Kaci Hickox, the nurse who battled the states of New Jersey and Maine to end her mandatory Ebola quarantine last October, can take some satisfaction in a new rebuke from President Obama’s bioethics advisory panel.
In a report released today, the Presidential Commission for the Study of Bioethical Issues concluded that states like New York and New Jersey that tried to impose mandatory 21-days quarantines for anyone who had contact with Ebola patients in West Africa acted without regard for science or ethics.
Ebola is only contagious when people are showing symptoms, but people can start to show symptoms within a 21-day incubation period. Hickox, who showed no symptoms on returning to the U.S. but was detained in a tent at Newark Airport for three days, became the de facto spokesperson for health workers who were outraged over the unnecessary restrictions of these policies.
“Needlessly restricting the freedom of expert and caring health care workers is both morally wrong and perilously counterproductive,” says Amy Gutmann, chair of the presidential commission, which released its findings on the U.S. response to the Ebola crisis in the report.
“In addition to violating basic freedoms, the unnecessary quarantines do not save lives–they lose lives. They lose lives by taking expert health care providers out of commission and discouraging them from coming forward.”
Last year, there was a large gap between the seriousness of Ebola in West Africa, where more than 9,000 people have died to date, and U.S. public’s health and safety fears on its own soil, where only four people were diagnosed with the virus. By late October, at the height of Ebola news coverage, a poll suggested that 40% of Americans were worried that they or someone they loved would contract the virus. Some politicians argued for measures–such as stopping all flights from West Africa to the U.S.–that would soothe fears but actually harm the cause of battling the epidemic in West Africa by making travel more difficult for aid workers and further destabilizing the region’s economy.
New Jersey Governor Chris Christie and New York Governor Andrew Cuomo were both responding to these fears when they announced the quarantine policy, after Craig Spencer, a recently-returned U.S. health worker, came down with Ebola in New York City. (Both states ended up reversing their mandatory quarantines after several days of blow back from scientists, the press, and the federal government.)
In an essay published in the New England Journal of Medicine this week, Spencer wrote of he and his fellow workers being treated like outcasts: “Instead of being welcomed as respected humanitarians, my U.S. colleagues who have returned home from battling Ebola have been treated as pariahs.”
The report offers seven recommendations based on the overall U.S. response to the outbreak, which was quite slow before becoming overly draconian. Some of the suggestions include strengthening the World Health Organization and the U.S. Public Health Service; developing communications strategies that ease public fears, spread science-based information, and minimize discrimination; and using “the least restrictive means necessary” to protect public health.
The quarantines, had they stayed in place or take place during future Ebola outbreaks, were an overkill response not based on science. Regular daily temperature monitoring would do, volunteer organizations like Doctors Without Borders said. What both the group and the bioethics panel worries most is policies like this do broader harm by discouraging health workers from volunteering in the first place.
“There are second order impacts of things you don’t do,” says Colonel Nelson Michael, director of the U.S. Military HIV Research Program, and another member of the commission.
Gutmann says that the U.S. government needs a better response to ward off panic, from the public and public officials: “There’s no doubt, and history shows this, that epidemics instill fear and panic,” she says. “It is the responsibility of public officials and the media to get information out as early as possible and as often as possible.”
You can read the full report here.