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.