This is the feds’ supposedly tough new policy, designed to strike a balance between the mandatory three-week quarantine of at-risk health-care workers back from the hot zone a la New York and New Jersey and the “f*** it, let’s go bowling” approach of Craig Spencer and Nancy Snyderman. New rule: If you’ve been treating someone with Ebola and have actually jabbed yourself with a used needle, you should probably maybe think about hanging around the house for a few weeks.
Apart from a daily jog out in public, that is.
The guidelines call for greater restrictions on movement for those at high risk, such as health care workers who had an accidental needle stick while treating an Ebola patient. Those people would be told not to use public transportation for 21 days, the incubation period for Ebola. People would also be at high risk if they cared for an Ebola patient at home in Africa without wearing proper protective equipment.
According to the guidelines, those at high risk would be allowed to leave their homes, such as to jog in a public park, but would not be allowed to attend “congregate gatherings,” such as a baseball game.
People who fall into the category of “some risk” for Ebola — such as a health care professional who worked in a West African hospital but who had no specific, unprotected exposure to Ebola — should be closely monitored, with their temperatures taken twice a day, Frieden said…
Frieden quoted from a landmark study of Ebola that shows it’s not highly contagious in the early stages of disease, and it doesn’t spread through casual contact. Among family caregivers who lived with Ebola patients and took care of them, for example, only 16% became infected. Among household members who didn’t provide direct care, none of the 76 people studied develop Ebola.
There’s a “low risk” category too for health-care workers who’ve treated an Ebola patient here in the United States instead of in west Africa … like, say. the two nurses in Dallas who contracted the disease from Thomas Duncan. Surreally, the first two confirmed cases of Ebola transmission inside the U.S. are being relegated to the category of least plausibility by the CDC, even though the agency’s taken a beating over the last few weeks for seemingly underestimating the risk to doctors and nurses.
In fact, everything in the new guidelines seems one notch more casual than it should be. You would think that “high risk” people, who’ve actually had skin contact with someone who’s infectious, should be fully quarantined and, in the case of an accidental needle stick, either hospitalized as a precaution or quarantined near a hospital. The “some risk” people like Spencer and Snyderman should try to arrange quarantine for three weeks; if their employer won’t give them three more weeks of leave, they should at least avoid contact with others as much as possible and be monitored frequently throughout the day. The “low risk” people could be monitored less often but should also avoid unnecessary contact with the public if possible. (Like, say, avoiding non-work-related flights from Dallas to Ohio.) To this day, if I’m not mistaken, Kent Brantly and Nancy Writebol don’t know how they contracted the disease in Africa; Doctors Without Borders, which naturally follows strict protocols in treating patients, has nonetheless seen 16 staffers come down with it, nine of whom died. Presumably Spencer had no reason to think he’d contracted it or he wouldn’t have gone bowling. If even trained professionals are getting caught by surprise in their exposure, why would the CDC err on the side of less quarantine once they’re back home? The public’s confidence in the agency is going to get much, much worse, needless to say, if we end up with another transmission from the “low” or “some risk” category.
The irony of all this, as Tim Cavanaugh notes, is that it’s the doctors at the centers of it who are making the public more, not less, anxious (not “panicked,” as is often wrongly said). If Spencer and Snyderman had diligently quarantined themselves, the public would have greater faith that voluntary quarantines are an acceptable alternative to the sort of state-imposed measure that Christie’s getting hammered for today. At the very least, you would think that at-risk health-care workers, knowing how desperately west Africa needs volunteers, would minimize their public exposure if only because they know that support for a travel ban will inevitably rise if Americans think those workers are being sloppy in containing the risk. Instead, here we are, with Spencer still in the hospital and the CDC giving thumbs up to trips to the public park to people who’ve violated their own protective protocols while treating people sick with the disease. Good work, guys.