New England Journal Of Medicine On Ebola Quarantines

The New England Journal of Medicine is out with an editorial on the Ebola quarantines that’s worth a read, here’s the money quote:

In the end, the calculus is simple, and we think the governors have it wrong. The health care workers returning from West Africa have been helping others and helping to end the epidemic that has killed thousands of people and scared millions. At this point the public does need assurances that returning workers will have their temperatures and health status monitored according to a set, documented protocol. In the unlikely event that they become febrile, they can follow the example of Craig Spencer, the physician from New York who alerted public health officials of his fever. As we continue to learn more about this virus, its transmission, and associated illness, we must continue to revisit our approach to its control and treatment. We should be guided by the science and not the tremendous fear that this virus evokes.

As the old blogosphere saying goes, read the whole thing, especially since it isn’t very long.

FILED UNDER: Health, Quick Takes,
Doug Mataconis
About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010. Before joining OTB, he wrote at Below The BeltwayThe Liberty Papers, and United Liberty Follow Doug on Twitter | Facebook

Comments

  1. Bob @ Youngstown says:

    Classic case of the politicians saying:
    ‘We do not believe the science, instead we will establish state policy based on fear ‘

  2. gVOR08 says:

    From the first paragraph of the linked article, “We understand their motivation for this policy — to protect the citizens of their states from contracting this often-fatal illness.” BS. (And the NEJM I’m sure knows it’s BS.) Their motivation is to pander by appearing to protect. Purely political, they don’t give a dump if it actually protects anybody.

    They go on to say that the choke point in controlling Ebola is getting enough workers on the ground in West Africa. “If we add barriers making it harder for volunteers to return to their community, we are hurting ourselves.”

  3. JKB says:

    So whose science do we follow? The DwB and CDC with their clear political agendas and record of being on the side of doing to little? Or the public health officials, such as those in NYC, who with their own political pressure spend millions of taxpayer dollars to contract trace and decom when someone following the DwB and CDC monitoring protocols tests positive.

    So which is it? Either a person is not contagious until after their fever spikes or they are? If that is uncertain, then the protocols need to be updated to reflect that earlier, if small, contagious period.

    Where’s the science that will give us reasonable certainty as to where to draw the line. So far, even Dr. Fauci is unwilling to state definitively, instead relying on vague “symptomatic” statements. If the latter is so, the the NYC doc was contagious when he went on his run, coffee, meatball, subway, bowling adventure since he reports to feeling down and fatigue is a symptom. Oops.

  4. C. Clavin says:

    @JKB:
    You never told us…what brand of diapers do you wear?

  5. JKB says:

    @C. Clavin:

    You got a problem with asking the hard science questions of when a person with Ebola becomes contagious to the point of needing to track their contacts and decom the facilities they used?

    I thought you wear all about the science?

  6. JKB says:

    Hey, did you notice that after all the Obama BS about America being prepared and weeks after the first case appeared in the US, days after the first case was confirmed in a neighboring city, that the NJ hospital had to pitch a tent with no heat, inadequate sanitary facilities, etc. for a feared case put in isolation?

    Much to Christie’s fault, he imposed the quarantine without preparing to do it even somewhat properly or decently.

  7. Scott says:

    No, no, no, no, no. This is what we should do:

    Stop The Ebola Calm-Mongering

  8. Bob @ Youngstown says:

    @JKB:

    the NYC doc was contagious when he went on his run, coffee, meatball, subway, bowling adventure

    So all persons that were in the vincinity of his “adventures” should be quarantined?
    Should that also include the ambulance personel who encountered him after he reported a fever?
    Should all the health care workers at Bellvue also be quarantined for 21 days.

    Actually, I think that Dr Fauci has been quite clear that contagion begins with fever and becomes progressivly worse as symptoms become more manifest. What he won’t do is give a 100%, iron-clad, no exceptions, no outliers, money-back guarantee. What the science has shown THUS FAR is that contagion begins with fever.

    Were you looking for a guarantee??

