Why States are Right to Quarantine Ebola Workers

10.28.14
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Health + Tech /28 Oct 2014
10.28.14

Why States are Right to Quarantine Ebola Workers

Now that eight states have implemented their own Ebola quarantine protocol for medical workers returning from Guinea, Liberia, and Sierra Leone, the debate is raging in the media about the efficacy and appropriateness of their actions. Some medical professionals have argued that patients are not contagious until they become symptomatic, so the quarantine is unnecessary. Others, such as Chris Christie, the governor of New Jersey, have stated that even medical workers cannot be relied upon 100% to either self-diagnose properly, or to act appropriately by reporting their symptoms to state and federal authorities, making the mandatory quarantine necessary.

Lost in the discussion is what has been reported from the medical professionals who treated Thomas Eric Duncan – patient zero in the U.S. – who died from the disease in Dallas after importing it from Liberia. In last Sunday’s 60 Minutes, they describe how when he first came to the hospital, Duncan said he had come from Africa, but failed to state that he had come from Liberia. That is one reason why he was sent home. It was only when he returned to the hospital three days later that he told the hospital workers that he had actually come from Liberia. Only then did the alarm bells go off. When questioned further by state authorities, he apparently then denied that he had said he had been in Liberia.

Also little reported are other instances where medical workers who had returned from West Africa to the U.S. had agreed to be self-quarantined for 21 days and not abided by their pledge to remain at home, only to be found going to public establishments, as happened in New Jersey.

Then there is the doctor in New York City who already had a low-grade fever and still went around town eating at restaurants, going bowling, and taking taxis and subways.

Herein lies the essence of the problem – and I have heard only one public official state it in clear and unapologetic terms – that person being Governor Christie: people in general, even medical professionals, cannot always be relied upon to do the right thing. In failing to do so, they potentially put others at risk.

While the CDC is publicly stating that one cannot catch Ebola unless in direct contact with bodily fluids, others in the medical community maintain that the virus can theoretically become airborne through droplets caused by sneezing or coughing, and the CDC’s own guidelines to airlines (updated October 15th) specifically state the importance of minimizing ‘infectious droplets’ in the air when cleaning airplanes in which persons infected with Ebola had traveled. This week, a report in the UK’s Daily Mail noted that based on studies conducted by the UK Defense Science and Technology Laboratory, the virus can ‘live’ on a variety of surfaces for hours and even weeks, depending on the surface and its temperature. Why is this not being reported in the media?! The government and CDC appear to be selective with the information they choose to release for public consumption.

Some in the medical community have argued that imposing a mandatory 21-day quarantine for medical workers returning from West Africa may prevent some individuals who might otherwise be inclined to volunteer to go fight the disease in the epicenter of the battle in West Africa. I think this is poppycock. They are suggesting that an individual who may go for months into the belly of the beast would have a problem protecting others from getting the disease by going into quarantine for a few weeks. I don’t believe that the majority of medical workers subscribe to this belief, but if some do, it is selfish, and sad.

My view is, too bad if those medical professionals have a problem with a mandatory quarantine. Are they saying that they are willing to put their own lives at risk by voluntarily working in West Africa, but they are unwilling to be ‘inconvenienced’ for a few weeks upon their return by staying at home — even though they will now be paid for their down time – in order to ensure against the spread of the disease? Ridiculous!

I think the states are right to do what the federal government refuses to do – impose a mandatory quarantine on medical workers who return from Guinea, Liberia, and Sierra Leone. I hope all the other states do so as well. I wish the same would be done for ANY individual who comes to the U.S. from these countries. That should be the price of entry, and anyone who comes to the U.S. from these countries should know it in advance and agree to it before coming. The stakes associated with not doing so are simply too high.

If the Obama administration were really serious about containing the spread of this disease in the U.S., it would impose the same mandatory quarantine on all returning health workers, and, if it were possible, all individuals coming to the U.S. from these West African countries. If people could be relied upon to be responsible and do the right thing 100% of the time, this would not be necessary – but, as Mr. Duncan and the other health workers referenced have proven — they cannot.

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