Survey Update......Survey is now closed. Please go to Survey Results to see the response from the allnurses community.
Once again, it is a nurse who has taken the Ebola media spotlight this week. Kaci Hickox, a nurse who cared for Ebola patients in Sierra Leone found herself quarantined against her will in New Jersey upon her return to the US, in spite of the fact that she tested negative for the virus. After a 3 day isolation in less than desirable accommodations, she was transported home where she was supposed to remain under home quarantine but is now declaring that the quarantine is unnecessary and counterproductive, and is openly defying the order by going out in public.
Additional breaches in voluntary quarantine from those returning from Ebola-plagued Africa occurred when NBC medical correspondent, Dr. Nancy Snyderman in New Jersey and Dr. Craig Spencer in New York left their homes and ventured out into public spaces.
On Monday, the U.S. Centers for Disease Control and Prevention (CDC) called for voluntary home quarantine for workers with the highest risk for Ebola infection. It also specified that most medical personnel returning from Sierra Leone, Liberia and Guinea would not need to be kept in isolation.
In spite of this, New Jersey Gov. Chris Christie, mandated a 21-day mandatory quarantine policy for all healthcare workers exposed to Ebola. Although this move has received much criticism, it did get the support of Dr. Bruce Beutler, an American doctor and researcher and Nobel Prize winner for Medicine and Physiology for his work researching the the body’s overall immune system. He is currently the Director of the Center for the Genetics of Host Defense at the University of Texas Southwestern Center in Dallas. He favors Christie’s quarantine policy “because it’s not entirely clear that they can’t transmit the disease,” referring to asymptomatic healthcare workers like Kaci Hickox.
New York and Illinois have also have followed suit and mandated mandatory 21-day home quarantine policies. Although there is plenty of scientific evidence indicating there’s very little chance that a random person will contract Ebola unless they touch bodily fluids of an infected person, the thought is that the authorities need to do something to calm Americans’ fears. As Mike Osterholm, an infectious disease epidemiologist at the University of Minnesota, says, "You want to try to eliminate not just real risk, but perceived risk."
There are thoughts on both sides of this issue which has led to heated discussions at times. There are concerns about the potential impact with both pathways of re-entry requirements for Ebola healthcare workers. What are your thoughts about this? Please take our survey to share your opinions. Let your voice be heard.
Until I see some compelling evidence that supports mandatory quarantine for anyone that may have come into contact with someone that can possibly have Ebola (heavy dose of sarcasm in that statement, btw!), I support that nurse's decision not to quarantine. The media has turned this into a witchhunt. At this point, I'm still more afraid of the flu. At least contagious people with Ebola are visibly sick. The flu just ninja attacks people.
My hospital - although we will never likely see an Ebola patient - has formulated a plan should we need it. Staff can volunteer for it. After caring for the patient, you will be quarantined for 21 days.....with your regular salary and accommodations which include basic living supplies. Since I live alone, I could easily stay in my home for 3 weeks. Food delivery and I get to catch up on TV and reading while curled up on my couch? Score!
I don't think it's necessary, but that plan is definitely preferable to the nonsense that's happened. I wish we could poll how many people think she's the devil, yet scream about the injustices of mandatory vaccine programs.
Until I see some compelling evidence that supports mandatory quarantine for anyone that may have come into contact with someone that can possibly have Ebola (heavy dose of sarcasm in that statement, btw!), I support that nurse's decision not to quarantine. The media has turned this into a witchhunt. At this point, I'm still more afraid of the flu. At least contagious people with Ebola are visibly sick. The flu just ninja attacks people.
My hospital - although we will never likely see an Ebola patient - has formulated a plan should we need it. Staff can volunteer for it. After caring for the patient, you will be quarantined for 21 days.....with your regular salary and accommodations which include basic living supplies. Since I live alone, I could easily stay in my home for 3 weeks. Food delivery and I get to catch up on TV and reading while curled up on my couch? Score!
I don't think it's necessary, but that plan is definitely preferable to the nonsense that's happened. I wish we could poll how many people think she's the devil, yet scream about the injustices of mandatory vaccine programs.
I want some of that program.
I wonder if your hospital has run the numbers on this though. How is it plausible to take 14-21 nurses every week plus other direct care staff out of commission for 3 weeks after one shift. It seems that within a couple of weeks you would have to shut down a whole ward or more depending on the size of the hospital.
I wonder if your hospital has run the numbers on this though. How is it plausible to take 14-27 nurses every week plus other direct care staff out of commission for 3 weeks after 1 one shift. It seems that within a couple of weeks you would have to shut down a whole ward or more depending on the size of the hospital.
Until I see some compelling evidence that supports mandatory quarantine for anyone that may have come into contact with someone that can possibly have Ebola (heavy dose of sarcasm in that statement, btw!), I support that nurse's decision not to quarantine. The media has turned this into a witchhunt. At this point, I'm still more afraid of the flu. At least contagious people with Ebola are visibly sick. The flu just ninja attacks people.
