A Maine judge on Friday ruled in favor of a nurse who defied a quarantine in a tense standoff with state authorities, saying local health officials failed to prove the need for a stricter order enforcing an Ebola quarantine.
District Court Chief Judge Charles LaVerdiere ordered nurse Kaci Hickox, who recently returned to the United States after treating Ebola patients in Sierra Leone, to submit to “direct active monitoring,” coordinate travel with public health officials and immediately notify health authorities should symptoms appear…
Her attorney, Norman Siegel, called the decision a victory.
“She won,” he said. “She is not quarantined. She can go out in the public. … (The judge) got the understanding of what liberty is about and how the government can’t restrict your liberty unless there is compelling justification.”
Go Kaci Hickox. Ride your bike. Take walks. Order pizza. Talk to reporters. Behave the same as any healthy, free, liberty-loving U.S. citizen should behave. And, by all means, follow the same procedures that U.N. Ambassador Samantha Power and others who have traveled to West Africa are following.
But, by no means, should Hickox submit to the ridiculous, fear-based policymaking on Ebola being concocted by state governors running for re-election. If those governors spent half their fear-mongering time trying to educate the public on the actual science behind Ebola, we’d all be better off. Instead, they are feeding the kinds of hysteria that has led to recent survey results showing that large numbers of Americans believe they or their family members will be infected by Ebola…
A three-feet exclusion zone around a non-symptomatic person accomplishes absolutely nothing other than to feed the myth that a non-symptomatic person can somehow infect others through the air. (But I guess it’s better than the 3,000-mile exclusion zone that a school in Mississippi effectively declared when it ordered a principal to stay home because he had traveled to Zambia.)
I hope that Hickox challenges the 24-hour court order and, when it expires, kisses her boyfriend and shakes hands with well-wishers and behaves normally unless and until symptoms compel her to do otherwise. Her acts of defiance, in the name of science, are doing far more to educate the public about Ebola myths than a group of governors whose primary concern isn’t public safety but fear-mongering for the sake of winning votes on Tuesday.
The White House said on Thursday that it did not support the decision by a nurse in Maine to flout the voluntary quarantine imposed upon her by state authorities concerned about her exposure to Ebola.
A spokesman for Barack Obama said that it was up to states to set their own public health rules, although he believed they should be guided by science…
Asked whether that meant the administration believed Maine was not following the science, Earnest told the Guardian he was not in a position to judge.
But he said officials from the Centers for Disease Control and Prevention (CDC) had been in touch with the state to stress the importance of following scientific guidance when setting quarantine policy and “risk assessments should guide the degree to which the health of an individual” poses a risk.
Given the lack of case history, it is very, very difficult to predict whether Hickox or the state would prevail. One factor that may override all other considerations is that local judges are typically hesitant to overrule local officials in the heat of the moment on matters of public safety. “The science is pretty clear, but we need to understand the atmosphere in which this is unfolding,” says Parmet. “It’s a lot easier for them to look at it afterward and say this was a mistake.”
A decision by the Maine court won’t end the national debate. It would, however, give momentum to the winning side. If a judge were to decide that Maine doesn’t have the legal authority to quarantine Hickox, medical workers who face similar restrictions in the future will be that much more likely to challenge those measures in court. Likewise, if the court sides with the state, those workers might be less likely to fight. “The only prediction I can make now,” says Parmet,” is that there will be a lot more litigation and a lot more chaos in the weeks to come.”
A CBS News poll released Wednesday showed a whopping 80 percent of Americans believe that some kind of quarantine is warranted for U.S. citizens traveling from West Africa back to the United States. I would argue that number is probably a little bit inflated — CBS didn’t mention that such quarantines last 21 days or where they would take place — but it’s pretty clear the vast majority of Americans are on-board with a whatever-it-takes approach to containing the spread of the disease.
Another case in point is the latest Washington Post-ABC News poll, which shows 70 percent of Americans want some kind of travel restrictions when it comes to people traveling to the United States from West Africa…
For Hickox, it’s not yet a chorus of criticism, but it’s picking up, particularly in the conservative blogosphere. And given the very real fear in the American public and the overwhelming support for the kind of quarantine that Hickox is flouting, she’s turning into the face of a cause that very few Americans believe in.
Governor Chris Christie explained to local reporters that he was confident with his quarantine policy to combat Ebola in spite of pressure from the Obama administration, explaining that his policy was based on “common sense.”
“If you’ve been a healthcare worker who’s been directly exposed to the virus, active virus, and you come back to the U.S. you should quarantine for 21 days,” he said simply…
“I don’t know when the White House is going to get around to admitting that and not giving us seven minute lectures from the South Lawn, and just get to work,” he said.
For individuals who in their service abroad exemplified Americans’ generosity of spirit, Hickox and Spencer have demonstrated a shocking lack of it since returning back home. Strictly monitored house quarantine — de facto house arrest — is undoubtedly an abrogation of civil liberties. But 21 days of it — lavishly state-funded — to be followed by perfect liberty assuming no problems, seems like a minimal sacrifice to ask of those who put themselves voluntarily in danger. When it comes to a disease that liquefies your internal organs and pushes blood out your eyeballs, “Better safe than sorry” would seem a dictum to which everyone could agree.
