Stricter quarantines for dealing with potential Ebola cases in the U.S. could discourage health workers from volunteering in the impacted West African countries, thereby making the outbreak harder to contain, experts say.
New York, New Jersey and Illinois announced mandatory 21-day quarantines for those arriving back in the United States after having direct contact with Ebola-infected individuals in West Africa. The outbreak — the largest in history — has left more than 10,000 people infected and nearly 5,000 dead, the World Health Organization announced Saturday.
"It may be politically the obvious thing to do but it may well be counterproductive," said Stephen Morse, an epidemiology professor at Columbia University. "If people are forced to quarantine for three weeks that means most of them will not be able to do any sort of work and that means essentially lost income."
The new mandates are also worrisome since people in the general public, if included in mandatory quarantines, may be less likely to come forward if they have symptoms because such measures will increase the stigma surrounding the virus, Morse added.
"We need to rethink this with science and reason," said Robert Glatter, an emergency medicine physician at Lenox Hill Hospital, located in New York City's Upper East Side. "It's going to discourage health care workers from going out to the source, which is where we need to be."
A health care worker — who treated Ebola patients in West Africa and is being quarantined at University Hospital in Newark, N.J. — tested negative for Ebola on Saturday, health officials said. The nurse revealed her identity as Kaci Hickox in a first-person story published Saturday by The Dallas Morning News, where she criticizes the treatment she received when she arrived at Newark Liberty International Airport on Friday.
"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," Hickox writes. "I am scared that, like me, they will arrive and see a frenzy of disorganization, fear and, most frightening, quarantine."
In announcing the new quarantine mandates, New York and New Jersey said they will work to establish an interview and screening process to determine a person's risk level by considering where they traveled and their level of exposure to the virus.
"Depending on the risk level, a person could require mandatory 21-day quarantine, or at a government-regulated facility," New York Gov. Andrew Cuomo said. "Low-risk would be regularly monitored for temperature and symptoms. Others will have a protocol developed to fit their particular circumstances."
New York's first Ebola patient is Craig Spencer, a 33-year-old emergency physician being treated in an isolation unit at Bellevue Hospital Center after he tested positive for virus Thursday. He recently returned from Guinea where he volunteered for international health care group Doctors without Borders.
While there have been no confirmed Ebola cases in Illinois, Illinois Gov. Pat Quinn said he was enacting the measure because quarantines are "too important" to be voluntary.
"We must take every step necessary to ensure the people of Illinois are protected from potential exposure to the Ebola virus," he said.
Morse said he expects other states will enact similar rules, adding the federal government might also get on board to take action as fear of the virus spreads.
"They will be under pressure to be seen as trying to 'protect the public,'" Morse said of federal officials.
Still, the measures could provide peace of mind to a wary public, said Albert Wu, a professor of health policy and management and an attending physician at Johns Hopkins University.
"I suspect that this mandatory quarantine wouldn't add very much except for providing reassurance for people panicked by the idea," he said.
So far, 10,141 people in Nigeria, Senegal, Guinea, Liberia, Mali, Sierra Leone, Spain and the United States have been infected by the disease, according to the World Health Organization. The group said 4,922 people have died from it.
"This is just the tip of the iceberg," Glatter said. "There are many cases to come."
0 comments:
Post a Comment