There are basically three reasons to monitor/quarantine someone who has had some kind of "exposure" to Ebola (using that in quotes because no-one that had contact with the nurse from Dallas was really exposed to Ebola, but they did have some kind of interaction with a nurse who did).
- medical
- political
- public policy/managing public fears
Kaci Hickox objected to being quarantined unnecessarily because there was no medical reason to do so. Her lawyer complained about the decision being a political one when it should be a medical decision. I think he is right about Christie/Cuomo's decisions to isolate her in the parking lot. That was all about political cover for them.
He is wrong when you look at the recent context of business closings in New York, school closings in Texas and Ohio as a result of incidental contact with personnel from Presbyterian in Dallas. The reason that she should have remained isolated is that it is important in managing public fears. Willfully violating the restrictions that were in place undermines public trust, and makes it more difficult for people to trust public (read: government/CDC) decisions, which will ultimately make subsequent responses more restrictive and expensive.
My contention is that if travel guidelines and self-isolation rules were more restrictive in the first instance in Dallas, then you would build public trust, highlight that the concern should be on the medical workers that are truly at high risk, and minimize concern about its spread to the general population.
Once you build public trust and ease fears (which have turned out to be largely baseless, if the base is medical knowledge about this virus and its history of transmission), then you can ease restrictions into something more reasonable and acceptable to both the healthcare workers and public at large.
My concerns about this whole response are:
- Possibility of discouraging medical workers from traveling to Africa to manage the disease there
- Expense of irrational responses
- Expense of restrictions to medical workers (make them cancel travel plans, but make sure they are duly compensated)
- Scalability of response if the disease grows to hundreds of thousands or more in Africa
I am not afraid of catching Ebola on the bus... I am more afraid of business owners getting shut down because someone gets on the bus when they promised not to. One of our friends is a doctor at Presby and this has hit his pocket book even though only the ER and ICU are even remotely affected, and he's in the professional buildings. My primary care physician is at Methodist Richardson, and his nurse is afraid of the fear of Ebola because it could affect them as well. As it was explained to me, the ER at Methodist is shut down and moved to another location as of April, so it will only operate as Ebola-only if they ever get a case there.
