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.

[Glycerine82, LPN]

I agree with the OP. Kaci is correct, science, medicine and the law are on her side. She doesn't have Ebola antibodies, therefore she doesn't have Ebola. She isn't going to suddenly develop Ebola next week, that is ludicrous. 2 days, 21 days, it doesn't matter. She doesn't have it and holding her against her will is illegal and immoral.

Honestly, I am so disappointed in nurses; I'd have hoped they would know better. Case in point that Nursing education is in the crapper.

A- freakingmen!

[Glycerine82, LPN]

According to the following New England Journal of Medicine article, 89% of patients with Ebola presented with a fever; this means that 11% do not. This also means that health care workers returning from Africa after taking care of Ebola patients and having them self-monitor by taking their temp twice a day is not 100% effective. We need to err on the side of caution with this serious illness in order to prevent its spread. After reviewing the science, I think anyone who comes in contact with someone with Ebola needs to be quarantined for the full incubation period in order to prevent the spread of this disease. Here's the article: MMS: Error

Fever is only one symptom, and the facts (aka science) dictates it's not transmissible without symptoms. So that one huge factor. Add to that the fact that it's already been 12 days, that's factor 2. So assuming she will develop more symptoms in the next 9 days and be found to actually HAVE Ebola, its STILL not likely she would spread it to anyone, with the exception of family members, MAYBE. (Mr. Duncan did not give it to any of the people sharing his apartment).

All of those put together makes her pose NO risk to the general public.

[md777]

To recap, what this means is that 13% of Ebola patients exhibit no symptoms at all, yet they could be spreading the disease to someone else. This is very alarming. For this reason I support a quarantine for all those who have come in contact with an Ebola patient for the full incubation period. As nurses we need to be doing everything we can to prevent the spread of this serious disease. We need to be aggressive in fighting it and if we err, we need to err on the side of caution.

[md777]

Glycerine 82, not necessarily true. According to the following article, which quotes Dr. Beutner, Nobel-prize winning phyician and the New England Journal of Medicine, 13% of Ebola patients exhibit no symptoms at all and these patients could potentially be infecting other people. For this reason I think a quarantine of those of have been in contact with Ebola patients, until the full incubation period is up, is scientifically sound if we want to stop the transmission of this disease. Christie's controversial Ebola quarantine now embraced by Nobel Prize-winning doctor | NJ.com

[elkpark]

Here's some more science. The Ebola virus can survive on a surface for quite a while. This fact alone shows that we need to be very cautious with Ebola and err on the side of caution. Here's the article: The survival of filoviruses in liquids, on solid substrates and in a dynamic aerosol - Piercy - 2010 - Journal of Applied Microbiology - Wiley Online Library

Yes, that study, done in the UK, found that one specific strain of Ebola can survive for as long as 50 days on glass surfaces (only) in temperatures of 4 degrees C (39 degrees F). One strain only, on glass only, at temperatures no higher than 39 degrees F. I don't know about you, but I don't spend much time in near-freezing environments (not if I can help it :)). The vast majority of studies on the subject have found that, under normal conditions, the virus survives for no more than a few hours (or less!) to a few days.

The thing about science is that, if you look hard enough, you can always find one article, or one individual, who supports your existing opinion (kinda like the Bible -- people manage to use it to support any position that suits them). That's why one opinion, or one article, isn't considered proof of anything, and studies have to be replicated before the results are taken seriously.

Honest to goodness, if the rationales put forth on this site for quarantining those exposed to Ebola "to err on the side of caution" were extrapolated to other illnesses, we would all end up quarantined for the rest of our lives (y'know, just to be cautious ... That's good, right??)

[md777]

Elkpark, you are not being rational to compare Ebola to all other diseases, most of which don't have as high a death rate as Ebola. When you are dealing with a disease that has this high a death rate you need to be extra careful. With diseases that have this high of a death rate I support a quarantine, but yes, most diseases don't have this high of a death rate.

Kaci said the science doesn't support a quarantine. So, I decided to see if she was right. I found she is absolutely wrong. The judge that gave in to her was foolish and irresponsible and the governor of Maine is right and he should appeal this judge's decision.

