Dr. Craig Spencer, New York’s first Ebola patient and a former classmate of mine, contracted Ebola in October 2014 while doing aid work in Guinea. He fell ill several days later after he returned home. During the few days before he had any symptoms, Dr. Spencer practiced self-monitoring, a strategy workers who were potentially exposed to the virus use to assess and report their symptoms on a twice-daily basis. After recording a high temperature, Dr. Spencer reported it and was immediately isolated at Bellevue Hospital Center. He did not spread the disease to his fiancée or anyone else, demonstrating that self-monitoring was successful. However, the amount of backlash he and his family received from the media and the public was horrendous. His every move leading up to his hospitalization was scrutinized and he was called everything but the hero that he was. He detailed his experience in an article for the New England Journal of Medicine, criticizing the media and politicians for their response, which added to the fear and lack of understanding of the disease. It could have been an opportunity to educate the public and bring attention to the still-raging epidemic in West Africa, but instead some politicians instituted mandatory quarantines for aid workers returning from West Africa.
A report released last week by the Yale Global Health Justice Partnership and the American Civil Liberties Union declared Ebola quarantines of returned medical personnel from West Africa unconstitutional and medically unjustified. I couldn’t agree more. Instead of ensuring the health and safety of all citizens, state politicians enacted strict mandatory quarantines, which only added to unnecessary hysteria throughout the country.
The report found that at least 40 people in 18 states received quarantine orders related to Ebola and were confined to their homes for up to three weeks. More than 200 others voluntarily quarantined themselves to avoid legal and public backlash. None of the quarantined individuals developed any symptoms of the virus.
Ebola is spread through direct contact with blood or body fluids from an infected person or someone who has recently died from the virus. Ebola is not spread through air, water or food. Symptoms can show between 2 and 21 days after contracting the virus. The one fact that politicians and the media ignored in the aftermath of Dr. Spencer’s diagnosis was that someone who is not showing any symptoms is not infectious, i.e. they cannot pass on the virus. I think they forgot to check out this helpful infographic from the CDC.
There has been an enormous loss of life in West African countries. The average case fatality rate is estimated around 50%, however it was likely higher during the early part of this epidemic due to the stigma and fear of the disease, which results in a delay of treatment. Also, a lack of necessary infrastructure and capacity to treat the infected resulted in higher fatality rates. Support from other countries’ medical personnel was desperately needed to prevent new cases and the spread of the disease across borders. Mandatory quarantines do just the opposite. They discourage nurses, doctors and other workers from going to countries where they were desperately needed. Even with these countries now in recovery, trained personnel are still needed to help build the capacity and medical infrastructure of countries that lost thousands of people. Doing so helps countries prepare for future infectious disease outbreaks and decreases the likelihood they will spread to the U.S.
When Dr. Spencer was hospitalized, state politicians ignored science and acted for their own personal political gain. Their hasty reaction increased public anxiety and caused unnecessary backlash toward returning health workers and their families.
In future outbreaks of serious infectious diseases without effective vaccine or treatments, we need policies based on science. Hopefully this report leads to clearer criteria for the future.