RN Detained and Quarantined As Ebola Hysteria Reaches a New Low

[MissyWrite]

NJ and NY have instituted a policy of placing health workers into mandatory 21-day quarantine upon their return from West Africa if they came into contact with Ebola patients.

This new policy is a reaction to unfounded public hysteria surrounding Dr. Craig Spencer's return to NYC after working with Doctors Without Borders, and his subsequent diagnosis of Ebola, after he had taken the subway and gone bowling. People fear Ebola can be spread through casual contact with an asymptomatic person, even though public health experts say there's plenty of scientific evidence indicating that isn't the case.

Is this policy based on the facts about Ebola transmission? Is it based on science? No, it's not, and in fact no one is saying that it is:

"Voluntary quarantine is almost an oxymoron," New York Governor Andrew Cuomo said. "We've seen what happens. ... You ride a subway. You ride a bus. You could infect hundreds and hundreds of people."

"Public health experts say there's plenty of scientific evidence indicating that there's very little chance that a random person will get Ebola, unless they are in very close contact -- close enough to share bodily fluids -- with someone who has it.

Still, there's also a sense that authorities have to do something because of Americans' fears -- rational or not -- and belief that the country is better off being safe than sorry.

Osterholm says, "You want to try to eliminate not just real risk, but perceived risk."

Mike Osterholm is an infectious disease epidemiologist at the University of Minnesota.

Because of this irrational "perceived" risk, Kaci Hickox, 33, an RN who has been caring for Ebola patients while on assignment with Doctors Without Borders in Sierra Leone, was detained at the airport, interrogated for hours, and placed in mandatory quarantine at a New Jersey hospital upon her return to the U.S. on Friday.

She has tested negative in a preliminary test for Ebola, and she does not have a fever, but the hospital says she will remain under mandatory quarantine for 21 days. She is not allowed to leave the hospital, unless officials reconsider that decision.

Here are some excerpts from her experience so far:

I am a nurse who has just returned to the U.S. after working with Doctors Without Borders in Sierra Leone - an Ebola-affected country. I have been quarantined in New Jersey. This is not a situation I would wish on anyone, and I am scared for those who will follow me...

I arrived at the Newark Liberty International Airport around 1 p.m. on Friday, after a grueling two-day journey from Sierra Leone. I walked up to the immigration official...

I told him that I have traveled from Sierra Leone and he replied, a little less enthusiastically: "No problem. They are probably going to ask you a few questions."...

He put on gloves and a mask and called someone. Then he escorted me to the quarantine office a few yards away. I was told to sit down. Everyone that came out of the offices was hurrying from room to room in white protective coveralls, gloves, masks, and a disposable face shield.

One after another, people asked me questions. Some introduced themselves, some didn't. One man who must have been an immigration officer because he was wearing a weapon belt that I could see protruding from his white coveralls barked questions at me as if I was a criminal.

Two other officials asked about my work in Sierra Leone. One of them was from the Centers for Disease Control and Prevention.

I was tired, hungry and confused, but I tried to remain calm. My temperature was taken using a forehead scanner and it read a temperature of 98. I was feeling physically healthy but emotionally exhausted.

Three hours passed. No one seemed to be in charge. No one would tell me what was going on or what would happen to me.

I called my family to let them know that I was OK. I was hungry and thirsty and asked for something to eat and drink. I was given a granola bar and some water. I wondered what I had done wrong.

Four hours after I landed at the airport, an official approached me with a forehead scanner. My cheeks were flushed, I was upset at being held with no explanation. The scanner recorded my temperature as 101. The female officer looked smug. "You have a fever now," she said. I explained that an oral thermometer would be more accurate and that the forehead scanner was recording an elevated temperature because I was flushed and upset.

I was left alone in the room for another three hours. At around 7 p.m., I was told that I must go to a local hospital. I asked for the name and address of the facility. I realized that information was only shared with me if I asked.

Eight police cars escorted me to the University Hospital in Newark. Sirens blared, lights flashed. Again, I wondered what I had done wrong.

At the hospital, I was escorted to a tent that sat outside of the building. The infectious disease and emergency department doctors took my temperature and other vitals and looked puzzled. "Your temperature is 98.6," they said. "You don't have a fever but we were told you had a fever."

After my temperature was recorded as 98.6 on the oral thermometer, the doctor decided to see what the forehead scanner records. It read 101. The doctor felts my neck and looked at the temperature again. "There's no way you have a fever," he said. "Your face is just flushed."

My blood was taken and tested for Ebola. It came back negative........

http://www.dallasnews.com/ebola/headlines/20141025-uta-grad-isolated-at-new-jersey-hospital-as-part-of-ebola-quarantine.ece

This is what happens to nurses when public ignorance and hysteria is placated by politicians.

We've already seen nurses blamed for just about everything Ebola-related since the first case in Dallas, and now we see a nurse being held against her will, for no reason except to make scared people "feel safer."

