Ebola in U.S.: Struggle over quarantine, stigmatization

Oct. 27 — Epidemiology nurse Kaci Hickox had traveled to Sierra Leone on behalf of Doctors Without Borders to help treat patients suffering from Ebola virus disease. Upon returning to the U.S. Oct. 24, Hickox was placed under quarantine. She reported no symptoms of the dreaded disease. [She was released from quarantine after much criticism of the policy and is home to Maine. — Eds.]

As of Oct. 27, there is no consistent protocol across the U.S. for how to treat returning medical workers and other travelers from Sierra Leone, Liberia and Guinea (Conakry). Three days earlier, the governors of New York and New Jersey issued edicts to hold such people in quarantine for 21 days. Illinois and Florida decided to do the same.

Hickox expressed her indignation, saying she was “treated like a criminal” by the authorities in the state. The nurse said that she was questioned for hours upon entry at Newark Liberty International Airport and immediately ordered into isolation. She was placed in an unheated tent with no bathroom.

Hickox threatened to take legal action against the state of New Jersey, saying the imposed isolation was inhumane. The forced isolation and confinement of Hickox raise constitutional and civil liberties issues, given that she remains asymptomatic and has not tested positive for EVD, said her legal counsel Norman Siegel, a well-known civil liberties attorney. “The policy is overly broad when applied to her,” Siegel stressed.

An Oct. 26 Reuters news article reported, “Kaci Hickox, a nurse placed in 21-day quarantine in a New Jersey hospital after returning from treating Ebola patients in Sierra Leone, will contest her quarantine in court, her attorney said on Sunday [Oct. 26], arguing the order violates her constitutional rights.”

Hickox joins a continuous chorus of complaints by nurses who say that the U.S. health care system lacks medical protocols for dealing with EVD. This unpreparedness led to two transmissions of the disease in Dallas as well as a general sense of panic and stigmatization of people from Africa, including those from countries far from the outbreak of EVD.

The administration of President Barack Obama has spoken out against a travel ban from West African states. The U.S. government has instituted screening measures for people traveling from the most severely impacted nations. The White House also contested the policies implemented in New York and New Jersey. This led, on Oct. 26, to New York Gov. Andrew Cuomo modifying the quarantine order so that people without symptoms can be quarantined at home.

Racism, anti-worker bias and xenophobia

In Maple Shade, N.J., a town in Gov. Chris Christie’s state, two Rwandan children were withdrawn from school after a letter was sent to the parents of all students saying that the East African pupils would be monitored three times a day. Rwanda, which is in East Africa, nearly 3,000 miles away from any of the severely impacted states in the far western part of the continent, has not reported any cases in the latest EVD outbreak.

Four cases of EVD have been diagnosed in the U.S. since the latest outbreak in West Africa. Thomas Eric Duncan, a Liberian national, died after he was first sent home when reporting to an emergency room at the Texas Health Presbyterian Hospital in Dallas. Incompetence there contributed to his death and to the infection of two nurses who provided care for Duncan.

Both of the nurses, Nina Pham and Amber Vinson, were determined to have recovered and have been released from specialized treatment units at the National Institutes of Health and Emory University, respectively.

Dr. Craig Spencer, a graduate of Wayne State University Medical School in Detroit, is the latest diagnosed case, and he is being treated at Bellevue Hospital in New York City. Spencer was also a volunteer with Doctors Without Borders in Guinea. He had traveled widely in the city on Oct. 21, the day before he registered a slight fever, and the ensuing publicity raised enormous fears in the city despite the unlikelihood of transmission.

According to those who treat EVD, transmission requires exposure to bodily fluids from someone exhibiting symptoms. The need for a rational and humane response to EVD is seriously needed in the U.S. Officials and media sources must be educated about the most recent outbreak of the disease and the nature of transmission.

In addition, the U.S. ruling class and state should provide maximum assistance and support to those countries where the disease has had a devastating impact. Attempts aimed at the isolation and stigmatization of the people from these West African states, and those who are assisting them, can worsen the existing conditions in both the U.S. and internationally.