Standing up to the Ebola scaremongers

KACI HICKOX went on a bike ride with her boyfriend last week--and it earned her national media attention.

This "radical" act was a principled stand by Hickox--a nurse who recently returned from Sierra Leone, where she worked with Ebola patients as part of a team with the international medical group Doctors Without Borders--against the irrational and unproductive policies of U.S. officials regarding the Ebola epidemic.

Hickox has been speaking out since her return to the U.S. on October 25. Upon arriving in New Jersey, she was placed in an involuntary quarantine after a temperature scan of her forehead--after waiting three hours at the airport--read slightly higher than normal. This is a common issue with such scanners, which don't give an accurate reading of body temperature.

In fact, Hickox did not have a fever--or any symptoms of Ebola. But that didn't stop officials from "escorting" her to University Hospital in Newark and insisting on punitive quarantine policies.

Despite having no symptoms, Hickox was initially forced to stay in an unheated tent inside the hospital, with a box for a toilet and no shower facilities. "It is not the recommendation of public health and medical experts at this point." Hickox told CNN. "To make me stay for 21 days...to put me through this emotional and physical stress is completely unacceptable."

In an essay published by the Dallas Morning News after she was first quarantined, Hickox put the hysterical response of U.S. officials into perspective by referencing the devastation that Ebola has caused in Western Africa:

I sat alone in the isolation tent and thought of many colleagues who will return home to America and face the same ordeal. Will they be made to feel like criminals and prisoners?

I recalled my last night at the Ebola management center in Sierra Leone. I was called in at midnight because a 10-year-old girl was having seizures. I coaxed crushed tablets of Tylenol and an anti-seizure medicine into her mouth as her body jolted in the bed.

It was the hardest night of my life. I watched a young girl die in a tent, away from her family.

With few resources and no treatment for Ebola, we tried to offer our patients dignity and humanity in the face of their immense suffering.

The epidemic continues to ravage West Africa. Recently, the World Health Organization announced that as many as 15,000 people have died from Ebola. We need more health care workers to help fight the epidemic in West Africa. The U.S. must treat returning health care workers with dignity and humanity.

IT WAS only after threatening to sue to the state of New Jersey that Hickox was finally allowed to leave the hospital and return to her home in Maine--but not before New Jersey Gov. Chris Christie sounded off. Christie made it sound as though Hickox was an ingrate for not wanting to be locked away for three weeks in a hospital, despite displaying zero symptoms.

"There's been all kinds of malarkey about this," Christie told reporters after being informed that Hickox was contemplating a lawsuit. "She was inside the hospital in a climate-controlled area with access to her cell phone, access to the Internet, and takeout food from the best restaurants in Newark."

Christie later called Hickox "obviously ill." Contrary to Dr. Christie's diagnosis, however, Hickox tested negative for the virus and had no symptoms of the disease while in quarantine. "If [Christie] knew anything about Ebola," Hickox said, "he would know that asymptomatic people are not infectious."

On MSNBC, Hickox added, "When Governor Christie stated that it was an abundance of caution--which is his reasoning for putting health care workers in a sort of quarantine for three weeks--it was really an abundance of politics. And I think all of the scientific and medical and public health community agrees with me on that statement."

Christie joined New York Gov. Andrew Cuomo in calling for a mandatory 21-day quarantine of any medical worker returning from Africa who's had contact with an Ebola patient. Govs. Pat Quinn of Illinois and Rick Scott of Florida issued similar quarantine orders.

However, both Christie and Cuomo were forced to relax their policies somewhat after criticism from public health officials and members of the Obama administration, including Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, who called mandatory 21-day quarantines "a little bit draconian."

In reality, policies like these have the potential to make the Ebola epidemic worse by discouraging medical workers from traveling to Africa and by creating an incentive for returning health care workers to fly into other states in an effort to avoid mandatory quarantines. As New York nurse Sean Petty explained:

You're very unlikely to be able to spread the disease even when you start getting symptoms. They also haven't thought it through. If you quarantine every health care worker that's treated Ebola patients, then you have to quarantine every nurse and doctor that's treating Craig Spencer right now at Bellevue Hospital. There are 24 different nurses per day who are treating Dr. Spencer. Do all of them need to be quarantined for 21 days? Yes or no?

