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."

[MissyWrite]

The nurses quarantine may not be ideal, but coming from the accommodations available in West Africa it couldn't be that bad!

Surely you don't mean the tent/no running water/ paper clothing/ no shower/porta-potty situation of the nurse who was quarantined, do you? This is the US, a third-world country that thinks pretty highly of itself, so surely better accommodations than that could easily be provided, especially if the person being detained was held in high esteem and respected.

[MissyWrite]

I think the WORST thing Cuomo and Christie did was to undermine the public's trust in nurses and doctors by saying they could not be trusted to self-monitor. That really gets to me. They went way too far with that one.

They portrayed us as scoundrels who don't care about anyone's health but our own. If that's true, then what is it that we do every day? And what are these nurses and doctors doing caring for people stricken with a horrifying disease that the world is terrified of?

Dr. Craig, Kaci Hickox, Amber Vinson, etc. have been vilified, when they should be considered the heroic, selfless people they are. Instead, they are hated by many, because of the politicians spreading misinformation for their own personal gain.

[Selfie]

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.

The problem is there have been so many inconsistencies in the treatment and care of ebola patients here in the US.

The CDC just RECENTLY decided what constitutes appropriate PPE. and that was ONLY after a health care worker in the US became infected.

Remember they were telling the staff in the hospitals to wear gowns and masks, and TAPE the neck openings?

The guidelines keep changing. Do you think the general public doesn't see this? Why should the public now trust them?

I'm all for no quarantine if the CDC, actually if a health care team, comes up with specific guidelines of reportable symptoms, along with an expressed understanding and agreement by the health care worker in contact with those with EBOLA.

[Selfie]

I think the WORST thing Cuomo and Christie did was to undermine the public's trust in nurses and doctors by saying they could not be trusted to self-monitor. That really gets to me. They went way too far with that one.

I agree. They are definitely taking advantage of this, but as far as I'm concerned, the CDC started it. They should have been more on top of their game.

[OCNRN63, RN]

Frankly I think a quarantine is not a bad idea and since the CDC has been running around and destroying every Ebola patient's home and its belongings in their decontamination effort, I would think they would prefer to be quarantined other than their home. Honestly I don't understand the need to destroy everyones belongings, seems way overkill to me! Personally I love my home and wouldn't want someone to come in and destroy everything. Now that I could see a lawsuit over, not a quarantine that is meant to protect everyone so you don't have to run around and find out who they were in contact with if they test positive for Ebola.

The nurses quarantine may not be ideal, but coming from the accommodations available in West Africa it couldn't be that bad!

Why don't you give being confined to a tent outside with paper clothing, no running water, no flush toilet, etc. a try, then let us know what it feels like. At least in Africa, she wasn't being vilified by her own sisters and brothers in nursing. She was appreciated.

It makes no sense to treat returning health care workers who aren't sick like this. As I've said previously, we treat the terrorists at Gitmo better.

[chadrn65]

“This protocol for a higher-risk individual will be implemented for the first time when a health care worker who came into contact with Ebola-positive individuals returns soon from New Jersey,” the statement said, referring to Ms. Hickox. “Under this policy, Maine will make every possible effort to implement an agreed-upon in-home quarantine. We fully expect individuals to voluntarily comply with an in-home quarantine.”

http://www.nytimes.com/2014/10/28/nyregion/nurse-in-newark-to-be-allowed-to-finish-ebola-quarantine-at-home-christie-says.html?_r=0

[MissyWrite]

"This protocol for a higher-risk individual will be implemented for the first time when a health care worker who came into contact with Ebola-positive individuals returns soon from New Jersey," the statement said, referring to Ms. Hickox. "Under this policy, Maine will make every possible effort to implement an agreed-upon in-home quarantine. We fully expect individuals to voluntarily comply with an in-home quarantine."

You will see this go to court, and you will see it lose.

Why?

In the United States of America, people are not forcibly detained without cause and without due process, and only those with a diagnosed infection can legally be quarantined.

Right now, politicians are trying to find some compromise between the abiding by the law of the land and placating public hysteria (getting votes). The law will win.

"You have heard the argument that we all need to sacrifice some liberty in order to assure our safety, that liberty and safety are in equipoise, and when they clash, it is the government that should balance one against the other and decide which shall prevail. This is, of course, an argument the government loves, as it presupposes that the government has the moral, legal and constitutional power to make this satanic bargain.

It doesn't.

This argument is antithetical to the principal value upon which America was founded.

James Madison, who wrote the Constitution, observed that in the history of the world, when freedom has been won, it happened because those in power begrudgingly permitted freedom as a condition of staying in power or even staying alive.

But not in America.

In America, the opposite occurred when free people voluntarily permitted the government to exercise the limited power needed to protect freedom. That is known as "the consent of the governed." To Jefferson and Madison, a government lacking that consent is illegitimate.

All persons are by nature free, and to preserve those freedoms, they have consented to a government. That was the government they gave us -- not power permitting liberty, but liberty permitting power -- and the instrument of that permission was the Constitution.