I have copied part of a post by poster md777 for your consideration below. This person's words are within the quotation marks:
"This article quotes the New England Journal of Medicine as saying that 13% of Ebola patients have no symptoms at all. Then they quote a physician who won the Nobel Prize for his work on immunology as saying that asymptomatic Ebola patients could spread the disease. AS LONG AS THERE IS A CHANCE THAT AN ASYMPTOMATIC EBOLA PATIENT COULD SPREAD THE DISEASE, AND BECAUSE EBOLA HAS SUCH A HIGH DEATH RATE, WE NEED TO QUARANTINE. Nurses, we need to be responsible. The public is looking to us. Christie's controversial Ebola quarantine now embraced by Nobel Prize-winning doctor | NJ.com
This article by the WHO says that for 3% of Ebola patients took longer than 21 days for their incubation period--up to 42 days in fact--which is why the WHO won't certify that a country is free of Ebola until there is no new cases for 42 days. This means that Kaci could yet come down with Ebola which is why she would be quarantined, especially since the previous article says there is a chance she could spread the disease while asymptomatic. WHO | Are the Ebola outbreaks in Nigeria and Senegal over?
The following New England Journal of Medicine article says that 11% of Ebola cases present with no fever. This is why having health workers self-monitor twice a day by taking their temp is not adequate. http://www.nejm.org/doi/full/10.1056...1680#t=article
Specializes in NICU, PICU, Transport, L&D, Hospice.
I have copied part of a post by poster md777 for your consideration below. This person's words are within the quotation marks:
"This article quotes the New England Journal of Medicine as saying that 13% of Ebola patients have no symptoms at all. Then they quote a physician who won the Nobel Prize for his work on immunology as saying that asymptomatic Ebola patients could spread the disease. AS LONG AS THERE IS A CHANCE THAT AN ASYMPTOMATIC EBOLA PATIENT COULD SPREAD THE DISEASE, AND BECAUSE EBOLA HAS SUCH A HIGH DEATH RATE, WE NEED TO QUARANTINE. Nurses, we need to be responsible. The public is looking to us. Christie's controversial Ebola quarantine now embraced by Nobel Prize-winning doctor | NJ.com
This article by the WHO says that for 3% of Ebola patients took longer than 21 days for their incubation period--up to 42 days in fact--which is why the WHO won't certify that a country is free of Ebola until there is no new cases for 42 days. This means that Kaci could yet come down with Ebola which is why she would be quarantined, especially since the previous article says there is a chance she could spread the disease while asymptomatic. WHO | Are the Ebola outbreaks in Nigeria and Senegal over?
The following New England Journal of Medicine article says that 11% of Ebola cases present with no fever. This is why having health workers self-monitor twice a day by taking their temp is not adequate. http://www.nejm.org/doi/full/10.1056...1680#t=article
Please do not feel the need to share your personal fear with the general public.
Please do not believe that your fear should result in the loss of freedom for another.
When the country reacts out of fear we get stuff like the Patriot Act and give up our rights and the rights of others...exclusively because we are afraid.
So, be fearful, isolate yourself, fine...you must stop short of hollering fire in the theater however.
Please explain how she is putting a population at risk. She is not infectious. She does not have Ebola. She is monitoring her temperature and last I heard she hasn't gone to any public places (unless the woods in her remote area count).
You never know. I mean, she could infect a squirrel or some other innocent small woodland creature.
And I don't really want to imagine the exchange of body fluids required for such an infection to 'take'..! Then again, if she were to be randomly spitting on trees during her bike ride, and some poor unsuspecting squirrel were to come along and step on it.....and said squirrel were to then NOT use good hygiene techniques before having an acorn for lunch....oh, the horror!
Even though she gave selfishly to those in Africa, she needs to be respectful of the public here and the fears of contracting a deadly virus. Surely she can understand why people in NJ would be fearful. Have any of us been around a disease that has a 70-90%fatality rate?? Would you be concerned if your child was living next door to her and came in contact with her or her family? I would. Lets not forget secretions are: tears, mucus, blood, stool, urine etc. While she may not be contagious, who is to say that her sneeze could be? Would you put yourself at risk? Why don't you go up to her door and see what happens? She is a highly educated woman, who understands the risks of this illness. I don't think it is too much to ask for her to quarantine herself in her home for 21 days. Are her rights being tromped on, yes, but it is for the prevention of a potentially deadly disease. I don't think it is too much to ask. (Oh, when you opened her door, she sneezed, now how do you feel?)
My hospital - although we will never likely see an Ebola patient - has formulated a plan should we need it. Staff can volunteer for it. After caring for the patient, you will be quarantined for 21 days.....with your regular salary and accommodations which include basic living supplies. Since I live alone, I could easily stay in my home for 3 weeks. Food delivery and I get to catch up on TV and reading while curled up on my couch? Score!
