Support Kaci Hickox

[nurse2033]

She is the nurse who returned from Africa and was placed in quarantine despite not being sick. I'm not going to give all the details here, they are readily available online. I support her position and hope you do too. She is not sick, she should not be quarentined.

[wtbcrna, MSN, DNP, CRNA]

I feel ya about CC. He's a total jerk. But you have to understand. Even the most expert highly trained medical professionals make mistakes. Nothing is 100%. I just posted article from Dr C. He did everything right and still got infected with ebola. You have to understand africa is third world. They lack basic necessities like clean food and water. Even if kaci followed infection control measure to a t. She is not immune. In some places they were dumping dead bodies in the water sources! I mean how can you control that? Hcw have to eat and drink while there. Africans have certain rituals and burial methods. Well that goes in the soil. Walk without shoes on and your screwed. I mean come on. Use some common sense here. Africa doesn't have the best sanitation. So when these hcw come back to the us we better be keeping an eye on them! It pretty simple really. Maybe mandatory quarantine is not necessary but we must do everything we can to track and monitor these hcw when they come back.

All HCWs that took care of ebola patients are required to be monitored for at least 21 days post-exposure.

"IDSA Statement on Involuntary Quarantine of Healthcare Workers Returning From Ebola-Affected Countries

The Infectious Diseases Society of America strongly supports measures to minimize the risk of Ebola Virus disease (EVD) transmission in the US from travelers returning from Ebola-outbreak-affected countries. Many such persons are healthcare providers and other humanitarian aid workers, risking their personal health and safety in the fight against a large-scale and worsening outbreak that represents a global public health emergency. Controlling the Ebola outbreak at its source in West Africa is the most important way to end this ongoing humanitarian disaster and the corresponding threat of spread of Ebola to the US and other countries.

Strategies to limit the potential for EVD transmission from returning healthcare and humanitarian aid workers as well as from other travelers should be based on the best available medical, scientific and epidemiological evidence; be proportional to the risk; balance the rights of individuals and the community; minimize unintended negative consequences; and minimize unnecessary use of limited resources. For these reasons:

IDSA does not support mandatory involuntary quarantine of asymptomatic healthcare workers returning from Ebola-affected areas. This approach carries unintended negative consequences without significant additional benefits.

We support the policies promoted by the US public health experts at the Centers for Disease Control and Prevention and the National Institutes of Health. Furthermore:

• Active monitoring by public health authorities of persons who have recently been to Ebola-affected countries for the 21-day Ebola virus incubation period with prompt identification, isolation, and medical evaluation of all persons who develop symptoms is an effective strategy to limit transmission.
  
• Systems are in place to ensure prompt identification and isolation of all symptomatic persons at risk for EVD through both exit screening in Ebola-affected countries and comprehensive arrival screening of all persons traveling to the US from Ebola-affected countries.
  
• Asymptomatic persons are not known to represent a risk for EVD transmission. Transmission of EVD requires contact with the bodily fluids or blood of an ill person. Community contacts of a newly symptomatic EVD case are very unlikely to be at risk for EVD transmission.
  
• Because the transmission of EVD requires bodily fluid or blood contact, mandatory quarantine of asymptomatic healthcare workers who are expected to comply with active health monitoring by public health authorities provides no substantiated benefit and little, if any, theoretical benefit. Mandatory quarantine may also adversely impact the ability of US healthcare workers to participate in the care of suspected and confirmed Ebola patients.
  
• Mandatory quarantine may have the negative, unintended consequence of limiting the medical response in West Africa to EVD supported by national policy and humanitarian aid agencies. This medical response is critical to provide ongoing support for outbreak control activities in West Africa where medical support is desperately needed. Further, mandatory involuntary quarantine requirements may decrease the willingness of US healthcare workers to participate in the evaluation and care of persons with suspected and confirmed EVD both abroad and in the US.
  
• Quarantine authority remains an important option that exists at state and local levels and can be invoked as necessary by public health authorities for high-risk circumstances. Policies on quarantine can be revised as necessary in response to new information."
  

IDSA : Ebola Quarantine Statement

Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure | Ebola Hemorrhagic Fever | CDC

[Crazynut]

I was just pointing out similar things i had said. Obviously we do not agree on mandatory quarantines. But that doesn't mean that my points arent valid. People don't realize how little research we have on ebola in humans. There's alot of lab research on animals. Isolating markers etc. but compared to other diseases we have little research on the effects on humans. Because its so deadly the patients die before we can perform the research. I mean can you imagine conducting a double blind study in african hot zones. No running water or electricity. There is still alot we dont know about it. And I'm glad he pointed that out.

[Crazynut]

Honestly most of those guidelines I agree with. It seems reasonable. They main issue for me are gray areas. Like a hcw that is just starting to feel sick. But they still go out in public anyways. Where do you draw that line? I think we need to have strict monitoring from experts. And clear guidelines. Because remember the CDC was the ones that told Amber she could fly. Then they threw her under the bus said she shouldnt have flown. Like facepalm. Lol from what we do know ebola progresses quickly. Say an exposed hcw is on a 10 hr flight across the country. They progress to vomiting in flight. I mean you just never know. I dont think they should be thrown in jail. But I think they should lay low for a few weeks after returning from hot zone areas. Theres a difference between isolation and quaratine. Dont be going to a football game where there's thousands of people. Just use some common sense. When I'm not feeling good. Even if im not sick yet. I just feel crappy. I keep my butt at home! I may run the store pick up a few things. But then i come home lay low and rest! Its called common sense!

