A judge in Maine ruled yesterday against the quarantine of Kaci Hickox which the governor of Maine has attempted to impose, agreeing with the medical evidence that Hickox “currently does not show symptoms of Ebola and is therefore not infectious.” This is a victory for Hickox personally, along with a victory for both science and civil liberties.
The politicization of Ebola has demonstrated the usual divisions between left and right in this country. As on so many other issues, the right wing has rejected scientific findings, distorted scientific information which conflicted with their political goals, and ignored the rights of the individual. This also provides another example of the emptiness of Republican claims of wanting to keep government out of health care decisions.
While the media has concentrated on a small number of people who have returned from West Africa, Médecins Sans Frontières (Doctors Without Borders) has had a staff of over 3300. Of these 3300 MSF staffers, only 23 have contracted Ebola. The staff includes over 700 who came to West Africa from other nations with only one developing symptoms of Ebola after returning home. The one doctor who did return to New York subsequently followed protocols for continued monitoring and was hospitalized prior to spreading the infection to anyone else.
With these odds, there is no justification in assuming that Hickox, or any other medical worker, is infected with Ebola merely due to having worked in the affected nations. People who are infected have a very low viral load early and do not spread the disease until after they exhibit symptoms, which Hickox has not done. It is becoming increasingly unlikely that she will. While a twenty-one incubation period is commonly cited by the media, and should be used as a precaution, in reality the vast majority of patients exhibit symptoms in six to twelve days. Monitoring for twenty-one days provides an ample additional margin of safety to the public.
While some Republicans have played politics with the issue and, as happens far too often, some Democrats such as Andrew Cuomo initially acquiesced in fear, the guidelines from the CDC and precautions already in effect are sufficient to protect the public and, to err on the side of safety, call for greater restrictions than are necessary based upon the science. There is no need for politicians to go beyond these precautions and unjustly restrict the civil liberties of Americans. The monitoring protocols already in place from Doctors Without Borders can be seen here.
Some conservatives are latching onto this fallacious blog post which claims that scientific studies show that airport screening is ineffective. Major problems with the author’s argument include that the studies cited were on different viruses which have major clinical differences from Ebola and therefore are not at all relevant to Ebola. In addition, airport screening is only one small part of the overall monitoring for Ebola over a twenty-one day period.
In response to the controversy engendered by those who have been ignoring the science, the American Nurses Association released this statement on October 29:
The American Nurses Association (ANA) opposes the mandatory quarantine of health care professionals who return to the United States from West African nations where Ebola is widespread. ANA supports registered nurse Kaci Hickox, who recently returned to the United States after treating Ebola patients in Sierra Leone, in her challenge of a 21-day quarantine imposed by state officials in Maine, her home state. Hickox arrived at Newark airport on Oct. 24 and was immediately quarantined in a hospital tent by New Jersey state officials, who eventually allowed her to travel to Maine via private transport on Oct. 27. After testing negative twice for Ebola, nurse Hickox, who continues to be symptom free, poses no public threat yet is restricted to her home.
ANA, along with the American Hospital Association and American Medical Association, supports the Centers for Disease Control and Prevention’s (CDC) guidance based on the best available scientific evidence. The CDC guidance would not require a mandatory 21-day quarantine of Hickox given risk levels outlined by the CDC in her particular case. ANA urges authorities to refrain from imposing more restrictive conditions than indicated in the CDC guidelines, which will only raise the level of fear and misinformation that currently exists.
ANA supports a policy of appropriate monitoring for health care workers who have cared for or been in contact with patients with Ebola. Those who are not exhibiting symptoms of illness consistent with Ebola do not require quarantine. Monitoring should follow recommendations outlined by the CDC based on risk levels and the presence or absence of symptoms, including regular monitoring of body temperature and oversight by a public health agency. If symptoms do occur, the appropriate next step is isolation and transport to a medical facility for further evaluation. ANA seeks to balance protection of public health and safety with individual liberties. Policies to protect the public from the transmission of Ebola must be based on evidence and science, not fear.
Mandatory quarantine for individuals who do not have symptoms or risk factors is not backed by science. Such actions undermine efforts to recruit sufficient numbers of volunteer nurses and other health care professionals, who are essential to help contain the spread of the disease in West Africa.
ANA’s position emphasizing evidence and science as the foundation for decision-making extends to proposals to ban travel to the United States from West African nations affected by the Ebola outbreak. There is no evidence to suggest that a travel ban would be effective; public health experts oppose it. In fact, a ban could be counterproductive, encouraging individuals to try to circumvent reporting and other systems. ANA supports the current requirement that those traveling to the U.S. from affected nations in West Africa, including health care professionals who have provided care to Ebola patients, once they have passed initial screening, engage in monitoring according to CDC guidelines and reporting to their respective public health agencies.”
Multiple other medical organizations have issued statements in opposition to imposing quarantines including the American Medical Association, the Infectious Diseases Society of America, and the Association for Professionals in Infection Control and Epidemiology. Unfortunately far too few people are paying attention to the views of the experts.
Updated from a post at Liberal Values
graphic via shutterstock.com
