Top NIH Ebola Specialist Says Quarantines Will Jeopardize Americans

Top NIH Ebola Specialist Says Quarantines Will Jeopardize Americans

WASHINGTON -- The top government infectious disease specialist warned politicians against Ebola quarantines on Sunday, saying aggressive protocols targeting all health workers who fight the disease are not backed up by good science and could ultimately threaten public health in the United States.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, made several TV appearances Sunday to note that harsh treatment of health workers returning from Africa could backfire, jeopardizing Americans.

"If you put everyone in one basket, even people who are clearly no threat, then we have the problem of the disincentive of people that we need," Fauci told ABC. "Let’s not forget the best way to stop this epidemic and protect America is to stop it in Africa, and you can really help stopping it in Africa if we have our people, our heroes, the health care workers, go there and help us to protect America."

The states of New York, New Jersey, Illinois and Florida over the weekend implemented an abrupt 21-day quarantine of health workers who fly into certain airports after treating Ebola patients in Africa. Kaci Hickox, a nurse who had volunteered to treat Ebola patients in Sierra Leone, sharply criticized her recent homecoming reception in an op-ed for the Dallas Morning News. Hickox said she was treated like a "criminal" and detained for several hours in "a frenzy of disorganization" and "fear." Hickox tested negative for Ebola once she was allowed to leave the airport for a hospital, where she is now being quarantined.

"The evidence tells us that people who are not ill, who don't have symptoms, who -- with whom you don't come into contact with body fluids -- they are not a threat, they are not going to spread it," Fauci told ABC. "We have to be careful when we make policy, that we don't have unintended consequences .... I'm concerned of the disincentive for the health care workers. And it's interesting. I think people lose that the best way to protect us is to stop it in Africa."

Ebola can only be transmitted by direct contact with the bodily fluids of someone who is showing symptoms of the disease. Experts say that monitoring those who have returned from West Africa and appear healthy through routine tests like taking one's temperature can prevent even infected people from spreading the disease without discouraging future volunteers. Only four Ebola cases have occurred in the United States since the outbreak in West Africa. Fauci treated one of them, Dallas nurse Nina Pham, who has now recovered.

Another U.S. Ebola patient, Dr. Craig Spencer, tested positive for the disease a few days after returning from treating patients in Guinea. Because he had monitored himself regularly and went to the hospital after registering a fever of 100.3 degrees, it is very unlikely that he transmitted the disease to anyone else. He is now being quarantined, however, while he fights active symptoms.

Fauci's comments were echoed by Samantha Power, the U.S. ambassador to the United Nations.

"All of us need to make clear what these health workers mean to us and how much we value their services, how much we value their contribution," Power said Sunday on NBC's "Meet the Press." "We need to make sure they are treated like conquering heroes."

"I sat alone in the isolation tent and thought of many colleagues who will return home to America and face the same ordeal," Hickox wrote in her op-ed. "Will they be made to feel like criminals and prisoners?"