"It does present serious civil liberties questions," said Norman Siegel, a civil liberties lawyer in New York and the former executive director of the New York Civil Liberties Union. "Historically, we've had these kinds of issues occur previously, and the courts then resolved the individual liberty issue against the larger concerns of the public's health concerns. So it then becomes a factual issue, the fact that she tested negative."

"It's completely unnecessary," said Harvard's Ashish Jha, the director of the Harvard Global Health Institute).

"I'm a believer in an abundance of caution but I'm not a believer of an abundance of idiocy."

[RN_2012, BSN, RN]

This is an image, it sure looks like it is outside or under a patio setting.

[Tenebrae, BSN, RN]

One of the biggest concerns I have at this point is that it seems health policy is being formed from and based on international hysteria instead of evidenced based tried and tested research

We are in a bad place when we are making decisions without all the facts

None of you are experts on ebola so the moral outrage from you is a moot point. If you or a loved one contracted the disease because someone who was over there was out and about while they were sick and contagious I bet your tune would be a different one. Regardless of how they say it is spread it's a deadly disease and the comparison between it and the flu is stupid. Millions of people get the flu every year so the death rate is small compared to how many do survive. On the other hand the death rate is quite a large number in ebola cases and if millions of people had it more would die from that than the flu.

As for how it's spread why is it that people are still getting it even though they wear the protective gear. Either there is a break in protocol on their part or it is airborne.

[Tenebrae, BSN, RN]

We can't have it both ways. Nurses complained about having to take care of possible Ebola infected patients. Nurses complained that the PPE was inadequate. The general public complained about the fact that we didn't close flights from West Africa. This nurse's temp was 101 degrees F. My temp doesn't go up that high when I am upset, like she claimed.

I took a patients blood glucose levels recently using one type of testing monitor. It read 1.9. The patient was fully concsious and asymptomatic. I rested using another brand of monitor, it read 7.8

Electronic instruments used in health care are far from being infalliable

[jadelpn, LPN, EMT-B]

I did in fact read that this nurse in question did have an 101 degree fever well after her initial assessment, THEN that was responded to. She felt is was because she was "flushed".

And as of reports this morning, has at some point hired an attorney.

Call me crazy, but if one is working in the heart of this disease, there SHOULD be a quarantine, until such time as there is no more risk.

There were more than a small group of people who were horrified that the MD was out in public whilst incubating Ebola. The city responds to that by making mandates, and now it is someone's liberties are being taken advantage of.

It needs to be one thing or another. But steps to not attempt to quarantine this public health threat have consistently been met with outrage.

Additionally, what in the world is stopping this nurse from saying, you know what, I am so out of here, getting up, and leaving? I am not sure she is on lock down. And attorney who will not show up at the site and escort their client home? What is it an arrestable offense to leave? Shouldn't the attorney who is working for this nurse be more proactive? Shouldn't the nurse--"Ok, big wig human rights attorney, come and get me. Now."

[Tenebrae, BSN, RN]

I was talking to my sister about this today. Shes an ED consultant and survived through the chch earthquakes. She doesnt necessarily have a problem with mandatory isolation. However in a proper hospital, with a working shower, a proper toilet, access to friends and family albeit with barrier nursing in place.

This is one time the litigious nature in the US may play to this nurses benefit.

Like I said, form health policy based on actual evidence. To have a knee jerk reaction like this because the public wants to see action but dont really know what sort of action they want to see is just dumb

[Selfie]

QUOTE: Additionally, what in the world is stopping this nurse from saying, you know what, I am so out of here, getting up, and leaving? I am not sure she is on lock down. And attorney who will not show up at the site and escort their client home? What is it an arrestable offense to leave? Shouldn't the attorney who is working for this nurse be more proactive? Shouldn't the nurse--"Ok, big wig human rights attorney, come and get me. Now."

I wouldn't want to have to worry about jail time after quarantine- for breaking quarantine, backlash from the public, and possibility of being reported to the BON.

My guess is that she'll be able to finish quarantine at home now that gov Cuomo has loosened the guidelines.I

[macawake, MSN]

I noticed that some people seem to feel that there’s a contradiction in demanding proper PPE when caring for infected patients, and at the same time have the opinion that healthcare workers shouldn’t be quarantined upon return from work in the outbreak area. I don’t believe it’s a matter of wanting to have it both ways. I think that this is an apples and oranges situation.

We know that symptomatic diagnosed patients with a high viral load and “leaking” bodily fluids, are infectious. Therefore it makes perfect sense that healthcare workers caring for these patients, utilize proper PPE. It also makes sense for a healthcare worker to take precautions and use PPE if a patient starts having symptoms consistent with EVD, if they’ve been in contact with infected people, until an infection can be ruled out.

