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Update November 6, 2014- Despite more than 80% of responders in various polls feeling that the Obama administration’s handling of Ebola was wrong, on Face the Nation, President Obama said this (see video).
Ebola just became political. On Friday, governors from the largest states (New York, New Jersey, Florida, and Illinois) essentially staged a mutiny and defied President Obama by instituting mandatory quarantine policies for any healthcare worker returning from the African hot spots of the Ebola epidemic.
Many of these governors are up for re-election in two weeks, and also have plans to run for president in 2016. President Obama’s handling of the Ebola crisis is very unpopular in the polls, and the governors are taking bold stands for the sake of campaigns.
It is painful for me to write this since I disagree with most everything that Governors Christie, Cuomo, and Scott stand for, but they happen to be correct in this decision. Mandatory quarantine for aid workers returning from Africa is the smartest thing to do from an epidemiology standpoint. A broken clock is correct twice a day, and so are the governors in this instance.
However, immediately piling on in opposition are the opponents of the governors and those who are trying to curry favor with the Obama administration. In bleeding heart appeals, they argue that mandatory quarantines will discourage American healthcare providers from going to Africa, and that helping stop the epidemic in Africa is the best way to ensure American safety. They are wrong.
First, it is pure conjecture to say that quarantines will hamper the Ebola relief in Africa by reducing the number of people willing to travel. It is quite likely that the same do-gooders with a mission in life to help people at any risk will still travel to Africa and endure the quarantines.
Secondly, there is no evidence that American doctors and nurses are actually preventing the spread of Ebola, and thereby making Americans safer. They are only helping save lives after they become infected.
Thirdly, and most importantly, there is tangible evidence that the well-intentioned healthcare workers traveling to Africa are in fact jeopardizing Americans by bringing the virus back to the homeland. It is an irrefutable fact that the only cases of Ebola in the United States came here via jet planes carrying African aid healthcare workers or relatives of Ebola victims. Therefore, one can make a good argument that, if quarantines in the United States reduced the influx of infected healthcare workers, then the United States would be better off.
So, on one hand, we have only the speculative concern that mandatory quarantines might indirectly end up harming the safety of the homeland. On the other hand, we know for a fact that people coming into the United States after helping Ebola victims in Africa are spreading the disease to North America. The decision is a no-brainer.
Full mandatory quarantines are required, as opposed to mere self-monitoring or honor-system house arrests, because we know for a fact that the latter are utterly ineffective. Even among honorable medical doctors trying to abide by the rules, the self-monitoring has failed.
Dr. Spencer left his home in Harlem despite feeling ill, and traveled all over New York City, causing the city to spend millions in dollars to back-trace his movements and decontaminate the restaurants and bowling alley where he visited. NBC’s Chief Medical Correspondent, Nancy Snyderman, MD, simply flat out cheated and left her voluntary house quarantine to get take-out food, despite her cameraman being in the hospital with Ebola. In Dallas, the family of the Ebola patient Duncan tried to leave their voluntary home-quarantine as well.
The governors are not overreacting by implementing mandatory quarantine. They have seen medical doctors violate the voluntary isolation protocols.
ABC’s Chief Medical Correspondent, Dr. Richard Besser, has been one of the most vocal against the mandatory quarantine for the reasons listed above. I have been debating him via Twitter, and he wrote, “No cases of Ebola occurred from contact w/ Dallas nurses. One led to many episodes of over-reaction not driven by real risk.” and the comment received dozens of re-tweets.
As an epidemiologist who used to run the CDC, Dr. Besser knows better. He knows that it is outrageously irresponsible to take a small sample size and extrapolate “therefore, there is no risk”. He knows that the 10,000 or more cases of Ebola in Africa were spread from infected people to their close relatives, and that the uninfected folks in Dallas just got lucky.
So, why do smart people like Dr. Besser say these things? They are simply pandering for political reasons. Perhaps he wants to be the next CDC chief once the CDC’s Dr. Frieden is ousted.
On the night that Dr. Spencer was admitted to Bellevue Hospital with Ebola, New York’s Mayor de Blasio repeated over and over that Ebola is extremely difficult to contract. Nothing could be further from the truth. Particles of the Ebola virus are found in quantities of 10-Billion per milliliter of blood, compared to HIV which is on the order of only millions per millileter. The doctor sick in Bellevue, and the nurses in Dallas, all wore protective hazmat suits and still became ill. When politicians tell bad lies to the public, they lose the trust of the public, and even more panic ensues.
Mandatory quarantines are the only known tool available to the epidemiologist that can prevent outbreaks. The World Health Organization and CDC have quarantines as part of their protocols. However, all quarantines are not created equally.
From early reports, the first nurse to be ensnared in the New Jersey quarantine policy, Kaci Hickox, was treated like a criminal by TSA agents at the airport, then placed into some sort of military-style tent located god knows where. This is idiotic and inhumane.
The brave volunteer healthcare workers risking their lives in Africa and America should be flown via charter jet home, then placed in a special hotel or hospital ward. Untrained TSA agents at the airport should never be involved.
The politicians and TV pundits acting as their mouthpieces who oppose the mandatory quarantining of healthcare providers do so because they are afraid of going down in history as racists or hysterical. They are also misguided by advisors within the Washington bubble who care more about geopolitics than the well-being of the average American. In President Obama’s case, he also has a personal affinity for Africa due to his heritage.
All of that has led to an Ebola response that has more than 80% of Americans in polls wanting a stronger response. Mandatory quarantines are the right thing to do scientifically, medically, and politically.