  9. Grewgills says:

    @JKB:
    If the contagion was as you claim you fear, then MANY more people in Texas would have contracted it. Either you are a political opportunist trying to score points in a rather odious way or you are willfully ignorant or you are a coward or some combination of the three. None of those is particularly flattering, but your continued pattern of behavior in the face of mounting evidence leaves only those options.

  10. Jenos Idanian #13 says:

    I’d be a lot more impressed if these scientists relied on science for their arguments, and didn’t pile on appeals to emotion in their article.

    We should be honoring, not quarantining, health care workers who put their lives at risk not only to save people suffering from Ebola virus disease in West Africa but also to help achieve source control, bringing the world closer to stopping the spread of this killer epidemic.

    Why they were exposed to Ebola is totally irrlevant, from a medical standpoint. Remember Thomas Duncan, the man who brought Ebola to the US? He was infected while assisting an infected pregnant woman — a very noble action. Suppose he had contracted the disease by raping an infected woman. What difference would that have made, medically? None.

    Mickey Kaus has an interesting idea I think worth considering. Let’s set up Ebola Springs. Let’s lease a luxury resort where we can send everyone who needs quarantining. Give them three weeks or so of a comfy hotel, free internet, recreation, TV, movies, fine food, whatever we can give them. At the end of their stay, they get a certificate of appreciation and sent home, free of charge.

    Hell, if some are so inclined, they can make a reality show out of their quarantine. Considering the ratings the Kardashians get, it’d probably be a money-maker.

    Then, at the end, we turn it over to the CDC for hands-on training in decontaminating potential hot zones.

  11. grumpy realist says:

    @JKB: I would consider that this is a fault of whoever is managing the health establishments in New Jersey, not that of President Obama. Why is this not the responsibility of Chris Christie, as well?

  12. Grewgills says:

    @grumpy realist:

    Why they were exposed to Ebola is totally irrlevant, from a medical standpoint.

    They laid out the medical reasons as well. The appeal to emotion, I would say to common decency, is about treating people who put their lives on the line while taking vacation time and using their own money to aid in a humanitarian crisis with respect and common decency.

    The ebola resort is just silly. It would be much more expensive than simple home monitoring with home or hospital quarantine when necessary.

  13. Grewgills says:

    @Grewgills:
    Oops, wrong link. It should be @Jenos Idanian #13:

  14. JKB says:

    @Bob @ Youngstown:

    Symptoms of Ebola include

    Fever
    Severe headache
    Muscle pain
    Weakness
    Diarrhea
    Vomiting
    Abdominal (stomach) pain
    Unexplained hemorrhage (bleeding or bruising)

    So if those are the symptoms and “Ebola can only be spread to others after symptoms begin. Symptoms can appear from 2 to 21 days after exposure.”

    Now where do you see that transmission is dependent upon temperature? It might be true, but none of the experts have said that? It is what they practice for zipping someone off to the hospital but it is not what they say about spreading the virus.

    How long does Ebola live outside the body?
    Ebola is killed with hospital-grade disinfectants (such as household bleach). Ebola on dry surfaces, such as doorknobs and countertops, can survive for several hours; however, virus in body fluids (such as blood) can survive up to several days at room temperature.

    All the quotes are from the CDC website.

  15. Jenos Idanian #13 says:

    @JKB: The CDC’s priorities seem to be:

    1) Prevent a panic about an Ebola outbreak.

    2) Prevent an Ebola outbreak.

    Personally, I’d prefer if they were in the opposite order…

  16. Tony W says:

    Meanwhile the scaredy-pants conservatives ignore actual threats while bleating on about an obscure virus that they don’t understand. Actual threats include guns and influenza and car wrecks and household poisonings and lightning strikes and everything else that actually kills Americans.

  17. lounsbury says:

    @Jenos Idanian #13:
    No, that seems like quite the right order for a rational analysis, as opposed to a shrieking panic reaction.

    The bloody Nigerians and Senegalese managed to handle their two discrete travel based incidents without working themselves up into a mindless lather, like you lot are doing.

    Bloody hell, what a bunch of senseless cowardly cretins you are.