Before You Go

1
Ebola is highly infectious and even being in the same room as someone with the disease can put you at risk
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Not as far as we know. Ebola isn't contagious until symptoms begin, and it spreads through direct contact with the bodily fluids of patients. It is not, from what we know of the science so far, an airborne virus. So contact with the patient's sweat, blood, vomit, feces or semen could cause infection, and the body remains infectious after death. Much of the spread in west Africa has been attributed to the initial distrust of medical staff, leaving many to be treated at home by loved ones, poorly equipped medics catching the disease from patients, and the traditional burial rites involving manually washing of the dead body. From what we know already, you can't catch it from the air, you can't catch it from food, you can't catch it from water.
2
You need to be worried if someone is sneezing or coughing hard
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Apart from the fact that sneezing and coughing aren't generally thought to be symptoms of Ebola, the disease is not airborne, so unless someone coughed their phlegm directly into your mouth, you wouldn't catch the disease. Though medical staff will take every precaution to avoid coming into contact with the body of an infected person at all costs, with stringent hygiene there should be a way to contain the virus if it reaches the UK.
3
Cancelling all flights from west Africa would stop the spread of Ebola
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This actually has pretty serious implications. British Airways suspended its four-times-weekly flights to Liberia and Sierra Leone until the end of March, the only direct flight to the region from the UK. In practice, anyone can just change planes somewhere else and get to Britain from Europe, north Africa, or the Middle East. And aid agencies say that flight cancellations are hampering efforts to get the disease under control, they rely on commercial flights to get to the infected regions. Liberia's information minister, Lewis Brown, told the Telegraph this week that BA was putting more people in danger. "We need as many airlines coming in to this region as possible, because the cost of bringing in supplies and aid workers is becoming prohibitive," he told the Telegraph. "There just aren't enough seats on the planes. I can understand BA's initial reaction back in August, but they must remember this is a global fight now, not just a west African one, and we can't just be shut out." Christopher Stokes, director of MSF in Brussels, agreed: “Airlines have shut down many flights and the unintended consequence has been to slow and hamper the relief effort, paradoxically increasing the risk of this epidemic spreading across countries in west Africa first, then potentially elsewhere. We have to stop Ebola at source and this means we have to be able to go there.”
4
Temperature screening at airports is an effective way to stop those who have the disease from travelling
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The screening process is pretty porous, especially when individuals want to subvert it. Wake up on the morning of your flight, feel a bit hot, and you definitely don't want to be sent to an isolation booth for days and have to miss your flight. Take an ibuprofen and you can lower your temperature enough to get past the scanners. And if you suspect you have Ebola, you might be desperate to leave, seeing how much better the treatment success has been in western nations. And experts have warned that you cannot expect people to be honest about who they have had contact with. Thomas Eric Duncan, the Ebola victim who died in Texas, told officials he had not been in contact with anyone with the disease, but had in fact visited someone in the late stages of the virus, though he said he believed it was malaria. The extra screening that the US implemented since his death probably wouldn't have singled out Duncan when he arrived from hard-hit Liberia last month, because he had no symptoms while travelling.
5
Border staff should stop people coming in to the country who are at risk
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They're not doctors, and it's a monumental task to train 23,500 people who work for the UK Border Agency how to correctly diagnose a complex disease, and spot it in the millions of people who come through British transport hubs. Public Health England has provided UK Border Force with advice on the assessment of an unwell patient on entry to UK, but they can't be expected to check everyone.
6
Screening at British airports should be implemented to stop unwell people coming in from affected areas
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As mentioned before, the UK, especially London, is a major transport hub. Unlike the US, most of those coming from west Africa will have crossed through Europe, so infected people could be coming from practically anywhere, not just flights directly from those countries. This would require the UK to screen every returning traveller, as people could return to the UK from an affected country through any port of entry. This would be huge numbers of low risk people, at vast, vast expense.
7
Ebola doesn't have a cure
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There are several cures currently being tested for Ebola. They include the ZMapp vaccine which was administered to British sufferer William Pooley and two other Americans who caught the disease in west Africa and they all recovered. Supplies of the drug have now run dry, and it has not been through clinical trials to prove its effectiveness. Mapp Biopharmaceutical, the company that makes ZMapp, says the drug's supplies are exhausted and that it takes months to make even a small batch. But an Ebola cure is very much on the horizon, and would have come sooner had it been seen as any kind of priority for drug companies before it started reaching the western world.
8
Ebola is a death sentence
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It is true that certain strains of Ebola have had a death rate of 90%. However, with this particular epidemic the stats are more positive, a death rate of around 60%. Those who have decent, strong immune systems, are able to access intravenous fluids and scrupulous health care are far more likely to survive, which is why the survival rate of westerners who contract the disease is far better. Experts have suggested that, rather than waste money on pointless airport screenings, funds could be used to improve infrastructure in the affected nations to help halt the spread of the disease at source.
9
Ebola turns you into a zombie
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Just, no.

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