Policy should never be determined by fear

Sunday, October 26, 2014

Good morning:

Policy should never be determined by fear.

For example, on Friday, Governor Cuomo of New York and Governor Christie of New Jersey imposed a mandatory 21-day quarantine on people arriving from West Africa who have had contact with Ebola patients. They acted without consulting infectious disease experts or giving much, if any thought to how or by whom the quarantine should be implemented.

They also failed to give due respect and consideration to our returning medical volunteers whose heroic and selfless efforts to comfort and save those afflicted with Ebola deserve recognition and our heartfelt thanks.

Instead, read what happened to Kaci Hickox, a nurse who has basically been jailed in mandatory quarantine in a New Jersey hospital for 21 days after returning from Sierra Leone on Friday, despite testing negative for Ebola.

In her letter to the Dallas News, she describes “a frenzy of disorganization, fear and, most frightening, quarantine.” Her letter begins,

I arrived at the Newark Liberty International Airport around 1 p.m. on Friday, after a grueling two-day journey from Sierra Leone. I walked up to the immigration official at the airport and was greeted with a big smile and a “hello.”

I told him that I have traveled from Sierra Leone and he replied, a little less enthusiastically: “No problem. They are probably going to ask you a few questions.”

He put on gloves and a mask and called someone. Then he escorted me to the quarantine office a few yards away. I was told to sit down. Everyone that came out of the offices was hurrying from room to room in white protective coveralls, gloves, masks, and a disposable face shield.

One after another, people asked me questions. Some introduced themselves, some didn’t. One man who must have been an immigration officer because he was wearing a weapon belt that I could see protruding from his white coveralls barked questions at me as if I was a criminal.

To read the rest of her letter, go here.

This policy is ill informed and wrong on so many levels that I hardly know where to begin. Not only does it violate civil liberties and disrespect people who have risked their lives without financial compensation to save lives, but it also discourages others from volunteering at a time when medical assistance is desperately needed to prevent Ebola from spreading.

20 Responses to Policy should never be determined by fear

  1. butterflydreamer2 says:

    What bothers me is a few that have gotten Ebola are in the medical field. They more than anyone should know that when they are not quite feeling up to par, it is not okay to get on a plane, take a subway, bowl, or go out of the home. Oh they only had a low grade fever, most people usually take Tylenol when they are not feeling up to par, which would then reflect only a slight fever. Common sense would tell you if you have been around and treating someone with Ebola, especially if you’re not feeling quite right, keep your ass at home away from others.

    As far as the nurse, they did need to treat her so harsh. It’s to bad that others in the medical field have used poor judgment that have led to the need to quarantine. It may not be easy to get, but who in the world would put their family at risk even a very small risk.

    • The doctor in NY was self-monitoring and when he got a fever, he reported and went to the hospital, just like he was supposed to do. No one in the medical community is criticizing him and there is basically a zero chance that he infected anyone else because he was not throwing up. A person cannot be infected unless they have contact with bodily fluids and touch their mouth or nose transferring the virus.

      • butterflydreamer2 says:

        ” Spencer was in contact with four people after he started exhibiting symptoms, authorities said. Ebola isn’t contagious until someone has symptoms.”

        “Three people — his fiancée and two friends — are being placed on quarantine and monitored, health officials said.”

        I just heard that there are 2 people here in Riverside County who are being monitored at home. They are considered low risk, because the have no symptoms, and stated they were in not contact with anyone with Ebola. They were stopped at the airport because the came from one of the three affected countries.

        I am okay with not halting flights for people leaving the three affected countries, but I do believe they need to be quarantined for a month before leaving the country. I am puzzled how those who were in the country but no contact with Ebola are considered “low risk”, and medical workers who have been treating Ebola patients are considered basically “no risk”. I don’t have any knowledge on Ebola, I just believe it’s better to be safe than sorry, especially those treating Ebola patients.

        • I disagree.

          Better safe than sorry is a poor excuse to take away a person’s freedom.

          The CDC and other medical experts who know about Ebola have stated Dr. Spencer did nothing wrong.

          I don’t have a problem with monitoring a home quarantine, so long as the needs of the person quarantined are attended to and they do not lose a job.

