Nurse, doctor's fiancee released from hospital quarantines

This may moot the lawsuit Kaci Hickox planned to file against New Jersey, but it won’t end the debate over the proper way to deal with health-care professionals returning from contact with Ebola patients. The state of New Jersey announced that they would release Hickox from mandatory quarantine after testing negative for the disease, but the tests don’t normally indicate infection in its earlier stages:

New Jersey officials announced Monday they plan on releasing the nurse quarantined over fears she was exposed to the Ebola virus while volunteering in West Africa.

Kaci Hickox said over the weekend she planned on filing a federal lawsuit over her confinement, saying she felt “like a criminal.”

In a statement, the New Jersey Department of Health said she has been asymptomatic for the last 24 hours.

“After being evaluated in coordination with the CDC and the treating clinicians at University Hospital, the patient is being discharged,” the statement read.

Hickox had blasted the quarantine and hired a well-known civil rights attorney to challenge it. She and her attorney argued that the order violated her freedom without any due process, plus that it would have a chilling effect on volunteers to stop the disease in western Africa before it spreads farther. Hickox may have had a better argument on competence, describing the ad hoc arrangements made for her quarantine:

“When you’re talking about doing the quarantine it seems like audibles are being called, it’s being done on the fly,” LaPook said. “This is something that has to be thought out.”

Hickox told LaPook some evidence of this comes from the fact that her isolation room has no shower and only a simple porta-potty with minimal privacy, that she was for a time given only cold scrubs to wear, and all this despite that fact that she tested negatively initially.

Hickox is angry over being treated like a criminal at the airport, but the issue is a lack of trust — including among those who should know better. The problem that ensnared Kaci Hickox is that previous health-care professionals couldn’t be trusted to act properly after treating Ebola patients. Amber Vinson took two plane flights while becoming symptomatic, both with the CDC’s blessing, putting hundreds of people at risk for infection, all of whom are still in the potential incubation period. Craig Spencer went out for a night on the town in New York City the day after fatigue symptoms began presenting themselves. Spencer passed the CDC’s enhanced screening measures, and yet still got ill and put hundred of people at risk to go jogging and bowling.

Ron Fournier makes that point in his column today:

Whom do you trust?

The consensus of the scientific community is that mandatory quarantines will discourage health care workers from fighting the roots of the disease in West Africa, a long-term threat to the United States.

But at least one health care professional, Dr. Nancy Snyderman, an NBC correspondent who had traveled to Liberia and whose cameraman had contracted Ebola, violated a voluntary-based protocol by picking up food at a restaurant near her home. When a doctor, Craig Spencer, tested positive in New York City on Thursday, forensic scientists had to retrace his every step.

Do you trust doctors and nurses to monitor themselves?

Not any more. And if we can’t trust Ebola experts to isolate themselves for three weeks after their last contact with Ebola, then it’s impossible to argue that others will perform any more professionally than the professionals.

Spencer also put his fiancee and two friends at risk, all three of whom went into quarantines. The fiancee has been allowed to continue her quarantine at home:

The fiancée of the humanitarian doctor who contracted Ebola in West Africa returned to the couple’s Manhattan home Saturday night.

Morgan Dixon, her face covered in a pale scarf, walked into her Harlem building without saying a word just before 7 p.m.

The 30-year-old grant writer was quarantined at Bellevue Hospital since Thursday when Dr. Craig Spencer, 33, was diagnosed with the lethal virus.

This won’t be a self-isolation, though:

A health department police officer will remain posted outside her door 24 hours a day. As an additional precaution, an NYPD officer will be manning the building entrance.

So, no Snyderman-style dash for soup at the local bistro, in other words. The state of New York may have backed down on the quarantine location, but not the policy. Despite the release of Hickox, it doesn’t appear that New Jersey and Chris Christie have retreated on the policy either, as Hickox will board a private flight to Maine rather than stay in the Garden State.

Meanwhile, another traveler has gone into isolation in New York City after traveling through Guinea, and this one’s a particularly disturbing case:

A pediatric patient is being tested for Ebola at Bellevue Hospital, the New York City Health Department said.

The child, who had been in one of the three West African countries affected by the disease in the past 21 days, was taken to Bellevue Sunday night after reporting a fever, the Health Department said.

Sources told CBS Radio station 1010 WINS the patient is a 5-year-old boy and that the family had traveled from Guinea.

We’ll know more about this case by the evening, when the CDC’s test results are expected to come back. One has to wonder when the family re-entered the US, and whether the child has been to school during the interim period. These are the questions that quarantines and isolation are designed to avoid. Those protocols could be better designed and applied more consistently, but the truth is that exposure to Ebola cases have already infected three American health-care professionals, with two of those infections in the US, and we’ve had at least one traveler who became patient zero for those secondary infections. After the CDC’s errors and the failures of Spencer and Vinson to self-isolate effectively, a more hygienic and mandatory response to protect American population centers should not be out of the question.

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