Quarantines for Ebola Health Workers Don't Stop the Disease


November 08,2014

Fear of Ebola has spread around the world. Some countries have closed their borders to citizens of Liberia, Guinea and Sierra Leone. In the United States, returning health workers have been verbally attacked and, in at least one case, confined to an unheated outdoor tent in chilly autumn temperatures.

Nurse Kaci Hickox was forced into a mandatory quarantine in a cold tent outside a New Jersey hospital after returning to the U.S. from Sierra Leone. Hickox did not have a fever or other symptoms of Ebola. New Jersey Governor Chris Christie ordered the quarantine and defended his move.

"We are not going to take any risks with the public health in New Jersey," said Christie.

Only two Americans, both nurses, contracted Ebola at a Dallas hospital from a Liberian man who died from the virus. One nurse flew to Cleveland before coming down with the telltale fever.

Infectious disease experts say the risk of getting Ebola, even from someone who has just started a fever, is very low.

Dr. Alan Magill spoke by Skype from a conference in New Orleans, where Ebola experts were to gather -- except the governor of Louisiana imposed mandatory quarantines on anyone who had been to West Africa, even if they had not come into contact with Ebola patients.

"Intimate contact with infectious bodily fluids is how people get infected. That is typically not what is seen on an airplane," said Magill.

Stephen Morrison works on global health issues at the Center for Strategic and International Studies. He said the quarantine is not based on science, but it works for the governors.

"They are trying to minimize risk. They are also trying to control public panic and fear," he said.

Morrison said the governors also were trying to curry favor with voters in an election year. Public opinion polls indicate 75 percent to 80 percent of Americans want returning health workers to undergo a mandatory 21-day quarantine after treating Ebola patients, even if they do not have a fever. But experts say mandatory quarantines can backfire. They can discourage health workers from volunteering.

"I think the overriding priority is to end the epidemic, so that means we make it as easy as we can for our workers to go and to come back," said Magill.

After three days, Hickox was allowed to return to her home in Maine, where the state’s governor ordered her to stay indoors under a mandatory quarantine. She refused to follow it, took her case to court and won. But, she said, more needs to be done.

"We will only win this battle, as we continue this discussion, as we gain a better collective understanding about Ebola and public health, as we overcome the fear, and most importantly, as we end the outbreak that is still ongoing in West Africa today," she said.

Hickox is now allowed to leave her house, but has agreed not to go to populated places.