          • butterflydreamer2 says:

            I will agree with you that they should be attended to and should not lose their job, in fact they should be paid for the time they are required to be at home.

  2. girlp says:

    Thomas Duncan’s family and the staff at the hospital had hands on contact with Thomas. Some of his family put his clothes and sheets in plastic bags they did not wear gloves. Out of these people two developed Ebola. Even the emergency staff did not get the virus. Why can’t people see this virus is not easy to get.

  3. Malisha says:

    A friend of mine is dying of cancer in Capetown, South Africa. So another friend of mine went to see her there, and when she returned, was questioned at the airport and gave all the correct answers (had not been to Liberia, Guinea, Nigeria, Sierra Leon, no exposure to Ebola). Three days later she fell ill and went to an ER where they flew into Ebola panic, isolated her, told her husband he couldn’t see her, started training him in the isolation protocol, and failed to test for any of the more logical illnesses.

    To make a long and horrible story short, her husband raised a ruckus and insisted on some tests based on his observation that she couldn’t walk straight and had a speech defect and some other fairly obvious symptoms not related to Ebola. Finally they started testing for other things and determined (confirmed) that she had suffered a stroke. But they lost a week’s treatment for stroke by the fact that they were treating her for Ebola!

    Now with PT, OT and speech therapy she is recovering and her husband is helping. This was a very prominent hospital with an excellent reputation.

    • girlp says:

      Fear based policy is the worst policy, who decided that she had Ebola without testing for Ebola, why didn’t they interview her; ask about her symptoms….this is sad, she could have died of a conditon that could possibly been treated that day and not spend months possibly a year or more recovering.

      • a2nite says:

        They did.

        They decided to hold her prisoner for 21 days because evil Christie and evil Cuomo came up with some idea that sounded good to the stupid fearful masses because the evil RWMSM is ginning this up.

        Well, we had Japanese-American citizens held captive because of WWII. It might have saved some of them from being murdered by the citizenry, but not right at all.

        More people have TB (drug resistant), measles, the flu. More people died during the latest mass murder spree school shooting. The problem with public health is people are selfish and don’t care about their neighbors; they want to do whatever they want, like the infected doctor. He was inconsiderate and could have stayed out of public more than he did.

      • a2nite says:

        Because she got a lawyer & she wasn’t going to put up with any crap from listening to her interviews.

        Good for her!!!!

        There was nothing evidence based to justify her illegal & immoral incarceration. CC & Cuomo are aholes who were catering to stupid, fearful residents. Stupid irrational thinking is a poor reason to institute a policy when you don’t have facts, or data, or reason based protocols.

        It was stupid, glad she can go home.

        I’m more afraid of the public health problems around gun violence, the flu, or evil drug resistant TB.

        I’m glad evil CC caved, less likely he’ll be the TGOP nominee in 2016. He’s evil & their voters are stupid, which translates to dangerous.

  4. colin black says:

    This is a gift for radicals….And The Gov..

    The publicity and Fear the Western Media Is createing about this deadly virus Is handing a weapon straight into Terrorists hands.

    The media/ authourites have already created the Terror all the radicals need do Is capilitise .

    And I am sure they will .
    They have followers willing to strap bombs to there person .
    So finding people willing to contract and spread this virus will be easy
    Its a natural form of germ warfare.
    Or so the powers that be will lead us to believe..
    Now Im sure If I have thought of this scenario .
    The various think tanks filled with brainiacs .will also have ..

    Infact this Is probably the outcome the West /American/ New World ..Order..Is ochrastrateing.

    What a convenant way to not only reduce the population but also impose martial law..

    The civilian population would be demanding it be imposed for there safety.

    Of course there will already be a vaccine to inoculate the important people and there kith an kin.

    Whilst the weak poor vulnerable can be eradicated along with undesirables.

    This may be the outcome of the present crisis or perhaps this is just a conditioning exercise.
    To place the posabilty of such an event into the worlds consciousness .

  5. towerflower says:

    At what point do the civil liberties of the majority override that of the one? While I can understand the frustration of those who selfishly give their time to help others, I doubt that a quarantine upon their return will effect them from volunteering in the future. After all they are already giving up their time to help those who need it the most so if you have someone willing to do this in the first place I doubt 21 days will make that much of a deal breaker to them.