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/NEJMoa1411680#t=article

And yes, Elkpark, the following Journal of Applied Microbiology says that the Ebola virus can survive on a surface for hours to days, depending on the surface and the temperature. Even a few hours is enough to infect people and therefore needs to be taken seriously when we are dealing with a disease with such a high death rate. The survival of filoviruses in liquids, on solid substrates and in a dynamic aerosol - Piercy - 2010 - Journal of Applied Microbiology - Wiley Online Library

Nurses, we need to be responsible. And yes, we need to follow the science. And the science supports a quarantine because this disease has such a high death rate. Also, I'm suspecting this disease is spread easier than we think. The reason I'm suspecting that is because of those 2 ICU nurses in Dallas who got Ebola from their patient. I'm sure they were taking every precaution and being extra careful, and yet they still got the disease from their patient. Which tells me it's spread easier than we think.

[AmyRN303, BSN, RN]

Ok, but why does this disease have such a high mortality rate? And so far, in this country, let's note that only on person has died from it, while others have fully recovered. We have resources here that we don't have in the field. I feel like the media is portraying Ebola as this scary evil virus which is not understood. Wrong. People die from hypovolemic shock. And we know how to manage that...even in my little unit I see people with hypovolemia daily. Fluid resuscitation, volume expanders, pressors, etc. before we start running around like chickens with our heads cut off, let's get down to the basic etiology of the disease process.

I feel like the general public remembers movies like "Contagion" and "Outbreak" and are hearing sinister music playing in their heads. It's inducing panic.

[Laurie52]

Isolation and Quarantine

Isolation and quarantine help protect the public by preventing exposure to people who have or may have a contagious disease.

Isolation separates sick people with a contagious disease from people who are not sick.

Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

In addition to serving as medical functions, isolation and quarantine also are "police power" functions, derived from the right of the state to take action affecting individuals for the benefit of society.

Federal Law

The federal government derives its authority for isolation and quarantine from the Commerce Clause of the U.S. Constitution.

This information was taken from the CDC website. Among the diseases that the federal government should be isolating is viral hemorrhagic fevers. Whether you agree or not, the government does have the authority to quarantine individuals.

I think this nurse, who incidentally works for the CDC, has gotten exactly what she wants, her 15 minutes of fame.

The death toll for this disease has surpassed 5000 so I think we can all agree, it is contagious.

[Rose_Queen, BSN, MSN, RN]

The death toll for this disease has surpassed 5000 so I think we can all agree, it is contagious.

In Liberia, less than 150 in 100,000 citizens have contracted the disease. In Sierra Leone, less than 100 in 100,000 have contracted the disease. In Guinea, less than 25 in 100,000 have contracted the disease. Yes, the death toll is high, but looking at those numbers, it is not easy to contract, plus you have to take into consideration the medical care in those countries (the graphics in the linked article will compare these countries to first world countries- worth a view). Taking away the civil liberties of people because they might have a disease is unconscionable. Once they become symptomatic, yes, they need to be isolated and quarantined. But we cannot live in a nation ruled by "what ifs" and "mights". That is what is leading to the irrational fear that led to politicians (in no way medical/scientific professionals who should be the ones in charge) making decisions to quarantine healthy individuals. Placating fear will backfire; scientific reason needs to be priority. Public education through reliable channels, not media looking to sensationalize for readers/viewers, is what needs to happen. As for seeking fame, I don't fault her for going public about civil rights violations. Silence and obedience without valid rationale will only lead to a further loss of rights. What would you do if your rights were being violated and no one else spoke up?

(source: Ebola in graphics: The toll of a tragedy | The Economist)

[Susie2310]

Taking away the civil liberties of people because they might have a disease is unconscionable. Once they become symptomatic, yes, they need to be isolated and quarantined. But we cannot live in a nation ruled by "what ifs" and "mights". That is what is leading to the irrational fear that led to politicians (in no way medical/scientific professionals who should be the ones in charge) making decisions to quarantine healthy individuals. Placating fear will backfire; scientific reason needs to be priority. Public education through reliable channels, not media looking to sensationalize for readers/viewers, is what needs to happen. As for seeking fame, I don't fault her for going public about civil rights violations. Silence and obedience without valid rationale will only lead to a further loss of rights. What would you do if your rights were being violated and no one else spoke up?

Did you read what the above poster md777 said? Did you read the links he/she provided? This poster discussed the possibility of transmission of the virus during the incubation period.

[Katmomto3]

The country should be UNITED in everything we do against Ebola. If some people are more comfortable with healthcare workers having a period of home quarantine upon return then do it. Science based or not, mental pandemonium is almost just as bad as an epidemic. Going to volunteer is all "your choice" (an amazing unselfish choice), so do it knowing that you must quarantine when you get home.

[houtxn]

A nurse who refuses to cooporate with medical authorities should have her license revoked.

But it isn't the medical authorities she isn't cooperating with, it's politicians she isn't cooperating with. Politician /= medical authority.