I’ve been ranting to Cathy about this for the last few weeks.
I heard on the radio a while back a round table of self-congratulatory scientists explaining why Chris Christie’s decision to quarantine medical workers who had been exposed to Ebola was politics and not science. Why? Because “Ebola is not contagious until the patient is symptomatic. That’s science. Quarantine is unscientific.” And it’s probably mean too. One of them said he would gladly go bowling with someone who is “Ebola positive” because until he’s symptomatic, he is not contagious.
And then there was the article comparing people’s reaction to Ebola to their reaction to AIDS. That one had me scratching my head. AIDS can only be transmitted in highly specialized contexts in which there is blood to blood interaction between to individuals, something that is pretty difficult to achieve in normal social contact. Ebola on the other hand is hugely infectious, so much so that even nurses and doctors who go out of their way to protect themselves can still get it! So what is the point of comparing it to AIDS? All you are accomplishing is to overshadow the already difficult set of issues with the insinuation that there is bigotry at work in the decision making process. Next it will be that people are ebolaphobic. Well you can count me in. I’m eboloaphobic.
And then there was Obama saying that he was not going close down travel from infected countries because if people want to get here they will find a way, and this will just make dealing with the problem more difficult. Really? Stopping travel from countries on the other side of the Atlantic would have no effect on potentially infected people coming here? That is just a non- argument. How would people get here anyway? In boats? It’s just a matter of refusing visas like other countries have done. If you don’t have a visa, you don’t get in. Pretty straightforward.
And then there was the argument that forcing a 21 day quarantine for health workers who are returning from infected regions of the world and have been in recent and prolonged contact with infected individuals is a bad. Less people, it is argued, will go to help fight Ebola in infected regions and the disease will continue to spread, and the whole world will be at risk. I don’t get why we always have to argue in extremes. I was relieved to hear one caller, a doctor, on a talk show who had a brain on her shoulders point out that you don’t have to quarantine health workers in tents or impose other oppressive measures. You can provide a fun and healthy environment, making the 21 day delay more of a treat than a punishment.
Then more recently NPR reported on data that is supposed to support this connection between post-assignment quarantine and Ebola fight volunteerism. It turns out that since NY and New Jersey implemented their quarantine rules, volunteer applications have gone down 17%. Left out was whether this data represented only the states in question or the entire country. Kind of an important detail because we would not expect a decision in two states to impact national figures that much. There was the brief, obligatory, mention in the report that the downturn might just be because of the holidays. Ya think?
The point is someone has a bee in their bonnet about quarantine, about it being unscientific, or about it leading to or being associated with mass hysteria, about it being based on ignorance, and maybe even rooted in that same old american bigotry that is responsible all other sorts of repression.
Here’s the thing that bug me: it’s that this is a weird kind of obfuscation of the real issue. And it really bugs me when people take the intellectual high ground while leaving huge issues addressed. Here are the reasons we are right to be very careful indeed with Ebola and should not take quarantine in one form or another off the table.
- Ebola is highly contagious. Do you really want to be the person who said “It’s no big deal” and then people died?
- You have to find a balance between fixing Ebola in Africa and keeping people safe at home. You can’t compromise on this. If that means making it harder for people to volunteer, then so be it. Health workers of all people, it seems to me, would be understanding about this. Indeed I have heard interviews of health workers that showed this.
- People’s perceptions, whether they are scientific or not, are important. That has to be considered. It can’t just be dismissed as “politics”. People do crazy things when they feel unsafe. Like the group of Ebola deniers in Sierra Leon who early on stormed one of the clinics, claiming it was all a Western lie, and carrying off sick people on their shoulders. And no, we are not so sophisticated to be above this sort of thing. We should not assume that people will behave rationally or think scientifically when it comes to the possibility of exposure to a highly contagious and fatal disease. We should not be exasperated with them about this, but realistic.
- Here’s the one that really bugs me, coming from the supposed “scientific” approach. The claim is made that a person can be Ebola positive but not contagious as long as they are not symptomatic. So no worries! Let’s go bowling with Ebola positive people. Parents, you can be Ebola positive and still hang out with your family and sleep the marital bed. But here’s the crucial question: when does a person become symptomatic? And do you want to be around when that happens? And will the individual in question even know? They wake up in the morning with a fever. When did it kick in? And when it kicks in, what guarantees that the infected individual will do the right thing? These are extremely important questions that need answering before all merrily agree with “science” and skip happily down the road hand in hand with our Ebola positive friends and neighbors.
I’m not arguing for the most extreme or most stupid approaches to quarantine. But can we think more clearly about this please and not insert all sorts of red herrings into the situation? The most important thing about an Ebola infected person is that they are a potentially deadly presence. This is science. Of course, they are human beings and should be treated with dignity and intelligence. But it’s not paranoid or ignorant to insist that this be taken with the utmost seriousness or to insist that people at a higher risk of infection be treated with the greatest possible degree of caution. And it is in no sense science to argue otherwise. Well I can only hope that if we do have a wave of actual Ebola infections in our country thinking will very quickly become un-fuzzy and focused on biological realities.