    So far there have been several stories on those on a voluntary quarantine violating it, if a person cannot be trusted to follow a voluntary quarantine then other actions must be taken.

    Even this latest doctor who first felt out of sorts for 2 days before the start of his fever didn’t find it in himself to stay put to make sure his out of sorts feeling didn’t mean something else instead he took mass transit a few times, went out to dinner, and went bowling.

    The potential for the disease going global is very real in this day of age.

    • At what point do the civil liberties of the majority override that of the one? While I can understand the frustration of those who selfishly give their time to help others, I doubt that a quarantine upon their return will effect them from volunteering in the future. After all they are already giving up their time to help those who need it the most so if you have someone willing to do this in the first place I doubt 21 days will make that much of a deal breaker to them.

      For the reasons you expressed, I am not as concerned about the quarantine as I am about the manner in which the situation was handled and the circumstances of her confinement. She was not symptomatic and her blood test was negative for Ebola. There was no reason to treat her that way.

      I would have been furious and in a mood to throw punches at anyone who tried to prevent me from leaving. I’m not saying that I would, but I would have been tempted.

      With a little planning, that situation could have been avoided.

      Issuing a panicky knee-jerk declaration without consulting health officials or having a process in place to respect the dignity and sacrifice of the health workers is poor leadership.

      • Samantha33 says:

        I changed my user name from the usual because I wanted to be extra careful not appear to be giving medical advice. LOL! But if you look carefully, most of the frequent flyers here would be able to figure out who I am. LOL!

        Professor: I agree that there is an issue with the manner it was done. But the key is not in the tests given. But rather the mode of transmission necessary to contract Ebola.

        As a 4th year medical student, I must say that her being asymptomatic and her blood tests being negative COULD be inconsequential if she was traveling just a few days after working in an Ebola affected area. Ebola is in a class of viruses called the Filiovirus. It is an RNA virus. HIV is also an RNA virus. As such, it would take time for the virus to replicate in the blood. For example, we often say that someone is “undetectable” when it comes to HIV because the therapy they have been given prevents the replication of the virus to the point that the virus is “undetectable” to the tests given/used. It does not mean that they are free of HIV, but the virus is kept below the point of detection. This same person can pass on HIV to another person through bodily fluids such as blood and semen. If this HIV individual stopped taking their medications, the virus would then begin to replicate more and would become detectable. For RNA or DNA viruses, they have to invade healthy cells, replicate and then destroy that cell so that its virus particles can escape to destroy other cells. The rate of this depends on the assembly mechanism of the virus and the health issues of the host. For example, it may take up to 12 weeks for HIV to be detectable. So her being undetectable when she came into the country was inconsequential because the virus may not have had time to replicate.

        My point of explaining all of this is that it doesn’t appear that health officials themselves know how long it takes for the virus to become detectable on an ELISA test. Ebola has been around for decades. But Westerners (except for the do-gooders who when to work with these people) didn’t care about it as long as it stayed in Africa.

        That said, like with HIV disease, Ebola is spread through close contact with bodily fluids. All of the people, who have gotten sick have been the people, who have handled the bodily fluids of someone, who is sick with Ebola. Their other casual contacts have not gotten Ebola. Even before this outbreak we were taught that Ebola was not airborne and required contact with bodily fluids of another person who was sick. That is why this freak out by governors is ridiculous. The way they are acting, then every single person with HIV disease and every healthcare professional working with a patient with HIV disease should be quarantined. I better stop, don’t want to give them any ideas.

      • bronxlady1 says:

        You are absolutely right Mr. Leatherman. It is understood that public safety is important as well as the health of the doctor, but the quickness with which some people went to attack this doctor with snarky remarks and some thinly veiled threats is appalling. I thought I was reading a rant page rather than a forum for adult discussion. Thank goodness cooler heads are prevailing to protect the doctor from a very rough crowd of verbal abusers.

  6. Two sides to a story says:

    Welcome to the USA. : /

  7. racerrodig says:

    I live in NJ and I can saw from experience…..

    Christie is a big fat idiot.

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