What doesn’t make sense is to take a hysterical approach and implement draconian measures, when we’re dealing with a person who we know poses no threat to others. Yes, we actually do know that asymptomatic persons aren’t infectious.

What will it take to convince everyone of this? How many more decades have to pass, when no healthcare worker returning from work in outbreak areas, infect someone in the asymptomatic phase of the disease? To think that a healthcare worker poses a threat to society when they haven’t even once infected a loved one, whom they have close contact with and share living quarters with, isn’t logical and isn’t scientifically sound.

Another thing people need to realize. The current outbreak, even though it's big and serious as it is, would have been much larger if infected, asymptomatic persons infected others through casual contacts.

If new evidence comes to light, that would be the time to reevaluate disease transmission. Living in fear, waiting for something that will in all likelihood never happen, is detrimental to society as a whole and a grave infringement on the rights of individual healthcare worker’s.

My biggest concern regarding this outbreak has been and still is that hysteria and fear will increase and spread even further.

So far, it’s “only” (that’s certainly bad enough) American healthcare workers who've had their freedom curtailed. The thing is, the general public in Europe, Asia and unaffected parts of Africa are scared too. How long before their fears make politicians in other parts of the world also cave, and the supply of healthcare workers volunteering in the outbreak is drastically reduced? The precedent set by Govs. Cuomo and Christie may have far-reaching consequences. Let’s hope it won’t come to that.

[MissyWrite]

"When officials respond to panic with quarantine they basically say they can't trust public health officials, science and the ethics of doctors and nurses.

There is no substitute for that trust. None. If state and city officials undermine trust out of panic or politics, then they destroy the best weapon we have to control Ebola — good science implemented by heroes.

It may be too late to reverse the leap to quarantine for those politicians deem at risk. But it is a leap into an unknown that we are likely to come to regret."

[h=1]Bioethicist: 7 Reasons Ebola Quarantine Is a Bad, Bad Idea[/h]http://www.nbcnews.com/storyline/ebola-virus-outbreak/bioethicist-7-reasons-ebola-quarantine-bad-bad-idea-n234346

[MissyWrite]

Is it a good thing to feed into public hysteria, and force quarantine on returning Ebola healthcare providers? I don't know. Maybe not. Is it a good thing to ignore the public's fear and tell them they're morons? I think not. Definitely not if you're a politician.

American citizens cannot be detained and held against their will for no reason. It's one of the basic tenets of our society. Public hysteria, quite simply, is NOT a valid reason to relieve someone of their rights.

Just because it is being done to the nurse in NJ does not make it legal. Her quarantine will be challenged in court, and she will win. Why? Because laws regarding quarantine state that a person must actually be INFECTED with a disease in order to be quarantined.

Kind of makes sense, doesn't it?

Here is a relevant part of US law regarding quarantine:

264. Regulations to control communicable diseases:

"...provide for the apprehension and examination of any individual reasonably believed to be infected with a communicable disease in a qualifying stage and ...to be a probable source of infection to individuals who, while infected with such disease in a qualifying stage...

...if upon examination any such individual is found to be infected, he may be detained for such time and in such manner as may be reasonably necessary."

I'm not a lawyer, but it seems pretty clear that in order to be held in quarantine, a person must actually be infected.

The law does not say that any person can be detained whenever the public thinks they should. It says that a person can be detained only for reasons based on actual science.

When I saw Cuomo & Christie on TV all I could think of was the mandatory internment camps for the Japanese during WWII.

It's the same thing -- illegally detaining people because of the imagined fears of others. Very scary.

[CrunchRN, ADN, RN]

If they must do this you would think they could provide more than a tent and a sanican.

[macawake, MSN]

Bioethicist: 7 Reasons Ebola Quarantine Is a Bad, Bad Idea - NBC News

That’s a great link. What this man writes is an astute and accurate analysis. I wish everyone would read it, consider it and believe it. I mean, really take it to heart.

In order to “beat” Ebola we have to put our trust in science and fight hysteria, irrational fears and panic with education and information.

[MissyWrite]

In order to "beat" Ebola we have to put our trust in science and fight hysteria, irrational fears and panic with education and information.

Exactly. We can't let fear take control over intelligence.

"Several leading public health experts have suggested that Christie's decision to confine Hickox is an attempt to score political points, given the public's fear of Ebola."

It is outrageous that this politician would capitalize on the public's fears -- and increase those fears -- and violate civil liberties -- for personal gain! He is manipulating the public.

It is outrageous and unacceptable, to say the least, but his plan is working -- many people have become too irrational to think clearly and see what he's really up to. And he knows it.

How perfect is that?

Those who are thinking rationally and who DO know it will have to take control of this situation. And that is happening.

Excellent article:

[h=1]The Flu, TB and Now Ebola: A Rare Legal Remedy Returns[/h]http://www.nytimes.com/2014/10/27/nyregion/as-states-look-to-halt-ebola-restrictions-prompt-a-debate.html?_r=0