Why the Cuomo/Christie Ebola Quarantine is Stupid

Over the weekend, New York and New Jersey
Governors Andrew Cuomo (D) and Chris Christie (R)
imposed a quarantine on health care workers who treated Ebola
patients in West Africa that would confine them to a
government-regulated facility. This requirement is not
science-based and counter-productive. New York University
bioethicist Arthur Caplan offers a
nice summary of seven reasons why this policy is stupid. Here
are his main points:

1.
Quarantining
people without symptoms makes no scientific
sense.

They are not infectious. The only way to get Ebola is to have
someone vomit on you, bleed on you, share spit with you, have sex
with you or get fecal matter on you when they have a high viral
load. …

2. Quarantine is next to impossible to
enforce.

If you don’t want to stay in your home or wherever you are
supposed to stay for three weeks, then what? Do we shoot you, Taser
you, drag you back into your house in a protective suit, or
what?

And who is responsible for watching you 24-7? Quarantine relies
on the honor system. That essentially is what we count on when we
tell people with symptoms to call 911 or the health department.
…

5. Health care workers who take care of those who really
do have Ebola at big hospitals, such as Bellevue or Emory, are at
the greatest risk.

If you quarantine them you are taking your best professionals
offline for three weeks — and there are not a lot of
replacements.

6. Who will volunteer to go to West Africa to stamp out
the epidemic, if they know they face three weeks of confinement
upon their return?

Those who go are heroes who face hell on earth. Can’t they be
trusted to do the right thing and self-monitor when they get
back?

On Fox News Sunday, Anthony S. Fauci, director of the
National Institute of Allergy and Infectious Diseases,
said:

“The best way to protect us is to stop the epidemic in Africa,
and we need those health-care workers, so we do not want to put
them in a position where it makes it very, very uncomfortable for
them to even volunteer to go.”

On Monday, the two governors have had a rethink and are walking
back panicked policies. Returning health workers will now merely be
confined to their homes. This is still too much.

Consider that the
76 health care workers who had contact with Ebola patient
Thomas Eric Duncan are not being quarantined. Instead they report
in daily on their health and are asked to avoid crowded public
venues. It’s been 19 days since Duncan died, and so far only two
nurses who took care of him when he was at his most infectious
became ill. Recall also that four people lived with Duncan for at
least four days as his Ebola infection worsened and none of them
were infected. This suggests that it is highly unlikely that people
who bowled with
Dr. Craig Spencer are are at risk.

The CDC and Obama administration officials have certainly not
covered themselves in glory in their responses to the Ebola
situation, but grandstanding by governors is not a sensible way to
develop public health policy.