U.S. to Defend Maritime Borders Against Potential Pandemic

Op-Ed by Craig H. Allen Sr.

The recent ebola outbreak compels us to ask: Is the U.S. prepared to defend its maritime borders against a potential pandemic?

Marine insurers recently issued warnings advising ship operators trading to West Africa ports to take added precautions against exposure to the highly contagious Ebola virus currently ravaging that region, killing more than 900 and triggering a rare “level 1” emergency response by the U.S. Centers for Disease Control and Prevention (CDC). On August 7th, the U.S. Coast Guard issued a Marine Safety Information Bulletin on “Ebola Virus Precautions.”  Similar warnings were issued by the International Chamber of Shipping, International Maritime Employers’ Council and International Transport Workers’ Federation. 

Over the past several years, the World Health Organization has also issued global alerts concerning the 2009-2010 H1N1 “Swine flu” pandemic (which struck some 89 million people in the U.S. and prompted President Obama to declare a national emergency), along with regional outbreaks of coronaviruses (including the SARS coronavirus); pandemic, avian and mammalian influenza strains; and the historically familiar gallery of polio, Yellow fever, cholera and Plague.   

Heightened concern over potentially fatal contagious diseases that may strike at a local epidemic level or a global pandemic level comes at the same time that Mediterranean nations are grappling with a massive sea-borne migration crisis—the kind of irregular migration event all too familiar to the United States. The lethal combination these threats could pose to the United States serves as a wakeup call to our maritime security and public health forces prompting them to carefully assess their authority, capability and capacity to take effective measures to prevent the introduction of contagious diseases by persons entering the nation by sea, both legally and illegally. In an extreme case, those prevention measures might include what could be styled as the “nuclear” option: closing the nation’s borders entirely, a far-reaching measure the effect of which would dwarf the aviation suspension that emptied the U.S. skies after the September 11 attacks.

A Threat to the Nation’s Security

In 2009, national security expert Andrew Krepinevich published a chilling pandemic narrative in his book 7 Deadly Scenarios that featured a U.S.-bound “Plague Flotilla” of makeshift vessels loaded with thousands of refugees fleeing a devastating influenza pandemic sweeping Latin America. 

The next year, in his 2010 National Security Strategy, President Obama warned that: The threat of contagious disease transcends political boundaries, and the ability to prevent, quickly detect and contain outbreaks with pandemic potential has never been so important. An epidemic that begins in a single community can quickly evolve into a multinational health crisis that causes millions to suffer, as well as spark major disruptions to travel and trade. Addressing these transnational risks requires advance preparation, extensive collaboration with the global community, and the development of a resilient population at home. 

Several years earlier, spurred by the toll inflicted by avian influenza in Europe and Asia, and the virus’s potential to mutate into a contagious strain capable of human-to-human transmission, President George W. Bush promulgated his National Strategy for Pandemic Influenza, and followed it the next year with an Implementation Plan for the strategy. The Bush-era documents (and the federal government’s rarely-used authority to involuntarily detain persons carrying a contagious disease) attracted national media attention after an arriving trans-Atlantic airline passenger infected with a drug-resistant and generally fatal form of tuberculosis set off possible “patient zero” alarms at the CDC.  Those Bush documents still serve as the linchpin in the nation’s plan for pandemic prevention and response.   

While the Bush strategy and implementation plan were being developed, the homeland security and public health communities examined an array of prevention and response measures. Those measures ranged from travel restrictions; enhanced screening and inspections of passengers and cargo at ports of entry; heightened measures to interdict (and apprehend, detain and repatriate) those attempting to enter elsewhere; isolation of travelers displaying disease symptoms and quarantine of other individuals exposed to disease vectors; and local, regional or even nationwide border closures.  

For each option, government teams examined the legal authority to take such measures, the time and resources required to implement the measure, the likely effectiveness of each, their feasibility and economic, political and social costs, and the government’s capability and capacity to carry out the measure. Not surprisingly, border closure was universally viewed as only a remote possibility. In weighting prevention and mitigation options, for example, the Bush implementation plan observed that “While we will consider all possible options to limit the spread of a pandemic virus, we recognize that complete border closure would be difficult to enforce, present foreign affairs complications, and have significant negative social and economic consequences.”  

Implications for Maritime Transport Industry

In response to a contagious disease alert, risk-based vessel routing and in-port security measures must be adapted to the particular threat. Vessel security plans should be reviewed, updated as necessary and exercised. Fuel, water, food and critical supplies stocks should be maintained at levels adequate to sustain the vessel during foreseeable delays or diversions. 

Protection and care of the crew and any passengers are always the vessel owners’ primary concerns.  Owners and operators should insist on proof that all crewmembers are up-to-date with vaccinations and equip their vessels with an adequate stock of personal protective equipment (PPE) and sanitation and medical supplies. Masters should be prepared to meet port state requirements for vessels to submit a detailed Maritime Declaration of Health (International Health Regulations, Annex 8) and to document all precautions taken against disease exposure in a Ship Sanitation Control Exemption Certificate (International Health Regulations, Annex 3).  The U.S. also requires vessels to report to the CDC any crew or passenger illness or death within the last 15 days.  

As a nation that depends on the maritime transport network to move 90 percent of its goods, the United States would immediately find its critical food, energy and supply chains severed by a maritime border closure, causing widespread hardship. The effect on the maritime industry would be similarly devastating. 

Additionally, even measures short of a full border closure would likely treat all arriving vessels and their crews, passengers and cargoes as potential disease vectors that demand strict control and thorough inspection (and, perhaps, quarantine), potentially resulting in crippling service disruptions, diversions, delays and cancellations. Maritime service providers cannot avoid the governments’ pandemic prevention and response measures, but they can help mitigate their effects.  

One of the best forums for discussing mitigation measures is the relevant Area Maritime Security Committee (AMSC).  AMSCs were established in each captain of the port (COTP) zone in the United States following the September 11 attacks. Each AMSC develops an AMS Plan for its COTP zone and conducts periodic security exercises. Among other issues, AMS plans address quarantine and isolation measures that may be imposed. AMSCs may also serve as a forum for examining continuity of operations and port recovery planning.

Conclusion

Although it is clearly a regional tragedy, the West Africa Ebola Virus Disease outbreak does not present a clear and present danger to the United States. Nevertheless, pandemic threats, and the public reaction they may trigger, remind us to think broadly about the consequences of pandemic diseases and remain vigilant. 

For those in government, the lessons of Hurricane Katrina loom large here. An increasingly demanding public expects their government to protect them against risks posed by natural and man-made disasters. Best efforts simply will not suffice. Unfortunately, even the best plans are too often relegated to the bookshelf soon after the promulgation letter is signed. 

Experienced responders all understand that effective implementation requires that those plans be put to the test in periodic war games and table top or field exercises involving all of the relevant players. As threat levels rise, exercise frequency and operational detail must keep pace. Exercise scenarios must be sufficiently challenging that the public and private sector participants are forced to weigh all of the available response options, including closing the maritime border.

Vessel owners and operators must be mindful that their vessels’ mobility renders them potential disease carriers, and that those vessels will at best be subject to stricter scrutiny by port authorities, who may order vessels into quarantine until the inspection can be completed. In addition to precautions to protect and care for crew members, vessel owners and masters should be prepared to comply with enhanced reporting and inspection requirements. Finally, wise vessel owners or their representative organizations will want to closely engage with the other members of the port communities through the relevant AMSC process.

Craig H. Allen Sr. is the Judson Falknor Professor of Law and of Marine Affairs at the University of Washington. He is a retired Coast Guard officer and author of International Law for Seagoing Officers.