. More than 100 cases and 10 deaths have been confirmed in the DRC, while Uganda reported seven confirmed cases and one death. The mortality rate for Bundibugyo Ebola typically ranges between 25 and 50 percent, considerably lower than Zaire ebolavirus but still devastating without adequate medical support.

The response on the ground has been hampered by severe security problems. Reuters reported that at least three attacks on Ebola treatment facilities in northeastern DRC have caused dozens of patients to flee hospitals. The attackers appeared motivated either by demands to release deceased patients' bodies for burial or by fundamental distrust of the virus itself. Dr. Richard Lokudu, medical director of Mongbwalu General Referral Hospital in Ituri, told Reuters that "there is denial of the disease within the population."

The WHO's latest situation report described contact tracing as a "major challenge," with only 19.3 percent of contacts seen by health professionals within 24 hours as of May 23. Constraints included insecurity, movement restrictions, highly mobile mining communities, and dispersed cross-border populations.

Public health experts have been quick to point out that the administration's decision to keep Ebola-exposed Americans overseas sits on top of a broader pattern of dismantling America's global health infrastructure. USAID once maintained more than 50 staffers dedicated to responding to and preparing for disease outbreaks including Ebola and Marburg virus. The Department of Government Efficiency, run last year by Elon Musk, reduced that workforce to about six people.

Musk insisted at the time that funding for Ebola efforts was maintained. Common Dreams reported last week that USAID's Ebola prevention work was largely halted by DOGE cuts despite those assurances.

The State Department said it had mobilized approximately $23 million to help the DRC and Uganda respond to the outbreak. But Dr. Spencer characterized the administration's travel bans and border-focused approach as "a policy you put in place when you have nothing else meaningful to add. It gives the appearance of doing something while effectively doing nothing of value at all."

Secretary of State Marco Rubio blamed the WHO for being "a little late" to identify the outbreak, while insisting that "we can't have Ebola cases" in the United States and that keeping the disease out of US borders was the top priority. To that end, the administration invoked Title 42 to bar immigrants and legal permanent residents who had been in Congo, Uganda, or South Sudan within the previous 21 days from entering the country. The WHO warned that travel bans are not based in science.

The CDC's own staffing cuts have left the agency unable to conduct public health screenings at airports without calling on volunteers from its reduced workforce.

Dr. Spencer raised another concern that goes beyond medical logistics: the Kenya plan could actively undermine disease containment. If American healthcare workers and aid personnel know that any high-risk exposure will result in being shipped to Kenya rather than sent home, he wrote, "it is not hard to imagine people not being fully forthcoming about what may have happened to them. That is exactly backwards from how you contain a disease."

He also warned the policy would discourage Americans from joining the humanitarian response. Multiple healthcare providers were considering deployment with aid organizations when the news broke, Spencer said. "Programs and policies like this are exactly the reasons people will hesitate to sign up."

Dr. Krutika Kuppalli, who treated Ebola patients in Sierra Leone during the 2014 outbreak, called the plan nonsensical "from a preparedness, operational, or ethical standpoint." She pointed out that Public Health Service officers deploying to Kenya would have no experience providing high-level care for this infection. She also asked why any PHS officer would volunteer knowing that if they were exposed, they would not be repatriated.

The current outbreak already faces an acute shortage of experienced medical personnel. The last thing the response needs is fewer Americans willing to go.

Spencer emphasized one fact that makes the Kenya plan particularly dangerous: survival from Bundibugyo Ebola depends almost entirely on the quality of supportive care available, and there is no approved antiviral treatment for this strain. "Survival depends heavily on the quality of the system and the people around you," he wrote. "We have that system. I survived Ebola and am here today partly because of it. But we are choosing not to use it."

The irony is almost precise. During the 2014 outbreak, the United States deployed thousands of personnel overseas, built treatment facilities in Liberia, and brought infected Americans home for care at the highest level available. The system Spencer credited with saving his life was real, tested, and still exists. Under the current administration, it is being deliberately bypassed.

The question is not whether a facility can be stood up in Kenya. The question is why the United States would choose to build one when it already has better hospitals closer to home.