Nurse critical of quarantine
NEW YORK (AP) – The nurse who was quarantined at a New Jersey hospital because she had contact with Ebola patients in West Africa criticised the way her case has been handled, raising concerns from humanitarian and human rights groups over unclear policies for the newly launched quarantine programme.
Kaci Hickox, the first traveller quarantined under Ebola watches in New Jersey and New York, wrote the first-person account for the Dallas Morning News which was posted on the paper’s website Saturday. Her preliminary tests for Ebola came back negative.
“This is not a situation I would wish on anyone, and I am scared for those who will follow me,” Hickox wrote of her quarantine. “I am scared about how health care workers will be treated at airports when they declare that they have been fighting Ebola in West Africa. I am scared that, like me, they will arrive and see a frenzy of disorganization, fear and, most frightening, quarantine. … The US must treat returning health care workers with dignity and humanity.”
New York Governor Andrew Cuomo and New Jersey Governor Chris Christie on Friday imposed a mandatory quarantine of 21 days – the incubation period of the deadly virus – on travellers who have had contact with Ebola patients in the countries ravaged by Ebola – Liberia, Guinea and Sierra Leone. A similar measure was announced in Illinois, where officials say such travellers could be quarantined at home.
The hazy details of how such quarantines will be handled are drawing sharp criticism as infectious disease experts say enforcement logistics are up in the air. Health officials in all three states with quarantine policies did not return messages from The Associated Press seeking details about enforcement.
Cuomo on Saturday acknowledged that the policy might be hard to enforce, according to the New York Daily News.
The governor said officials had never considered whether people refusing to go along with the order could face prosecution or arrest, adding “It’s nothing that we’ve discussed, no,” the newspaper said.
In her essay, Hickox described being stopped at Newark Liberty International and questioned over several hours after touching down Friday. She said none of those who questioned her would explain what was going on or what would happen to her.
Hickox is a nurse who had been working with Doctors Without Borders in Sierra Leone. Officials said she was taken to a hospital after developing a fever, but Hickox said she was merely flushed because she was upset by the process. Hickox remained isolated in a building adjacent to the hospital, state health department officials said Sunday.
Doctors Without Borders executive director Sophie Delaunay complained Saturday about the “notable lack of clarity” from state officials about the quarantine policies, and an American Civil Liberties Union official in New Jersey said the state must provide more information on how it determined that mandatory quarantines were necessary.
“Coercive measures like mandatory quarantine of people exhibiting no symptoms of Ebola and when not medically necessary raise serious constitutional concerns about the state abusing its powers,” said Udi Ofer, executive director of the ACLU of New Jersey.
Doctors Without Borders said Hickox has not been issued an order of quarantine specifying how long she must be isolated and is being kept in an unheated tent. It urged the “fair and reasonable treatment” of health workers fighting the Ebola outbreak.
“We are attempting to clarify the details of the protocols with each state’s departments of health to gain a full understanding of their requirements and implications,” Delaunay said in a statement.
Christie, campaigning Saturday in Iowa for a fellow Republican, said he sympathizes for Hickox but said he has to do what he can to ensure public health safety.
“My heart goes out to her,” the governor said, while also noting that state and local health officials would make sure quarantine rules are enforced. He said the New Jersey State Police won’t be involved.
Health officials said preliminary tests for Ebola came back negative for Hickox but Newark University Hospital would not say if she would be released for the balance of the quarantine period or remain in the hospital.
In the very early stages of Ebola, patients may still test negative because the virus has not yet reached detectable levels in the blood. The U.S. Centers for Disease Control and Prevention says it may take up to three days after the onset of symptoms for the virus to reach detectable levels in some patients, prompting repeat testing in some cases.
Hickox’s mother, Karen Hickox, said Saturday her daughter probably wasn’t expecting to be quarantined upon her return to the United States, but is dealing with it.
“I spoke with her (Friday and Saturday),” she said. “She was more frustrated (Friday) but there were some tears (Saturday) … If you knew her, she’s a very compassionate person but she doesn’t usually get emotional.”
The quarantine measures were announced after a New York physician, Craig Spencer, working for Doctors Without Borders returned from Guinea was admitted to Manhattan’s Bellevue Hospital Center earlier this week to be treated for Ebola. Hospital officials said Saturday he was experiencing gastrointestinal symptoms and “entering the next phase of his illness.”
A senior White House official said Saturday that how to treat health care workers returning from the affected West African countries continues to be discussed at meetings on Ebola as the administration continues to take a “careful look” at its policies.
Dr Irwin Redlener, a Columbia University professor and director of the New York-based National Center for Disaster Preparedness, said the logistics of the states’ new quarantine policy are “a problem.”
“The challenge now is how you translate this quarantine plan to operational protocol,” Redlener said.
He warned that quarantines might discourage doctors and nurses from going to West Africa to help, an issue raised by aid groups and Dr Rick Sacra, one of the American health care workers successfully treated for Ebola contracted while he worked in Liberia.
“Until Ebola is under control in Africa, we’re never going to see the end of such cases coming to the United States,” Redlener said.