I have copied part of a post by poster md777 for your consideration below. This person's words are within the quotation marks:
"This article quotes the New England Journal of Medicine as saying that 13% of Ebola patients have no symptoms at all. Then they quote a physician who won the Nobel Prize for his work on immunology as saying that asymptomatic Ebola patients could spread the disease. AS LONG AS THERE IS A CHANCE THAT AN ASYMPTOMATIC EBOLA PATIENT COULD SPREAD THE DISEASE, AND BECAUSE EBOLA HAS SUCH A HIGH DEATH RATE, WE NEED TO QUARANTINE. Nurses, we need to be responsible. The public is looking to us. Christie's controversial Ebola quarantine now embraced by Nobel Prize-winning doctor | NJ.com
This article by the WHO says that for 3% of Ebola patients took longer than 21 days for their incubation period--up to 42 days in fact--which is why the WHO won't certify that a country is free of Ebola until there is no new cases for 42 days. This means that Kaci could yet come down with Ebola which is why she would be quarantined, especially since the previous article says there is a chance she could spread the disease while asymptomatic. WHO | Are the Ebola outbreaks in Nigeria and Senegal over?
The following New England Journal of Medicine article says that 11% of Ebola cases present with no fever. This is why having health workers self-monitor twice a day by taking their temp is not adequate. http://www.nejm.org/doi/full/10.1056...1680#t=article
It really is aggravating when people take research out of context as proof of something.
[h=3]"RESULTS[/h][h=3]Patients[/h]A total of 213 patients who had an illness that met the definition for suspected Lassa hemorrhagic fever or EVD were tested between May 25 and June 18, 2014, by means of conventional RT-PCR (Figure S1 and Table S1 in the Supplementary Appendix, available with the full text of this article at NEJM.org). Of these patients, 106 (50%) had positive results on testing for EBOV. The distribution of EVD according to age was bimodal, with peak incidences among children older than 15 years of age and among adults between the ages of 26 and 40 years (Figure S2 in the Supplementary Appendix). Among confirmed cases, 59 patients (60%) were female, including 1 pregnant woman who had a miscarriage immediately before her diagnosis. The majority of patients (92%) originated in Kailahun District, and most of them (82%) came from two chiefdoms in that district, Jawei and Kissi Teng (Tables S1 and S2 and Figure S3 in the Supplementary Appendix)."
These people were already identified as being sick and possibly having ebola. They were all symptomatic. That is why the CDC guidelines specify symptomatic patients should be quarantined and not just the ones experiencing fever.
I am not going through the entire reference list on this article, but the important thing to note is if you are not symptomatic then you are not going to transmit ebola. The author also suggests that quarantine time be extended to a confidence interval of 95% or 99%, but that would still leave extreme outliers in either group. These results have also not been verified/reproduced by any other researchers at this point in time, and actually are contradictory to all previous research done by groups of researchers from different agencies and independently.
The last article relates to people that are symptomatic and the possibility of transmitting ebola from surfaces and has no impact on mandatory quarantine.
In summary: Nothing in these articles represent a need to change anything. The most important thing to note is if you are not symptomatic then you are not going to pass ebola.
When and if there is enough research on a subject you should be able to cherry pick articles to support a position no matter how outlandish that position might be. That fortunately is not how research is utilized. Research has to be validated and reproducible, and even if one or two experts have a opinion that differ from the majority of research authorities that doesn't mean we change current standards every time they state their opinion.
Tell me how that would work at your hospital, and the hospital/ward stay operational for 2 week stay of an ebola patient? Do the physicians, techs, and everyone else do the same thing? Now, let us assume the ebola patient came through the ER you could essentially put a whole ER shift of staff on 3 weeks of quarantine. One ebola patient would be enough to close most small hospitals in 1-2 days with these requirements.
Does this still sound reasonable? To me it sounds like unrealistic expectations based on fear and not scientific evidence.
ShantheRN, BSN, RN
646 Posts
This has been a most interesting read.....
Until I see some compelling evidence that supports mandatory quarantine for anyone that may have come into contact with someone that can possibly have Ebola (heavy dose of sarcasm in that statement, btw!), I support that nurse's decision not to quarantine. The media has turned this into a witchhunt. At this point, I'm still more afraid of the flu. At least contagious people with Ebola are visibly sick. The flu just ninja attacks people.
My hospital - although we will never likely see an Ebola patient - has formulated a plan should we need it. Staff can volunteer for it. After caring for the patient, you will be quarantined for 21 days.....with your regular salary and accommodations which include basic living supplies. Since I live alone, I could easily stay in my home for 3 weeks. Food delivery and I get to catch up on TV and reading while curled up on my couch? Score!
I don't think it's necessary, but that plan is definitely preferable to the nonsense that's happened. I wish we could poll how many people think she's the devil, yet scream about the injustices of mandatory vaccine programs.