No sooner did two state governors wisely institute quarantine procedures for healthcare workers returning from West Africa Ebola “hot zones” then they promptly reversed course after pressure from the White House.
Healthcare worker Kaci Hickox, also a CDC employee and proud Democrat, pitched a fit over a 21-day quarantine imposed by New Jersey Governor Chris Christie. After immediate reaction and pressure from the White House and a threatened civil rights lawsuit, New Jersey Governor quickly gave in and released Ms. Hickox.
How ironic that Governor Christie, characterized as a “tough guy” in the mold of Tony Soprano, folded like a cheap suit after asserting his state’s rights to confront a serious public health threat. The governor, who likely has presidential aspirations, did not generate confidence that he would be able to stand up to an aggressive foreign leader by backing down in a single day. His capitulation was reminiscent of President Obama and the infamous “red line” with Syria. His actions may also remind many of his famous hug with the President after Hurricane Sandy, weeks before the last election.
The quarantines are scientifically sound. The role of the New Jersey Department of Health is to, “Perform vital functions in disease detection, prevention and control.” Across the harbor from Governor Christie’s state lie Liberty, Governor’s, Ward’s, and Staten Island. These have served as quarantine stations “to prevent the bringing in and spreading of infectious distempers in the colony.” Exactly what the quarantine of a healthcare worker returning from the hot zone accomplishes.
Such a quarantine, standard operating procedure in the early years of America, was described as a “little bit draconian,” by a senior U.S. health official Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases. Good thing these officials weren’t in charge during the founding of this country else we might not be here today after being wiped out by a surge of smallpox or TB.
Even Cuba has this figured out. Several hundred Cuban healthcare workers are combating Ebola in West Africa. But buried at the end of a Reuters article is this nugget; “All of them will be held for at least 21 days of observation at the hospital upon returning to Cuba, the same as any visitor coming to the island from the affected countries.”
That’s exactly what Governors Christie and Cuomo wanted to do. Will they now be accused of being communist sympathizers?
The CDC is against such strict quarantines. Instead they recommend, “looser Ebola monitoring” with guidelines for “medical workers at high risk to isolate themselves.” Yet it is said that, doctors make the worst patients. Is it realistic to expect that doctors and nurses will isolate themselves as recommended after exposure to Ebola? Dr. Craig Spencer, New York City’s first Ebola patient, “despite being on a self-imposed limited-contact regime,” rode subways, went bowling, and rode in taxis. Dr. Nancy Snyderman, medical correspondent for ABC News and former head and neck surgeon, was on a “voluntary quarantine” after her cameraman tested positive for Ebola. Instead of isolation, she broke quarantine in order to get some take out food.
That’s the point of mandatory quarantine, since some healthcare professionals are unable to follow the most basic rules of isolation. Instead of letting the governors take appropriate measures to protect the citizens of their states, President Obama knows better, or at least knows that a big election is just a week away.
Brian C Joondeph, MD, MPS, a Denver based physician, is an advocate of smaller, more efficient government. Twitter @retinaldoctor.