Ebola is deadly and highly contagious, but not easily transmitted. Fear and panic should not guide public health decisions. Science should.
Judge Charles C. LaVerdiere of Maine, ruled that Kaci Hickox, the nurse who came back home to Maine after caring for Ebola patients in West Africa, “can come and go as she pleases, as long as she is monitored for symptoms and lets health officials know where she’s going.” The judge also lifted his temporary order of yesterday (ordering Hickox to stay at least three feet away from other people and to stay away from crowds and public transportation), since he found that “authorities in Maine had not proved that further restricting Hickox’s movement was necessary to protect the public from infection.” Kaci will submit, per the court order, to direct active monitoring–having her temperature taken and being checked for symptoms as least once a day.
It is important to note that Kaci Hickox has no symptoms that indicate she contracted the deadly disease and that she is not infectious unless she exhibits symptoms (further information and facts about Ebola at Nina Pham is Ebola Free. We Can Beat Ebola, Yes We Can ).
The Kaci Hickox case exploded in the media after she was put in a quarantine tent in Newark, New Jersey (near the airport where she landed), and spent a week in isolation, per New Jersey governor Chris Christie’s initiative. Following her public protest and the concurrence of medical experts with her position that this is unwarranted, Christie and New Jersey relented and she was let go.
She, however, stayed in the public eye by violating an initial order to self-quarantine in her home, when she went for a bike ride with her boyfriend on Thursday. She stated to reporters:
“I hope that we can continue negotiations and work this out amicably…there is no legal action against me, so I’m free to go on a bike ride in my hometown.”
This statements generated a reply from Main Governor Paul LePage, indicating that efforts to negotiate with Hickox failed, and his office issued this statement: “The governor will exercise the full extend of his authority allowable by law,” which was ollowed today by the court ruling.
In his ruling Judge LaVerdiere stated:
“The court is fully aware that people are acting out of fear and that this fear is not entirely rational…however, whether that fear is rational or not, it is present and it is real. Respondent’s [Kaci] actions at this point, as a health care professional, need to demonstrate her full understanding of human nature and the real fear that exists. She should guide herself accordingly.”
From yesterday, and what a difference a day makes
There is no argument that Ebola is a deadly and highly contagious disease, but not easily transmitted. It is not a new disease (first recorded case is from 1976), and we have substantial experience dealing with it, its victims and the health care professional and volunteers who care for them. We know how it’s transmitted (direct contact with bodily fluids of an infected person in the contagious state). As with all such cases of a deadly disease with little education and facts acquisition by the public (think HIV/AIDS when that was first classified as such in early 1980s), fear and panic play a big part in the initial public response, something that some politicians and public officials feel obligated to take advantage of for political and personal gain.
Kaci Hickox and all others who, in spite of infection risk by this deadly disease, dedicate themselves to helping those sick with Ebola, should be applauded. In addition, every precaution must be taken to ensure the safety of those brave caregivers, as well as early detection and treatment of anyone who gets infected. Quarantine is appropriate if there is a medical and public health reason for it. This is a scientific issue and one the world community in general, and the U.S. medical and health authorities and experts specifically, have substantial experience with.
There is no real danger to the small Main community in this case. There is very little exposure, if any, to anyone by allowing Kaci (who has no symptoms), to take bike rides in this remote area and walk through town. We know what does and does not need to be done, and quarantining Kaci, just because people are afraid without a real basis in fact, makes no sense and is simply wrong. As a society we have given in to fear and ignorance before (persecution, drowning and burning at the stake of “witches” for one, mistreatment of people with HIV/AIDS for another).
We need our brave professional willing to treat people sick with infectious diseases. We need to motivate and support them and not “punish” them without good reason. Let’s leave it up to the experts to provide guidance here, follow their recommendations and not give in to unfounded misconceptions and ignorance based fears.
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