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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.
Specializes in Oncology; medical specialty website.
If Florence Nightengale hadn't bucked the establishment in her day to lay the groundwork for professional nursing, I wonder where the profession would be today. Maybe she should have just shut up and been a good little girl.
For some reason this topic seems to bring about unjustified absolutism at both ends of the spectrum.
There isn't evidence to confirm that asymptomatic individuals can or have transmitted ebola, there is also no evidence to say they can't. Either way there isn't any evidence that the risk is high enough to quarantine or otherwise aggressively monitor asymptomatic individuals. Some form of quarantine and/or intensive monitoring is indicated with symptomatic individuals such as Kaci Hickox based on current evidence based screening protocols.
The biggest reason we don't consider asymptomatic individuals to be likely to transmit ebola is that the symptoms themselves are what increases someone's potential to infect others, namely vomiting and diarrhea which are basically well designed viral spreading mechanisms. That doesn't mean however that someone can't have the virus in a post-incubation stage and remain asymptomatic. We know it can exist in bodily fluids for a significant period of time and that the person can remain asymptomatic, particularly in semen. So it would be a bit silly to declare it impossible for an asymptomatic person to transmit the virus, it is however highly unlikely which is why we limit more aggressive measures to those with symptoms.
Also, would you allow your children near her without any reserve? Would you allow her into your home without reserve?
I would, and I wouldn’t feel the least bit afraid to do so.
I believe in science, both online and in real life.
I recently had the opportunity to sit down with a group of people at work over a cup of coffee, and talk to a healthcare professional who’d returned from Monrovia, Liberia about two weeks prior. This person had been to Liberia with MSF and worked with Ebola patients. I wasn't nervous at all, neither were my co-workers who were also there at the time. My co-workers believe in science too.
For some reason this topic seems to bring about unjustified absolutism at both ends of the spectrum.
There isn't evidence to confirm that asymptomatic individuals can or have transmitted ebola, there is also no evidence to say they can't. Either way there isn't any evidence that the risk is high enough to quarantine or otherwise aggressively monitor asymptomatic individuals. Some form of quarantine and/or intensive monitoring is indicated with symptomatic individuals such as Kaci Hickox based on current evidence based screening protocols.
The biggest reason we don't consider asymptomatic individuals to be likely to transmit ebola is that the symptoms themselves are what increases someone's potential to infect others, namely vomiting and diarrhea which are basically well designed viral spreading mechanisms. That doesn't mean however that someone can't have the virus in a post-incubation stage and remain asymptomatic. We know it can exist in bodily fluids for a significant period of time and that the person can remain asymptomatic, particularly in semen. So it would be a bit silly to declare it impossible for an asymptomatic person to transmit the virus, it is however highly unlikely which is why we limit more aggressive measures to those with symptoms.
Kaci Hickox is asymptomatic she had slight elevation in her skin temperature at the airport, but when it was retaken orally she was afebrile. That makes her a low-risk asymptomatic person.
This is aimed towards vaccines, but applies to all uses of scientific evidence and what scientific evidence is and why there will never be an absolute to any scientific inquiry.
Kaci Hickox is asymptomatic she had slight elevation in her skin temperature at the airport, but when it was retaken orally she was afebrile. That makes her a low-risk asymptomatic person.
Actually that puts her into the symptomatic category. It's not unusual for someone with a viral infection, particularly in the early stages to have a labile temperature which is why generally accepted ebola screening protocols consider a single elevated temperature to trigger the need for further monitoring and reduction of their potential for exposing others. If continued checks (not just a single check) continue to show no fever then the risk level can eventually be reduced. The forehead scanners are hardly perfect, but that's been the standard for ebola screening for many years.
Actually that puts her into the symptomatic category. It's not unusual for someone with a viral infection, particularly in the early stages to have a labile temperature which is why generally accepted ebola screening protocols consider a single elevated temperature to trigger the need for further monitoring and reduction of their potential for exposing others. If continued checks (not just a single check) continue to show no fever then the risk level can eventually be reduced. The forehead scanners are hardly perfect, but that's been the standard for ebola screening for many years.
This has been discussed numerous times, and you are incorrect. The experts and the CDC disagree with you. She had a potential sign that she might have been symptomatic that was later shown to be due to the inaccuracy inherent with the type of thermometer that was used. Had she shown to be symptomatic the CDC could and would have enforced mandatory quarantine status.
The thermometers that measure skin temperature can be highly inaccurate and need to be followed up with an oral temperature.
The forehead scanners are hardly perfect, but that's been the standard for ebola screening for many years.
They are quite unreliable, but they are convenient, so perfect political solution. If I was returning from West Africa, knowing what happened to Kaci, I would insist on an oral temp unless that meant I would be locked up in a holding facility waiting for one, or locked up for asking for one.
They are quite unreliable, but they are convenient, so perfect political solution. If I was returning from West Africa, knowing what happened to Kaci, I would insist on an oral temp unless that meant I would be locked up in a holding facility waiting for one, or locked up for asking for one.
elkpark
14,633 Posts
Thanks for sharing that - LMAO!