How to Quarantine the Ebola Panic
A 14th-century weapon is not the best defense against a 21st-century illness. That's not simply common sense, it's also the scientific consensus, and why public officials in the U.S. are wrong to insist on mandatory quarantines for health workers returning from Ebola-afflicted West Africa.
New Jersey Governor Chris Christie and other governors who aren't willing to rely on science seem to believe that their states' residents need protection beyond what medical experts say is necessary -- in order to feel especially protected. That, presumably, will prevent widespread panic. A better way to keep the calm would be to bolster public education about Ebola.
Two truths about this disease, in particular, seem to be widely misunderstood: First, because the virus isn't airborne, it is not as easily spread as the flu or a cold. It spreads from person to person only through direct contact with infected blood, vomit, sweat or other bodily fluids. Second, people with the virus are incapable of transmitting it unless they have symptoms (fever, muscle pain, headache, sore throat), which can develop up to 21 days after infection. Fever comes before the contagious stage.
Taken together, these facts explain how unlikely it is that anyone in Manhattan or Brooklyn might have been infected by the doctor who went bowling before his first symptoms appeared. And these are the facts that governors and other public officials should do their best to repeat.
Instead, Christie and New York Governor Andrew Cuomo moved forward last week with a strict quarantine policy -- Cuomo has since softened his -- without so much as consulting the U.S. Centers for Disease Control and Prevention. Clearly, their decision was unnecessary and premature. Yet it also displays a worrisome disconnect in national public-health networks. Some amount of public panic is to be expected, and must be addressed. State health officials, however, should know better -- both about how Ebola spreads and the dangers of mandatory quarantines.
The humiliating discomfort inflicted on Kaci Hickox, the nurse who was kept in a tent at a hospital in Newark, New Jersey, merely because she had just returned from treating Ebola patients in Sierra Leone, shows what can happen when there is a lack of consideration for both science and civil liberties. Hickox has since been allowed to return to her home in Maine, where she will be monitored. During the SARS epidemic of 2003, public health officials learned that voluntary quarantines -- simply requesting that people who might have infectious illness limit their social interactions for a period of time -- are as effective as forced quarantines in helping stem an outbreak.
In the case of Ebola, the CDC now advises that health workers returning from West Africa report their temperature twice a day to state or local health officials -- but not be put in mandatory quarantine. Only those who are at relatively high risk of being infected -- because they were pricked by a needle while caring for an Ebola patient, for example, or weren't wearing protective gear -- should be told to stay home and away from other people even if they have no symptoms. Officials in Europe and in the U.K. have likewise decided against quarantining humanitarian workers returning from West Africa.
A third essential truth about Ebola is that the only way to stop an outbreak is to battle it at its source: in this case, in West Africa, where 5,000 have died and 5,700 more are infected. Tens of thousands more volunteers are needed to control the epidemic. That means giving doctors and nurses strong incentive to go there to lend a hand -- and an equally strong promise that when their work is done, they will be welcomed home.
--Editors: Mary Duenwald, Michael Newman
To contact the editor on this story:
David Shipley at firstname.lastname@example.org