Over the last few days, multiple media colleagues have asked me how I feel about the decision initially made by New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo to mandate quarantine for health workers returning from aiding in the Ebola crisis in West Africa.
My answer is consistent with what my views from very early on have been; a quarantine, means a quarantine.
These individuals need to be monitored by other health care professionals, and they need to be sequestered and released upon the recommended 21 day-incubation period for the Ebola virus.
The second question I’ve been asked is why I agree with the governors, and the answer is very simple: The chaos that any patient with the Ebola virus on U.S. soil creates is overwhelming.
Multiple people need to be tracked down; a complete upheaval of everyone’s life occurs. Businesses that the infected patient might have visited are shut down until they are declared decontaminated. And all of this is done on the basis of potentially minimizing any further contamination – which we know carries minimal risk unless the patient is exhibiting elicit fulminant symptoms of Ebola like fever, diarrhea or vomiting.
The ensuing chaos occurs because with such a long incubation period, the first few days or early period of the window might be missed -- hence the need for a quarantine upon return.
I don’t fault the heroic health care workers returning to the U.S. after treating infected patients in West Africa, with the exception, however, of this latest nurse, Kaci Hickox from Maine, who has threatened to sue over her detainment at Newark Liberty International Airport and subsequent quarantine at University Hospital in New Jersey.
Both personally and as a practicing physician, I do not appreciate her actions. As a health care worker, she knows perfectly well that she has to take responsibility for the well-being of the profession she has sworn to protect.
The mere fact that she is reportedly demanding that she be able to self-monitor, rather than quarantine, is inappropriate.
It should not come as a surprise that state governments are demanding health care professionals coming from West Africa are properly monitored. Many tend to forget that in most medical institutions, health care workers – including doctors – get tested for communicable diseases. An example being, if you don’t have, or fail to provide a recent tuberculosis screening, you cannot work in a hospital.
These protocols are in place because there have been cases in the U.S. where a health care worker has contaminated patients in hospitals either with tuberculosis or hepatitis, so why should we criticize the governors for aiming to protect their residents from Ebola?
Let’s focus on who created the Ebola-related chaos in the first place: the federal government. Policies on proper Ebola-related protocols have changed as often as people change their television channels. The latest mixed message from the Department of Defense and the White House is causing further confusion at the state and local levels.
Defense Secretary Chuck Hagel is ordering a 21-day quarantine for all military personnel returning from the Ebola mission in West Africa after a recommendation from the Joint Chiefs of Staff. With this decision, it is clear that the Joint Chiefs of Staff have concluded that a certain degree of organization is needed to deal with the shortcomings and the speculation of the Ebola crisis around the planet.
The Joint Chiefs know that they have a moral obligation and a duty to protect their troops, even if not a single soldier contracts Ebola. The threat of their soldiers’ safety is enough to force them to act.
Their decision echoes that of Christie and Cuomo, whose initial decision before a hailstorm of criticism from the White House and others forced them to amend it, first and foremost sought to protect their respective states’ residents.
What is missing here is the federal government’s own urge to protect the American public from Ebola in the same way that the governors and Joint Chiefs of Staff have sought to shield their people.
And by the way, Mr. President, where is my Ebola czar, Ron Klain? On which side of these policies does he find himself? Should the rest of America stand to benefit from the courageous thinking of Christie and Cuomo, and now Hagel, which your administration dismissed?
It seems to me that now, with all of the policy changes over the last 10 days, it’s high-time for Klain to weigh in. Is it possible he is waiting until after the November elections to see if he has a more friendly audience? I can’t possibly be sure, because he hasn’t made himself available yet for me to form an opinion.
From the beginning of the Ebola-related chaos in the U.S., I asked for Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention (CDC) to step down. I see that he has since taken himself off the news cycle, and Obama brought Klain in to take charge. But where is the action? It really says something about this current state of affairs when those in charge seem to be wishing problems and responsibilities will just go away by themselves.
It is time for the federal government to stop drawing lines in the sand, and rather than criticize those taking action, be clear on what our Ebola response will be.