They have elevated safety -- which is a goal of government -- to the level of freedom -- which created the government. This common and pedestrian argument makes the creature -- safety -- equal its creator -- freedom. That is a metaphysical impossibility because it presumes that the good to be purchased is somehow equal to the free choices of the purchaser.

What does this mean?

It means that when politicians say that liberty and safety need to be balanced against each other, they are philosophically, historically and constitutionally wrong. Liberty is the default position. Liberty is the essence of our natural state. Liberty cannot possibly be equal to a good we have instructed the government to obtain.

What is the only moral relationship between liberty and safety?

It cannot be balance, because liberty and safety are not equals, as one created the other. It can only be bias -- a continual predisposition toward and preference for freedom.

Every conceivable clash between the free choices of persons and their instructions to their government to safeguard freedom must favor the free choices because freedom is inalienable.

Just as I cannot authorize the government to take away your freedom any more than you can authorize it to take away mine, a majority of all but one cannot authorize the government in a free society to take freedom from that one individual.

So if somehow freedom and safety do clash, it is the free choice of each person to resolve that clash for himself, and not one the government can morally make.

The government will always make choices that favor its power because, as Ludwig von Mises reminded us, government is essentially the negation of freedom.

The reasons we have consented to limited government are to preserve the freedom to pursue happiness, the freedom to be different and the freedom to be left alone. None of these freedoms can exist if we are subservient to the government in the name of safety or anything else."

Giving Up Liberty for Security - Reason.com

If no rational, scientific reason is exists for forcible detention, it will not hold up in a court of US law.

[brandy1017, ASN, RN]

I think the WORST thing Cuomo and Christie did was to undermine the public's trust in nurses and doctors by saying they could not be trusted to self-monitor. That really gets to me. They went way too far with that one.

They portrayed us as scoundrels who don't care about anyone's health but our own. If that's true, then what is it that we do every day? And what are these nurses and doctors doing caring for people stricken with a horrifying disease that the world is terrified of?

Dr. Craig, Kaci Hickox, Amber Vinson, etc. have been vilified, when they should be considered the heroic, selfless people they are. Instead, they are hated by many, because of the politicians spreading misinformation for their own personal gain.

Yes they are heroic, but if they understood Ebola which the Dr certainly should he should have self quarantined for the 21 days to protect the public and his family. Amber probably didn't know better and was misinformed by the CDC to travel while under the incubation period. That turned into a PR disaster that they don't want to repeat and fortunately no one seems to have been harmed, but why take the chance?

Quarantine is a legitimate way to prevent the spread of a potentially fatal disease. What I don't understand is why the CDC feels the need to burn all the patient's belongings esp when the nurses came in with a fever, it's not like they puked all over their belongings. I would file a lawsuit over losing my belongings, not a quarantine.

[BlueDevil, DNP]

Ignorance and hysteria coming from the general public is frustrating, but not surprising; coming from nurses it is a disgrace.

People want to quarantine healthy people and yet refuse to get their own flu shot. Oh, the irony.

She has got a heck of a lawsuit, I hope she takes it all the way!

[macawake, MSN]

Yes they are heroic, but if they understood Ebola which the Dr certainly should he should have self quarantined for the 21 days to protect the public and his family.

I think that you underestimate the MSF nurses and physicians. They do know Ebola, better than most of us. Because they do, they don't think it's necessary to self-quarantine when they feel healthy and have no symptoms whatsoever. Because they understand the disease all too well, they will contact the proper healthcare authority if and when they become symptomatic.

Everyone, these are dedicated professionals committed to fighting the Ebola outbreak. Do you really think that they'd risk spreading the disease?

What I don't understand is why the CDC feels the need to burn all the patient's belongings esp when the nurses came in with a fever, it's not like they puked all over their belongings.

I think that you intuitively understand the point that I and others have been trying to make all along. You realize that the nurse's furniture/belongings pose no risk since she sought medical attention before she became ill enough to "lose control" of her bodily fluids. You understand that she hasn't contaminated inanimate objects before becoming symptomatic, the same goes for people. Think about it :)

[MissyWrite]

I think that you intuitively understand the point that I and others have been trying to make all along. You realize that the nurse’s furniture/belongings pose no risk since she sought medical attention before she became ill enough to “lose control” of her bodily fluids. You understand that she hasn’t contaminated inanimate objects before becoming symptomatic, the same goes for people. Think about it :)

I agree, she intuitively understands. Her irrational fear may be taking center stage at this time, but deep down, her innate intelligence is trying to assert itself. That's good, because intelligence is what we need right now. Intelligence and humanity, which has been in short supply. Humanity. It has a certain ring to it.

[FLAlleycat]

Ignorance and hysteria coming from the general public is frustrating, but not surprising; coming from nurses it is a disgrace.

People want to quarantine healthy people and yet refuse to get their own flu shot. Oh, the irony.

She has got a heck of a lawsuit, I hope she takes it all the way![/quote

I was wondering if quarantining everyone exposed to the flu (asymptomatic or symptomatic, I don't care) who did not get their flu vaccine would be acceptable? Would the governors back that? Probably not, even though their states will absolutely lose a few hundred constituents this season.

This is just for a humorous side to the Ebola hysteria in US . . . enjoy: