Above, a New Jersey police officer stands guard outside of University Hospital in Newark, where nurse Kaci Hickox was subject to a mandatory quarantine upon returning from West Africa, despite showing no symptoms of the Ebola virus.
The head of the United Nations Ebola response team is urging governments not to place medically unnecessary restrictions on health workers returning from West Africa, saying that decisions about such measures should be based on scientific evidence, not “hype and hysteria.”
Three states — New York, New Jersey and Illinois — announced this weekend that health workers would be quarantined after returning from Ebola-stricken countries, even if they are not showing symptoms of the virus. Several other states, including Florida, Maryland and Virginia, are requiring “high risk” health workers to isolate themselves, though the restrictions fall short of a legal order.
Leading health authorities have condemned these policies, saying they are not based on good science and, paradoxically, could ultimately threaten public health in the United States by making it harder for needed personnel to go to West Africa to help contain the outbreak, which has killed nearly 5,000 people and infected more than 10,000 across Liberia, Guinea and Sierra Leone, with isolated cases reaching Spain, the United States, and three neighboring African countries (Nigeria, Senegal, and Mali).
“Decisions (on quarantine) should be based on science and fact and not hype and hysteria,” Anthony Banbury, head of the U.N. Ebola Emergency Response Mission, told Reuters. “Anything that will dissuade foreign trained personnel from coming here to West Africa and joining us on the frontline to fight the fight would be very, very unfortunate.”
American aid workers in West Africa reduce Ebola threat at home
Foreign health workers are crucial to international efforts to contain an outbreak that the World Health Organization warns could result in 10,000 new cases a week before the end of the year. It’s also in our best interest to support those workers, as their presence in West Africa makes it safer for us back at home. Until the outbreak is brought under control at its source, the risk of global transmission will remain high and the threat to public health in the United States and elsewhere will continue to grow.
“The best way to protect us is to stop the epidemic in Africa, and we need those health care workers so we do not want to put them in a position where it makes it very, very uncomfortable for them to even volunteer to go,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Sunday.
Concern over the spread of Ebola in the United States — where, to date, only two people, nurses Nina Pham and Amber Vinson, have contracted the virus — has prompted some politicians to suggest taking drastic action to prevent infected travelers from entering the country. But top health officials say that indiscriminate travel restrictions and mandatory quarantines for returning workers are an extreme overreaction with dire consequences that “will come back to haunt us.”
And the first quarantine case has so far been a disaster. Kaci Hickox, who treated Ebola patients in Sierra Leone with the group Doctors Without Borders, said she was misdiagnosed with a fever upon her return to Newark Liberty International Airport. She described being treated like a “criminal” and being detained for several hours in “a frenzy of disorganization” and “fear” before being taken to a hospital to be quarantined. She was released to go to Maine today after she hired a lawyer and threatened to bring a lawsuit against the state for violating her “basic human rights.”
Quarantine policy already hurting humanitarian efforts
Banbury told Reuters that the U.N. mission’s most urgent need in West Africa is for hundreds of foreign healthcare workers, preferably those who were ready to run Ebola Treatment Units. “We need them and we need them really bad,” he said. But recruiting those desperately needed personnel could end up being a much bigger challenge if American doctors and nurses know they’ll lose the better part of a month to a quarantine at the end of their trip.
“The biggest problem (with the mandatory quarantine) is that it’s going to deter our volunteers,” Ebola survivor and aid worker Nancy Writebol told MSNBC’s “Andrea Mitchell Reports.” Writebol explained that most foreign aid workers in West Africa are using personal vacation time to be there, so while they may be able to get away for a few weeks, the extra 21 days would likely make the trip impossible. “Most doctors and nurses do not have the luxury of being away from their jobs or from their practices for that long,” Writebol said.
The international aid group Doctors Without Borders said Monday that the policies are already prompting some of its volunteers to reduce the length of their commitment. “We need to be guided by science and not political agendas,” Dr. Joanne Liu, the group’s international president, wrote in a statement. She warned that other countries could follow suit and enact similarly “short sighted” rules. She said diligent monitoring was a far better policy than “coercive isolation of asymptomatic individuals.”
The group, also known by its French name, Médecins Sans Frontières, has sent more than 700 health workers to West Africa since the outbreak began. Three of those workers have developed Ebola, including the New York City doctor, Craig Spencer. However, none of those cases has resulted in a single secondary case.
‘We don’t need politicians to make these kinds of decisions’
Ebola can only be transmitted by direct contact with the bodily fluids of someone who is showing symptoms of the disease. Experts say that monitoring those who have returned from West Africa and appear healthy through routine tests like taking one’s temperature can prevent even infected people from spreading the disease without discouraging future volunteers.
Following intense public scrutiny, Gov. Cuomo seemed to walk back the original policy he explicated on Saturday, conceding that health workers could complete the 21-day quarantine at home. Gov. Christie soon followed, though he became defensive when asked why he changed his mind, launching a twitter rant in which he shared the same YouTube video 8 times in the span of 17 minutes.
But even though Cuomo and Christie appear to have backed down for now, many are worried that their shortsighted policy could catch on in other states. After the two governors jointly announced their decision to quarantine asymptomatic health workers, Illinois Gov. Pat Quinn issued his own emergency order calling for similar mandatory quarantines, while at least three other states have enacted mandatory isolation procedures for all health workers returning from the affected countries.
The fear is that other governors could follow suit, further muddling the government’s response to a virus that has yet to spread to a single American outside of a hospital.
“We don’t need politicians to make these kinds of decisions,” Hickox told CNN on Sunday from her isolation tent inside Newark’s University Hospital. “We need public health experts to make these decisions.”