[Crazynut]

Oh and I dont agree that quaratines will affect people deciding to go help out. There's no evidence to support that claim. Just a general theory. Read the wording. It says it may cause it. Lol lawyer speak. Bottom line is we have ways to get aid to africa with or without quaratines.

[Crazynut]

Why do my creditial matter? Are you an ebola expert? It doesnt take an expert to read research articles and form an opinion. We are all entitled to our own opinions. I use except on this site. I dont understand why people feel the need to jump on the band wagon and attack someone that has a differing opinion.

[Crazynut]

You cant prove your argument right just like I cant. Im just presenting my side. Really none of us are right because the best solution is a balance between both sides. But seriously how do you not understand why i posted that article? To understand ebola you have to understand mode of transmission. In order to stop the spread you have to know how its spread! Oh and pm me with your NIH contact. I have a friend that has worked there for 20 yrs. i wonder if we know the same person!

[Horseshoe, BSN, RN]

Each state has their own laws. Some more strict than others. CA is dealing with this right now over measles. It just really bothers me that my fellow nurses don't understand the importance of public health. That you think one persons civil rights are more important than the health and well being of an entire community. OP commented that it is shown that it is not contagious until person is symptomatic. But that doesn't totally exclude the possibility that an asymptatic person can be contagious. Look at HIV. A person can be infected and asymptomatic for decades! They can still spread the disease. Obviously the higher viral load the more contagious. Everyone is different. Each person has different reactions. Why take that chance with something as deadly as ebola? Kaci knew the risks when she went over there. It comes with the territory. She should have know she would have some sort of isolation. I mean did she really think she could go to hot zone area and then go back to work the next week??? I would not want her to be my nurse! We can argue this until we are blue. Public health > civil rights. So until there is new case law that sets precedent that will not change.

Why should Kaci have known she would be forcibly quarantined when she came back? HCW treating ebola overseas have been coming back for DECADES with no forced quarantines. But for some reason this nurse should have foreseen that SHE would be the exception?!

Your post is nonsense.

[Horseshoe, BSN, RN]

http://m.jid.oxfordjournals.org/content/196/Supplement_2/S142.full?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Ebola%20transmission%20&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

My issues have always been mode of transmission, and when is it transmitted. This article found ebola in breast milk and semen even after it has been cleared from the blood. But the study is flawed as the ebola outbreaks are in africa which is third world. If you read journal articles about ebola you will find alot of them are flawed in some way. Just because it is so hard to research it in a third world place during a devastating outbreak. Which is why I previously commented that the science is weak. Its hard to get accurate results in africa.

Okay, well, let's look at how ebola "behaved" here in the US. Mr. Duncan traveled to Texas from Liberia after he was infected with ebola but not yet symptomatic. He sat on airplanes in Europe and in transit to the US before becoming symptomatic. Number of people infected: ZERO. He had contact with many people in Dallas, Texas both before and after he became symptomatic. He went to the ER with symptoms but was sent home, misdiagnosed. He became extremely ill. Yet NOT ONE of his close contacts became ill with ebola. Not his friends, not his very very close contacts at his apartment, none of the ER nurses with whom he interfaced, none until he came back the second time with a viral load through the roof.

Amber Vinson: traveled on mass transit while already infected both before and after she began experiencing symptoms. She infected NOT ONE person.

Nina Pham: was infected and had contacts with her boyfriend and others both before and after symptoms began. She infected NOT ONE person.

Dr. Craig Spencer: Arrived to NYC already infected with ebola. Interfaced with MANY people before he was symptomatic. Galavanted all over town one day before running a fever. Number of people infected: ZERO.

Asymptomatic health care workers have been coming back from Africa iwith no enforced quarantines after treating ebola patients for decades. Where has your outrage been all these years?

[Horseshoe, BSN, RN]

I dont think they should be thrown in jail. But I think they should lay low for a few weeks after returning from hot zone areas. Theres a difference between isolation and quaratine. Dont be going to a football game where there's thousands of people. Just use some common sense. When I'm not feeling good. Even if im not sick yet. I just feel crappy. I keep my butt at home! I may run the store pick up a few things. But then i come home lay low and rest! Its called common sense!

If you believe the above, then why the hell did you come on here criticizing Kaci Hickox for not wanting to be IMPRISONED when she was not sick?! She had every intention of following the current protocol for HCW coming back from Africa by monitoring her symptoms and calling the appropriate authorities the MINUTE she began experiencing symptoms. There was NO NEED for her to be forcibly jailed when she arrived back to the US and I don't blame her one bit for refusing to be a puppet for Chris Christie's political aims. Just because other people are passive and willing to cave and give up their rights to appease irrational fear does not mean Kaci Hickox was required to do the same.

Ridiculous.

[wtbcrna, MSN, DNP, CRNA]

Crazynut, there numerous research studies on humans with ebola, if you are saying there are not any human RCTs with ebola then that is correct and I would doubt there ever will be. There are decades of research on ebola, but like any other deadly contagious disease process there are never likely to be RCTs where one group is purposely exposed to the virus/disease. That doesn't mean we do not know enough to safely deal with ebola. The biggest problem Ebola in these other countries are cultural and hygienic practices that make containment and crossover from animals relatively easy and difficult to isolate. The U.S. and other 1st world nations do not experience these problems d/t are already effective public health measures, which do not include mandatory quarantine of asymptomatic individuals that have shown no sign of disease.

Also, your credentials absolutely matter when you state you have done research, complain that no one else reads scientific articles, and you fundamentally disagree with every national and internationally recognized public health agency.

[BostonFNP, APRN]

I do agree we should forcibly quarantine all the anti-vaxers but that's a different debate

Sent from my iPhone.

[BostonFNP, APRN]

Sent from my iPhone.