Experts: Quarantines may dissuade Ebola volunteers

[TomCADem]

Source: USA Today

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.

Read more: http://www.usatoday.com/story/news/nation/2014/10/25/ebola-stricter-quarantines/17900749/

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It is a wonder that nurses do not just boycott treating future Ebola patients. You have to wonder whether the private Texas hospital compensated the two nurses who were infected with Ebola, though maybe it is covered by workers' compensation, which would also bar any potential civil claims against the hospital.

[TwilightGardener]

1. What "work" would they be doing immediately? If these are health care personnel,

they should know that they shouldn't immediately jump back into patient care after arrival. I don't think three weeks bumming around at home is too much to ask. You shouldn't be near patients right after jumping off a plane from other countries where you had direct contact with very bad pathogens. Edit again to add: for health workers HERE, the hospital should do whatever it takes, and provide full pay, to allow their employees to care for ebola patients and stay home for three weeks afterward--transportation, meals, etc.

[Louisiana1976]

13. Exactly. Any health care worker who's under quarantine for three weeks should receive full pay.

[Travis_0004]

32. I dont think the issue is in US hospitals

A hospital can and should pay their employees if they quartine somebody for 3 weeks.

The issue comes fron a doctor or nurse who might be able to take off 3 weeks to volunteer helping ebola victims, but can not afford to take off 6 weeks if there is a quarine when they arrive back home.

[Man from Pickens]

28. yes

It's a direct consequence of the failure of others to do the right thing and play it safe. If you're going into a "hot zone", quarantine on return is a reasonable and sensible precaution - it shouldn't come as a surprise or be seen as an imposition, it should be part of the job.

[seabeyond]

29. what failure. self monitor has been 100% successful. at this point. nt

[whistler162]

30. And yet it hasn't....

http://abcnews.go.com/Health/ebola-nurse-violated-guidelines-flying-commercial-jet/story?id=26206090

[seabeyond]

31. temp of 99.5, cdc has it at 100.4. she self monitored and called cdc. she was not contagious,

and she gave no one the illness.

self monitoring has been, henceforth, 100% effective.

[uppityperson]

2. Nurses, doctors are trusted with life/death situations but not to self monitor properly?

"It may be politically the obvious thing to do but it may well be counterproductive". Indeed.

[bananas]

4. If you trust the nurses, you should sign their petition

They are asking you to, if you really trust them, show it by signing their petition:
http://www.nationalnursesunited.org/page/s/national-nurses-united-urges-you-to-take-action-now

[uppityperson]

6. Done before now, thanks for posting the link again.

[bananas]

8. Thank you! nt

[Psephos]

7. Some have already shown they do not self-monitor properly.

This is not theoretical.

http://seattletimes.com/html/nationworld/2024776084_apxebolanbc.html

http://www.cbsnews.com/news/ebola-outbreak-what-we-know-about-patient-dr-craig-spencers-movements/

Doctors can be the worst patients.

[uppityperson]

9. Do you understand the difference between self monitor and quarantine? Dr Spencer did proper

self monitoring, called for help when he got a fever, even though it was below what CDC considers reportable. Dr Spencer did a really good job of self monitoring.

Quarantine is when you are not supposed to leave a facility, room, home, etc. Self monitoring if taking your temperature, watching for other symptoms. Dr Spencer did it right. Nancy Snyderman broke quarantine, not self monitoring.

[Psephos]

14. I understand - do you?

He's costing uncounted thousands of dollars or more to figure out where he went and whom he contacted.

Semantics are not my standard of judgment. Effects and results are.

[uppityperson]

18. Dr Spencer self monitored properly. He did not self isolate. They are different things, like

Teaparty and Democratic party. It is not semantics but different things. Like influenza, norovirus, ebola are different things.

Dr Spencer self monitored properly, and Nancy Snyderman broke quaratine.

[Psephos]

19. He should have self-monitored whether he was self-isolating. n/t

[uppityperson]

20. He DID. He took his temperature regularly, called for help when it rose even though CDC said it

wasn't high enough to call. He watched for symptoms and when they began he called the authorities. That is what self monitoring is.

He. Did. Self. Monitor.

That is what he did. Self monitored.

He caught it early when symptoms were just starting, called for help.

[Psephos]

25. he. should. have. self. isolated. n/t

[uppityperson]

27. Changing goal posts there. Why should he have self isolated?

Some have already shown they do not self-monitor properly.

Do you understand the difference between self monitor and quarantine?

"I understand - do you?....Semantics are not my standard of judgment."

It is not semantics but different things.

"He should have self-monitored whether he was self-isolating"

He did self monitor.

"he. should. have. self. isolated."

Good, you are finally getting to your point. You understand the difference between self monitoring and self isolating. Good.

Why should he have self isolated when he was not contagious?

[candelista]

33. Why self isolate? The answer is obvious.

You asked, "Why should he have self isolated when he was not contagious?"

Because he might become contagious. Which is exactly what happened. He is now in the vomiting/diarrhea stage of the disease.

The motto is "Better safe than sorry."

What is your problem with this, other than your loyalty to current administration policies, whatever they are at any given time?

[uppityperson]

36. That is your fall back insult? "loyalty to the current admin policies"? Fail.

Do you understand what not being contagious means? It means he was not capable of giving others ebola. He was not contagious. He monitored himself and when he was getting to the point of possibly being contagious, he self isolated and called for help.

