Sunday, October 26, 2014

Ebola Chaos

What's a public official to do?   They cannot have people exposed to Ebola, a virus with no vaccine and a proven high mortality rate, running around a city "self-monitoring", even if it might work.  The political fallout of a worse case is off the charts.

But how do they justify quarantines when the leader of the federal response is hugging an Ebola victim the same day she is released from the hospital? 

It should be obvious the virus isn't transmitted through the air at this point.  Even close contact might not spread it, as the relatives of Thomas Duncan can now attest.  At the same time, the doctor who assumed normal frivolities around New York City less than 2 weeks after returning from the hot zone (and somehow making it though the thermometer gauntlet at JFK) was thought to be meticulous in his protection routine, yet he came down with the virus anyway.  So there is still some uncertainty.  As a rule public officials have a hard time playing games of risk-reward with such uncertainties.  Ergo, Christie and Cuomo's bi-partisan quarantine order.

But there are political risks anyway.  Already the quarantine is beginning to blowback on Christie in the form of the nurse selected as patient one:
Hickox says she has asked repeatedly but hasn't been told how long she'll be held at the hospital. "To put me in prison," she said, "is just inhumane."
War on women!   Notice the CNN report has not one mention of New York Governor Andrew Cuomo, who was just out the other day mocking the idea of 'self monitoring', calling it an oxymoron.   Yet patient one and CNN are laying blame on the fat guy. 

At the same time, grabbing citizens and placing them into mandatory quarantine, without access to lawyers or other advocates, is a long-held fear of the conservative right. It's something Obama was supposed to do, you know, the FEMA camps. Now a GOP governor is on the leading edge.  Alex Jones' head has probably exploded.  

And couldn't Christie have at least have called Governor Perry to get some advice on how they handled the mandatory quarantine of Thomas Duncan's relatives, who didn't seem to complain much (if there were any breathless CNN stories about Duncan's relatives being denied their civil rights and being treated inhumanely they seem to have disappeared now).   Ah, politics again. 

But a solution exists that doesn't involve government, one wrapped more in personal responsibility and civics. Nurse Hickox is associated with Doctors Without Borders, a group that has provided a large number of workers to the hot zones while at the same time taking a somewhat liberal approach regards returning volunteers.  This despite the fact the group has seen 16 workers infected with Ebola in the hot zones, with 9 of them dying as of October 14.  Another humanitarian group providing workers is Samaritan's Purse, who has their own approach to returning workers:
The relief group began requiring all returning staff to stay isolated for 21 days, away from family members. The organization houses workers within an hour’s drive of medical facilities, such as Emory University or the NIH, which are equipped to handle Ebola patients, in case someone gets sick. The workers, who are paid their normal salaries, are not allowed to take public transit or touch anyone, and they must take their temperature multiple times a day.
“That’s just a part of the deal, and they have accepted that,” said Isaacs, who acknowledges that the requirements make it potentially more difficult to recruit volunteers to work in West Africa. “We’ve never felt comfortable that just coming back and letting people go about life as normal and take their temp two times a day was sufficient.”
They admit their extra rigor might dissuade more volunteers, but listen to the comments of the quarantined nurse in New Jersey:
Hickox said she worries that her experience will discourage other aid workers from going to West Africa to help quell the Ebola outbreak. ..
[snip to a few sentences down]  Someone asked me earlier would I do this again if I knew what would happen, and my answer is categorically yes," she said. "I feel incredibly privileged to be able to do this work."
So yes and no.

The bottom line is that people are scared of the unknown.  In such times they expect prudence from public officials.  They see people dressed like astronauts still getting the virus and it's worrisome. They see Obama and all the other federal officials bending over backwards to dispel any notion of a problem, first saying it would never come to our shores, then saying it wouldn't spread, then it wouldn't become 'major'.  They remember Obama saying "if you like your doctor, you can keep your doctor, period".

Then they see people who might have been exposed but are not yet symptomatic breezing into the country past thermal scans that are useless unless someone has symptoms.  And they see an approach taken by groups like Samaritan's Purse and think "that sounds reasonable".   As time goes by and an outbreak doesn't occur, things will get better, whether by chance or by quarantine.  Then all the politicians can pat themselves on the back accordingly and we can all move on to the next crisis.

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