It's unnecessary and impractical, and has more to do with political pandering than real public health care policy and it's a shame. Also, if you have different policies in different states, than people will fly into other states to escape the quarantine and take themselves off the grid. It's a recipe for disaster.

AFTER FINALLY being allowed to return home to Maine, Hickox faced another quarantine order in that state. She pointed out that there was zero scientific rationale for officials to force her to stay in her home for three weeks, since Ebola is only contagious when people are symptomatic. Hickox said that the state's attempt to force her to stay in her home for three weeks wasn't just unnecessary fear-mongering, but illegal.

A Maine judge agreed, ruling on October 31 that the state couldn't quarantine Hickox against her will, but that she must submit to "direct active monitoring," coordinate travel with public health officials and immediately notify health authorities should symptoms appear--all of which she has been willing to do.

That didn't stop Maine Gov. Paul LePage from further smearing Hickox following the court ruling, telling reporters, "I don't trust her."

Such scapegoating is wholly unproductive when it comes to fighting Ebola in the U.S.--where so far, nurses Nina Pham and Amber Vinson have been the only people to contract the disease inside the country.

The only person currently testing positive for Ebola in the U.S., Dr. Craig Spencer, began showing symptoms in New York City after returning from treating patients in Guinea. The media wasted no time in whipping up a frenzy over the fact that Spencer had gone bowling and taken the subway.

This panicked reaction only increases the likelihood that health care workers might be discouraged from traveling to West Africa to help contain the epidemic there--where more than 5,000 have died and thousands more remain at risk.

That's why, according to Petty, Hickox should be celebrated as a hero several times over for the stand she has taken:

First, a hero for risking her life to try to fight a disease devastating one of the poorest places in the world. Second, a hero for fighting Cuomo and Christie and getting them to back down on their overzealous and idiotic quarantine order. Third, a hero for showing the world that there shouldn't be anything to be afraid of--which, among other things, may help re-inspire health care workers to go to West Africa and try to put an end to this madness.

Acknowledging the health care workers fighting the epidemic in West Africa--and stating that she plans on eventually returning to Africa to continue working against the disease--Hickox told reporters after her court victory, "They are why I'm here. I hope that one day, I can meet some of them at the airport and give them a big hug and let them know that we're in this together...This is important day for public health."

IN THE U.S., while the risk of catching Ebola remains vastly smaller than dying of the flu or contracting tuberculosis, the politicians' hysteria has already led to some ugly incidents of racism.

In New Burlington, N.J., two school children were initially kept from attending Howard Yocum Elementary School because they come from Rwanda--a country more than 2,000 miles away from the closest country with an Ebola outbreak.

In the Bronx, two young Senegalese boys were repeatedly taunted with chants about Ebola on the playground of their middle school before being physically attacked on October 25. And in Nazareth, Pa., 16-year-old Ibrahim Toumkara was taunted with chants of "Ebola" during a soccer match--and was thrown out of the match for fighting with one of the players who was taunting him.

The Washington Post recently reported that some West Africans have faced ostracism because of their countries of origin, with people refusing to shake their hands and bosses "recommending" in some cases that people not report to work.

"If I'm on the Metro, I don't talk," Alphonso Toweh, a Liberian immigrant, told the Post. "If I'm on the bus, I don't talk. If people hear the accent, they think you are Liberian, then you have Ebola, which is not the case. Not all Liberians have Ebola."

At a recent rally of Philadelphia's Liberian, Guinean, and Sierra Leonean communities called "Walk to Make a Difference: Operation Crush Ebola," Prince Kweh, a Liberian, told the Philadelphia Inquirer, "At the airport, on the train, on the trolley, people don't sit close to you. We want to send a message that we are not a virus, we are individuals."

According to Petty, the focus by the media and politicians on the supposed threat to the public in the U.S. has overshadowed actual efforts to fight the disease:

I think there's no question that the most effective public health response to this crisis is to end Ebola in Africa. The targeting and scapegoating of health care workers may have done irreparable damage to that effort. There's also the problem of undermining the actual science. When governors of states make policy that isn't backed up by science, they undermine the public's ability to validate solid information.

Basically, Cuomo, Christie and LePage are saying, "Yes, we know the CDC says they can't spread the disease, but a quarantine is necessary just in case." That's fear-mongering and creating panic.

As Hickox told reporters following her court victory:

I know that Ebola is a scary disease. I have seen it face to face. I know we are nowhere near winning this battle. We'll 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.