Ebola: Health Care Heroes Become Political Football

Epidemiology experts agree that there is no medical reason to quarantine asymptomatic health care workers who have been exposed to Eboli. Despite all the information available about how this virus is spread and the fact that it is not airborne, the governors of several states have decided to err on the side of panic that has been fostered by some media outlets, imposing unnecessary, and quite possibly, detrimental 21 one day quarantines on health care workers returning to the United States from regions of the world where they may have cared for patients with Ebola virus disease.

On Friday, New York Gov. Andrew Cuomo (D) and New Jersey Gov. Chris Christie (R) rolled out aggressive policies requiring quarantines for individuals who have had direct contact with Ebola patients in Liberia, Sierra Leone or Guinea. After federal officials and the medical community slammed the policies as scientifically unnecessary, the governors clarified on Sunday that the 21-day quarantine could be completed at home.

Though New York and New Jersey have received the most press attention, they’re not the only states that have done an about-face recently. Illinois, which on Friday implemented a mandatory stay-at-home quarantine policy, clarified on Monday that the policy excludes “medical workers who wore protective clothing,” the Chicago Tribune reported. But high-risk medical workers who have had direct contact with the skin or bodily fluids of an Ebola-infected person are still required to stay home in quarantine. [..]

Not all states have moved to a mandatory policy. Virginia Gov. Terry McAuliffe (D) announced on Monday that the state would be actively monitoring travelers from West Africa, but said quarantine for high-risk patients is voluntary for now.

That some states are going above and beyond the CDC’s recommendations certainly hasn’t escaped Frieden’s notice. On Monday’s call, he offered a word of caution about unintended consequences. Quarantines, he argued, would end up discouraging health care workers from going to West Africa in the first place. And should the disease continue to ravage that part of the globe, “the risk to us will increase,” he said.

“We will only get to zero risk by stopping it at the source,” said Frieden.

Since then the governors of Florida, Maryland and Maine, where Nurse Kaci Hickox, who has tested negative for Ebola lives and will be confined, have imposed similar draconian, irrational policies. Two weeks ago Connecticut Governor Dannel Malloy declared a health care emergency giving  the state’s public health commissioner broad power to quarantine anyone exposed to or infected with the Ebola virus. Why? Because, you know, it’s an election year. It is a despicable tactic playing on the unfounded fear that something might happen. This is making the heroes in the battle to save lives and halt the epidemic in West Africa pariahs. If this sounds familiar, it is. It is precisely what happened after 9/11. The fear that there would be another terror attack let to Americans forfeiting many of their freedoms in the name of some false security.

MSNBC’s Rachel Maddow described the confusion over Ebola quarantine policy for people returning to the US from countries crisis with Ebola as state governors abandon science-based recommendations and scramble to appease irrational public fears.

Unfortunately, as Peter van Buren points out in his article at FDL’s The Dissenter, this is all legal under the Commerce Act of the Constitution and the Public Health Service Act:

The federal government derives its authority for isolation and quarantine from the Commerce Clause of the Constitution. Under the Public Health Service Act, the Secretary of Health and Human Services is authorized to take measures to prevent the entry and spread of communicable diseases.

The authority for carrying out these measures is been delegated to the Centers for Disease Control and Prevention (CDC). Under 42 Code of Federal Regulations parts 70 and 71, CDC is authorized to apprehend, detain, and examine people arriving to the United States and traveling between states who are suspected of carrying communicable diseases. [..]

That said, the power to detain and quarantine often is left to the states, and both New York and New Jersey law provide for it. New York allows the decision to be challenged in a magistrate court; New Jersey does not have a similar law, though technically any form of detention can be broadly challenged under habeas corpus. But good luck with that- the Florida Supreme Court laid down the precedent in saying “The constitutional guarantees of life, liberty and property, of which a person cannot be deprived without due process of law, do not limit the exercise of the police power of the State to preserve the public health so long as that power is reasonably and fairly exercised and not abused.”

Peter also points out the ineffectiveness of this quarantine and the obvious political ploy to gain votes from a panicked public:

The New York and New Jersey quarantine laws at present only apply to a) health care workers b) returning from African “hot zone” countries through c) only two airports, JFK and Newark who d) had contact with ebola. That’s a very select group, chosen largely because New York’s sole ebola patient fit that exact profile. Persons such as regular travelers who fit the same profile,or persons who just flew internationally with the profiled individuals, are not included.

In addition, the New York and New Jersey plans seem to rely 100 percent on individuals who fit the profile self-identifying themselves for the mandatory quarantine. Anyone who wished to avoid it, especially a health professional who knew s/he was not an active carrier based on clearly identifiable and well-known symptoms such as a high fever, could just dummy up at the airport. Alternately, s/he could route flights to land somewhere else and take the bus home to Manhattan. [..]

Quarantining actually infectious people, who may indeed be a danger to public health is one thing. But like taking off our shoes and other security theatre that followed 9/11, the quarantine plan seems designed more for show than any hint of practicality.

Is it just a political ploy to garner votes from a panicked public?

Oh my yes. All of the state governors who pushed the plan through without the endorsement of the CDC or New York’s mayor are in election battles. The governors of New York, New Jersey, Illinois and Florida are up for reelection in about a week, and New Jersey governor Chris Christie is famously testing the waters for a possible 2016 presidential run. New York’s mayor is not up for reelection for years.

Fear-mongering works; ask any politician who has beaten the drum of “9/11, 9/11, 9/11″ since, well, 9/11. People are scared, mostly based on ignorance fanned by media who themselves seek to profit from fear.

That sort of disease seems more dangerous in the long run than a handful of ebola patients.