So why Hickox’s dissent? There is, first, her insistence on her own wellness: “I remain appalled by these home quarantine policies that have been forced upon me even though I am in perfectly good health and am feeling strong.” That is reassuring — until she suddenly stops feeling strong and is diagnosed with Ebola. The medical consensus is that a person is likely to be free from the threat of an Ebola onset 21 days after being in contact with the virus. Hickox’s six healthy days since leaving Sierra Leone are encouraging, but it’s a long while until she is out of the woods.
Second, she has said that she will “self-monitor” and report to the hospital if she believes herself symptomatic. But that claim is far from credible — first, because of Spencer’s example, and second, because of her demonstrated disdain for the state’s medical protocols. Does she really expect public-health officials to believe that, if she starts to feel weak and achy, she will immediately submit to their aggressive orders — like, you know, quarantine not in her own living room?
Yes, people overrate the danger of major Ebola contagion in this country. But when scientists talk about symptomatic patients, how symptomatic do they have to be? Not all patients get a fever, so what if they’re just feeling fatigued — which could be brushed off as a natural consequence of the psychologically and physically stressful work of caring for frightened, dying and truly contagious people — or a little off? Would they all adhere strictly to rules about staying home at that point and immediately calling authorities? Another issue that has to be taken into account is the tracking and cleaning that’s performed on all the places they’ve been for the 24 hours before they noticed symptoms. There are times when the impact on the many outweighs the impact on the one…
[H]aving gone there, health workers might return to protocols they find ridiculous in the much healthier and wealthier United States. Confronted with a novel situation, the country has been reacting bumpily to the business of protecting the public without giving in to unwarranted anxiety. In the absence of a coherent strategy at home, though, returned volunteers cannot make up individual quarantine protocols. Many health experts have expressed concern that overly harsh quarantine rules might discourage people from service in Africa. But a public backlash here could also be dangerous to the fight against Ebola. People are increasingly cynical about the assurances of federal health officials who have not shown that they’re on top of the situation at home.
The people who are trying to say stop worrying about Ebola in New York, stop worrying about Ebola at Newark airport, what they’re trying to do is lose the teachable moment. If they succeed in getting people to stop worrying, they will regret it, because there’s a lot to worry about it.
Calming us down shouldn’t be a goal. It would be different if people were panicking in the street.
But the evidence doesn’t say that people are unreasonably, dangerously upset. They’re sometimes worried about the right things more than the experts are. I think it’s reasonable that when people read that the CDC and WHO say Ebola is characterized by a sudden onset of symptoms to think, doesn’t that mean you could be fine at 10 o’clock and vomiting in the subway at noon? Then I think you should stay home. What’s irrational about that?
So what you’ve got are people who are climbing the learning curve, and in some cases learning more quickly than officials — learning that you probably can’t get it from someone who doesn’t have symptoms, but also leaning that the people who told you that have made some mistakes.
No one should be surprised that ordinary Americans are more inclined to press their elected officials for greater restrictions on people who travel to and from West Africa (and other areas of the world where Ebola is rampaging) than are healthcare officials. Accordingly, New Jersey Gov. Chris Christie of New Jersey and New York Gov. Andrew Cuomo imposed (somewhat flexible) 21-day quarantines for all travelers from West Africa re-entering the country through their states’ airports, with Christie telling the New York Times, “We are no longer relying on C.D.C. standards.”
American healthcare officials have sought to calm fears of Ebola with maybe the best of intentions. Officials have been right on target when noting that Ebola less is contagious than other diseases. However, by straining “scientific facts,” and failing to acknowledge what they don’t know about Ebola, and what cannot be known, they could have had the exact opposite effect and put Americans at greater risk—and lost credibility exactly when that virtue was most needed.
Healthcare and infectious disease experts should not expect ordinary Americans to understand the details of Ebola science. Instead, they should recognize that ordinary Americans will, for the most part, tend to evaluate the consistency in official pronouncements and deeds, which can make healthcare officials and scientists their own worst enemies on Ebola policy. In short, any Ebola “hysteria” should not be seen solely as the fault of “others,” meaning politicians and media. The country’s officials and experts must accept their own share of responsibility for “overreactions.” They have inadvertently squandered many Americans’ trust through semi-transparent gaps between rhetoric and deeds.
The only argument against a quarantine that makes sense is that the decision might dissuade U.S. health workers from going to West Africa. It can easily be answered. Pass a law to pay everyone’s full salary while they’re quarantined. Make it a free vacation. Get them every kind of benefit and service possible for those three weeks. And then when they’re well, thank them publicly. Have them in the balcony at the next State of the Union!…
It must be noted that all this—the quarantine argument, the travel ban—is another expression of the deep, tearing distance between America’s professional and political elites, who operate as if they are estranged from common sense, and normal people, who are becoming more estranged from the elites, their oblivious and politicized masters.
That distance has been growing all my adult life, but the Ebola argument has brought it into sharper relief. The elites should start twigging onto it. They are no longer immediately respected, their guidance is not reflexively taken. They seem more immersed in political thinking—what is the ideologically enlightened position to take, where’s the boss on it?—than in protecting public health…
All this will be part of the story on Tuesday, in the elections. It is hard to believe you can patronize people, and play them, and they will not, first chance they get, sharply rebuke you.