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The New York/New Jersey Ebola quarantine will only stoke fear and paranoia

The Governors of New York and New Jersey have issued a quarantine for people traveling from countries with Ebola who have had contact with someone who was infected or may have been infected. This seems a little like using a bucket to combat the rising sea levels of global warming.

Here are the problems with the idea of such a quarantine:

1) Biologically it doesn’t make sense. People transmit Ebola when they are sick, not when they are well. The WHO does not support quarantines and no one in the United States has contracted Ebola through casual contact or even in the emergency department where the first Ebola patient, Mr, Duncan, was seen.

2) False sense of security. Not everyone will know if they have had contact with someone who had Ebola. There are, after all, a lot of reasons people can have a fever. And of course not everyone will report if they have had contact (see below).

3) People are afraid. There is a lot of stigma about Ebola which actually contributes to transmission (fear makes people do irrational things). Fear of quarantine, fear of stigma, fear of authority could all contribute to someone being less than truthful and not necessarily on purpose. Fear injects a very strong bias.

4)Not everyone is honest on purpose/some people think rules don’t apply to them. I assume this information about possible Ebola contact is going to come from a questionnaire as there is no you-touched-someone-who-might-have-Ebola test. On your last flight how many people did you seen struggling with massive suitcases laboring under the assumption that it would fit in the overhead compartment? Exactly.

But the piece about health care workers in the quarantine really tells me this is a fear-based decision. The WHO does not recommend quarantine of health care workers caring for people infected with Ebola if they used appropriate protective gear. But say you do follow the “logic” of the New York/New Jersey Governors then what about the doctors and nurses and lab personnel and ambulance drivers in these states? Every time they care for an Ebola patient or a potential Ebola patient do they go on a 21 day quarantine (or quarantine until test results are available) even if they used appropriate methods for protection? According to the quarantine one potential exposure is enough, so then shouldn’t everyone have to be quarantined at the end of each shift? Doctors and nurses and lab personnel caring for an Ebola patient couldn’t of course see anyone else that shift. If an Ebola patient is going to be in the hospital for at least 14 days (and that’s likely  conservative), you would need 28 doctors and 56 nurses minimum (2 nurses at a time are recommended so there is a buddy system). How possibly could the state staff this or will hospitals be required to house Ebola caregivers and deliver meals to them, because you can’t go to the cafeteria on quarantine? It’s a pretty deep rabbit hole, but you can’t treat local doctors different from those returning from West Africa.

There are two reasons Ebola has run rampant in West Africa, lack of a medical infrastructure and fear/stigma. There is no way this quarantine will accomplish much except give a false sense of security and spread fear and stigma, which could paradoxically make things worse.

Discussion

9 thoughts on “The New York/New Jersey Ebola quarantine will only stoke fear and paranoia

  1. Amen. Thank you so much for this post.

    Posted by wildmedicinegirl | October 24, 2014, 3:47 pm
  2. I keep telling people they are more likely to be struck by lightning.

    Get a grip!

    Thank you for addressing these irrational fears.

    Posted by Erin Bliss | October 24, 2014, 3:54 pm
  3. So glad I follow this blog, otherwise I’d probably be one of the people freaking out as well. Sidenote–heard a new name for Ebola tonight: E. Boli.

    Posted by Anxious Mom | October 24, 2014, 8:24 pm
  4. Reblogged this on Conversations I Wish I Had and commented:
    My friend the epidemiologist would love your post. Literally, we were discussing this earlier.

    Posted by Lyla Michaels | October 24, 2014, 9:46 pm
  5. Tough issue. Do we want to trust everyone to self-monitor? There’s a very fine line between hysteria and reasonable caution

    Posted by drliou | October 25, 2014, 8:24 am
  6. Given not only the virulent nature of ebola but the fact that, at this time, we don’t have a known cure and the resultant obvious devastating effects that could follow an outbreak spread by even only one infected person: EVERY person, (medical personnel or otherwise), who returns from known ebola infected areas, (currently west Africa), should be quarantined on their return arrival point – regardless of the numbers involved and regardless of their apparent medical status.

    And the way CNN are sensationally, (as usual), and thus harmfully talking about current decisions being taken by Christie, good decisions taken by Christie, if you lot don’t follow rigorous quarantining procedures, regardless of whether or not people returning are displaying an illness, we might soon have to consider the USA an ebola infected area and as a result, lock you lot up whenever you leave American territorial lands ~ not such a bad thing really when you think about it and let’s face it, only about 74 Americans have passports, don’t they????

    Posted by 'ter | October 27, 2014, 6:07 pm
  7. Didn’t you read the OP, ‘Ter? You are more likely to end up with with an Ebola epidemic in the US when decisions are being made for political reasons, when people are being encouraged to panic and thus are acting out of fear.

    There’s a reason we have been collecting and sharing all this medical knowledge for centuries – so that when we face a different challenge decisions are based on medical knowledge and proven protocols are followed.

    Posted by maureen.brian | October 31, 2014, 1:31 am

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