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Saturday, November 1, 2014

The Issue of the Ebola Quarantine

This article was originally posted on Eagle Rising.


As I write this, we have a health care worker in Maine who was doing volunteer work in West Africa and who is fighting efforts to keep her quarantined. Kaci Hickox says it is a violation of her rights, and she is threatening to sue Maine if they try to enforce a quarantine on her. She is also threatening a  lawsuit against the state of New Jersey for keeping her in quarantine upon her arrival from Africa. They let her go after she raised such a fuss.

In the meantime, we have a doctor in New York City, Craig Spencer, who returned from similar work in West Africa. This doctor reported to a hospital when he became sick, but prior to showing symptoms was running all over town from one place to another. Yesterday we learned that he lied to authorities about his activities.

While I applaud the selflessness of these volunteers who have gone to West Africa to try and help people stricken with Ebola, there is nothing selfless about refusing to submit to a 21 day quarantine before they re-enter US society. In fact, it is downright selfish and irresponsible.

Hickox says that there is no need to quarantine her and she doubts the protocols. That flies in the face of two documented instances where Dallas nurses caring for Thomas Eric Duncan, the Liberian who came here and subsequently died, contracted the disease themselves. If they could catch Ebola, why is she immune?

It is also noted that the US servicemen who have been sent to West Africa are subject to the quarantine. The first of them have already entered quarantine at the US base at Vicenza, Italy. President Obama maintains that it is OK to subject the troops to the quarantine because, after all, they were ordered to go and didn't have a choice.  It is also noted that the troops are providing logistical support and are not in contact with patients. Yet, they are being quarantined before returning Stateside.

Meanwhile, President Obama, his "Ebola czar", and the rest of his administration are still unable to get a handle on this, refusing to issue a travel ban from the affected countries as hundreds of people arrive each day from Liberia and Sierra Leone feeling "just fine" as we await the next case in the US.

Given what has transpired, it is a matter of simple common sense. If you want to go to West Africa and volunteer your services, that is fine. I support any efforts to eradicate this virus at its source, and the US certainly has the resources to help. However, I still maintain that until we have this under control, we should not be allowing people with passports from the affected nations to come here. Secondly, our own citizens who go there must do so with the knowledge that they will be quarantined before re-entering our society.


7 comments:

Siarlys Jenkins said...

The demands placed on Hickox are irrational grandstanding, but the doctor you mention is responsible. Any sane person who returned from fighting Ebola would (a) spend 3-5 days away from the infected population in the country where they had been working, (b) not raise a huge fuss if detained for 24-72 hours on return (provided authorities had arranged suitable facilities -- which an improvised tent in a warehouse is not), and (c) refrain from going out in public for the first few days after release, e.g. subway cars, concerts, restaurants, etc.

If the doctor sets an example that people will run around taking heedless chances, then that spoils it for everyone else. But, the judge who ruled against the State of Maine was correct. It was hysteria, not science, that motivated the governor to demand some continued quarantine.

elwood p suggins said...

We have had compulsory military service, and no doubt will again at some future date (we would have it now if libs/dems had their way). We still have, I believe, mandatory vaccinations for various diseases (which, incidentally, have essentially eradicated them in this country). Etc., etc., etc.

I do not, then, comprehend why it is that quarantines, travel bans, etc., are out of line in regard to Ebola.

Siarlys Jenkins said...

Well elwood, these folks aren't in the army, so they aren't under military discipline. Nor has martial law been declared, and if it was, a lot more people would be complaining about it.

So, stripping away the thoughtless hyperbole, we have left the solid question of medical quarantine. As you may or may not know, this has been a difficult question for courts and legislatures for many decades. The law at this point authorizes quarantine, and considers it not to inherently violate the federal constitution, subject to a high standard of medical necessity.

I'm sure someone like you, concerned that the big bad federal government is taking away our rights as citizens, understands that unrestricted power to quarantine is a power that could be badly abused, including declaring a medical emergency where none existed, just to get back at political enemies or people who happened to be in the way.

So, quarantine is certainly not off the table. But, there must be a sound, scientific basis for it, and some basis to believe that without it, people would act in a manner that would endanger lives.

With 20/20 hindsight, its obvious that the doctor should have been quarantined, although five days would have been sufficient. It appears that the nurse is no danger to anyone. Enforcement cannot be tailored to each individual circumstance, so perhaps people like the nurse need to accept some quarantine.

Finally, it appears that the individuals on the front lines of enforcing quarantine are ill-trained, not terribly motivated, frightened, and unskilled, which of course makes people's blood pressure rise and induces avoidable resentment of the entire process.

People who are quarantined are not The Enemy. They should be treated with respect and provided reasonable quarters during quarantine. Quarantine should be kept as short as possible. As usual, this is a matter of getting it right, not absolute liberty vs. absolute repression.

elwood p suggins said...

effects noldovSiarlys--folks were subject to compulsory service well before they actually entered whatever branch of the military was involved and were therefore not "in the army" yet. Excepting mainly a relative few "connies", they were further subject to criminal sanctions if they did not submit Military discipline is a totally different thing, and some parts of the UCMJ might just surprise you.

I would call the interning of our own Japanese-American citizens in the 1940's, by a Democrat no less, as a prime example of "a power that could be (actually was) badly abused", which was much more oppressive and humiliating than any quarantine measures I have heard proposed, and for less reason at that.

Siarlys Jenkins said...

You are right about the interning of American citizens of Japanese descent -- and it should make you cautious about medical quarantine, not supinely flippant about it.

Could you document that anyone was subject to military discipline without being formally inducted into the armed forces? At most, I am familiar with mandatory medical examination for people called up, but not yet inducted, and registration requirements. That conscription existed should not lead you to believe that someone subject to conscription was subject to military discipline before being inducted.

elwood p suggins said...

Siarlys--FYI, the Selective Service System is an independent civilian agency within the Executive Branch, not a part of DOD. As such, no military discipline/involvement there.

As to pre-service medical exams, although they are ordered by SSS and not DOD, I suppose you possibly could be considered as "under military discipline" for maybe 30 minutes, since some/most/all of the medical staff conducting the exam are members of the military.

With regard to internment, those folks were, I believe and understand, subject to it for a period of up to several years, not a matter of days or a couple of weeks, as is the case with Ebola. Not at all comparable.

Siarlys Jenkins said...

Thank you elwood. You have conceded all points under discussion.