Art credit: littlebigplanet.wikia.com
Ohioans had a scare recently when a nurse with the Ebola virus flew in and out of Hopkins Airport. Were Ohioans' fears justified or unwarranted? Betsy McCaughey is an excellent resource on healthcare,
including Obamacare and the Ebola virus. Here’s her column from National Review online:
OCTOBER 31, 2014 6:18
PM
The Evidence
Demands Ebola Quarantines
We can applaud health workers and take the
prudent steps at the same time.
President Barack Obama and Kaci Hickox, a nurse who returned from
treating Ebola patients in Sierra Leone on October 24, are attacking states’
efforts to keep returning health-care workers away from the public for 21 days.
Governors in New Jersey, Illinois, Maine, Connecticut, and other states say it’s a wise precaution to prevent the virus
from possibly spreading. But Obama claims that these regulations are based on
fear, not science. And Hickox has successfully defied Maine’s effort to
restrict her to her home, bashing the quarantine as “unnecessary” and “not
evidence-based.” Judge Charles C. LaVerdiere ruled on Friday that Hickox is
free to travel without restrictions.
But, in fact, science is
against Obama, Hickox, and the judge. Evidence shows that to protect the
public, travelers from Ebola-plagued West Africa, especially doctors and nurses
who battled the virus, should be quarantined for 21 days.
Fever
Monitoring Is Unreliable
At least 100 people, including about five health-care
workers, enter the U.S. each day from Ebola-infected countries in West Africa.
At departure from there and arrival here, their temperatures are checked by
airport workers. But data from over 4,000 Ebola cases (the most complete
analysis ever) published October 16 in the New England
Journal of Medicine show that 13 percent of patients don’t develop a fever
early on.
Thomas Duncan, who brought
Ebola to Texas and infected two nurses, was able to get through fever
screening. It also failed to identify Craig Spencer, the physician with Doctors
without Borders, who returned home to New York infected with Ebola and then
went bowling, dined out, and took the subway. Now he is fighting for his life
in Bellevue Hospital, and public-health officials are scrambling to identify
the people who may have been exposed to him.
Spiking temperatures
eventually alerted Duncan and Spencer. But the research shows that in 13
percent of Ebola cases, the patient is already quite ill and diagnosed with the
virus but still does not have a fever.
Are Americans At Risk Of Catching
Ebola?
For most Americans, the
known risk of catching Ebola is currently small. Ebola is most contagious in
the later stages of illness, when victims here presumably would be in a
hospital, putting hospital workers at severe risk but not the rest of us.
Better sanitation facilities here than in Africa make it less likely that
Americans will be exposed to infectious bodily fluids.
Less likely, that is, but
not impossible. An infected person’s saliva can contain numerous virus
particles. When scientists say Ebola is not “airborne,” they mean the virus
doesn’t remain suspended in the air after the infected person leaves the area.
But Ebola might be contagious if the infected person coughs or sneezes, sending
droplets several feet. If droplets land in one’s eye, nose, or mouth or on a
cut or opening in your skin, it’s possible to get Ebola. On October 23, the CDC
edited its website to include this kind of transmission. Sharing finger food
from a common plate with someone infected with Ebola also could put you at
risk, according to research in the Journal of Infectious Diseases.
What about touching a
subway pole, door knob, or bowling ball? Unlike staph and other bacteria that
can last weeks on dry surfaces, viruses last only a few hours, and there is no
research confirming transmission that way. A 2007 study in The Journal of
Infectious Diseases shows that the virus can survive on objects much longer
if it is embedded in blood, for example, a bloody bandage, tampon, or tissue.
The CDC also included this information in its October 23 update, only seven
years after the research became available. Better late than not at all.
Then there’s the risk of
using a toilet right after an Ebola-infected patient has used it and flushed. A
bacterial infection common in hospitals, Clostridium difficile, is known
to spread that way. Investigators from the University of Illinois School of
Public Health make the connection: “Regarding diarrhea, even
when contained by toilets, toilet flushing emits a pathogen laden aerosol that
disperses in the air.”
These unknowns would humble
any scientist confronting a virus that has no cure for the infected and no
vaccine to protect the public. But not the Obama administration.
Why Not Just Test For It?
Kaci Hickox tested negative
for Ebola shortly after arriving in the U.S. and finding herself detained under
Governor Christie’s new 21-day quarantine policy. But Ebola lab tests (both
types available) don’t show the virus until the patient develops symptoms, and
even then they can give false negatives for a few more days, explains Dr. Sandro Cinti, an
infectious-disease specialist at the University of Michigan Hospital System.
Don’t Hazmat Suits Keep Workers Safe?
The CDC insists that
doctors and nurses working in Africa are not at a high risk of carrying Ebola
home because they wear protective gear. Not so fast. The World Health
Organization reports that 521 health-care workers have
contracted Ebola so far this year and 272 have died. Some had inadequate
equipment or training, but the fatalities include many with experience and full
protective gear. According to infectious-disease experts at Johns Hopkins, the gear,
though helpful, “is simply not enough.” That’s because there is no room for
error in removing it once it’s contaminated with vomit, diarrhea, or blood.
“The smallest mistake can be fatal,” Peter Piot, a renowned virologist who
co-discovered Ebola, has said.
It’s no wonder that Samaritan’s Purse, a relief
organization in North Carolina, imposes a 21-day isolation period on workers
returning from Ebola-affected countries. Similarly, hospitals require Ebola
volunteers to stay out of work for 21 days after their return to the U.S.
Hickox insists she’s
healthy. Let’s hope so. But the same New England Journal of Medicine
analysis of 4,000 Ebola cases shows that health-care workers are no quicker to
identify their own illness and get to a hospital than others.
Stigmatizing Or Honoring?
Hickox objects that Ebola volunteers are being
“stigmatized.” President Obama, sounding like the nation’s schoolmarm-in-chief,
lectured us on Wednesday that when these
volunteers come home “they deserve to be treated properly. They deserve to be
treated like the heroes they are.”
They are heroes, including
Kaci Hickox. But that doesn’t mean they shouldn’t be quarantined. On Monday,
the Joint Chiefs of Staff recommended that all U.S. troops returning
from West Africa undergo a 21-day quarantine. They’re heroes too.
There is no stigma to being
quarantined: Our heroic astronauts who landed on the moon were quarantined on their return, to be sure
they were not carrying unknown pathogens.
Obama is creating a false
choice by saying we have to applaud health-care workers instead of quarantining
them.
We should do both.
— Betsy McCaughey is
chairman of the Committee to Reduce Infection Deaths and a senior fellow at the
London Center for Policy Research.
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