He did what he was supposed to do. Watch himself, call when he showed symptoms.

By pulling that last line there, you lost any credibility.

[candelista]

39. Sorry if you did't get my point.

Maybe your feelings of political loyalty are harming your reading comprehension. He was exposed to ebola. In the initial stages, he was not contagious. But because he might become contagious, he should have self-isolated. And guess what? He would have been right to do this, because he became contagious.

What don't you understand about "an ounce of prevention is worth a pound of cure"?

[uppityperson]

41. "What is your problem with this, other than your loyalty to current administration policies..."

You are trying that "my opinion is based on sound science and logic where yours is based only on loyalty to the current administration" thing.

"What is your problem with this, other than your loyalty to current administration policies, whatever they are at any given time?"

There, copy/pasted so you can see what you wrote, even if you edit or self delete.

Here, I'll copy/paste this next snark for you also. "Maybe your feelings of political loyalty are harming your reading comprehension".

Yup. *Your* opinion is soundly logical, mine is based only on loyalty.

He was not contagious. He did not need to isolate himself until he became contagious. He was monitoring himself and called for help before he became contagious. "an ounce of prevention is worth a pound of cure" is what he was doing by monitoring himself.

[seabeyond]

43. does every medical personal and supporting role self isolate here in the u.s.? do you think

they would keep their job?

sorry boss. three weeks off.

think that might be a financial burden?

think htat might cause havoc in our healthcare?

maybe discourage anyone from helping anyone in the u.s. that has ebola?

or is it just those people over there we are going after?

[candelista]

34. Dr. Spencer is a counterexample to your trusting claim about medics.

You know that, right?

[uppityperson]

38. Why, because he took his temp and called BEFORE he met the CDC recommendations?

Because he self monitored and called for help before he needed to?

[candelista]

40. He should have self-isolated.

That much is now obvious, because he actually had the disease, and was going to become contagious. But I doubt at this point that any rational argument will convince you of anything, since your position seems to be based solely on emotional loyalty to the Obama Administration, whatever it does.

[uppityperson]

42. Once again, your fall back position is you are logical, I am only loyal

Seriously? I mean, SERIOUSLY?

You have not presented a rational argument yet and seemed to have missed my posts against quarantining.

He was not contagious and did not need to be isolated until he became contagious. That is what happened. Do you wear a condom around the house because you might have sex the next night? Why not?

[seabeyond]

44. why is that obvious? has a single person gotten ebola from health workers that self monitored and

later ended up testing for ebola?

what is the obvious, that i am missing?

[jtuck004]

3. Draft them and send them. They don't go, jail them or take their license,

which they got, partly, courtesy of the taxpayers who built their school.

[Erich Bloodaxe BSN]

15. Taxpayers who built what school?

I attended a nursing school that runs on student tuition, not taxpayer dollars, thanks. And I didn't have any scholarships, loans, or other financial aid to do so. Heck, I didn't even get tax credits, since I've already gone past that 'window' thanks to having so many degrees already.

And exactly why should American healthcare workers be 'drafted' to be sent to a foreign country? Which part of 'volunteers' seems weird to you?

[jtuck004]

22. With multiple degrees you don't know that tuition only pays for part of public schools, from

k through college? I have multiple degrees myself, and I knew it. And private schools are funded with hundreds of millions of taxpayer dollars, so no out there, either. Possible, but there is likely not a school of any significance that doesn't take a lot of money from taxpayers in one shape or form, even to pay your instructors, or get facilities. Except for the Folk School in Berea Kentucky, maybe. Not sure about that one.

Perhaps school is teaching people, students and some business owners to think they built it all themselves. They didn't. They should stop that.

And they don't give tax credit just because someone wants to stay in school and not get a job and get several degrees. Too bad. The credits are for specific things such as changing fields of work, or continuing ed - you have multiple degrees and didn't know that? Perhaps you should take a tax course. Many of those are tuition free, which may be a new experience for you.

As far as the draft, that was more a sarcastic statement. But if those in charge don't work on fixing their response and the public continues to doubt, or - if - there are a few cases reported in different cities, we might see it develop just like service in WWII. Many went and joined, but many didn't. And if you were a healthy young man back here in the states, and could have been there, and chose not to, there was a chance you were going to wind up beaten and bloody in the street, maybe more than once. And might not be all that safe in your own home, either. Funny how running away from a fight can often result in the fight coming to find you. And given how the villagers in this country have reacted to things over the past couple hundred years, I don't think something resembling that is a far reach at all, especially if they think they can keep the scourge from our shores. Even though it's already here. I hear that logic all the time.

[Erich Bloodaxe BSN]

24. The fact that you think people 'want to stay in school and not get a job'

tells me all I need to know about how you think.

I had a job for 11 years. Then the company folded, and hundreds of job apps went nowhere, so I got a few more degrees to try and get work in a new line, and I'm still trying to get a job.

So take that 'get a job' crap back to Redstate.

[JDPriestly]

5. Nonsense. The Hypocratic Oath means nothing if a 21-day quarantine discourages doctors

from helping the sick. I talked to a doctor just this last week who is volunteering for ebola training. Before she signed up, she was told about the 21-day quarantine after attending to an ebola patient. Her response: if I am a doctor, it's my duty to care for people no matter what.

I think enough doctors will feel like her.

The quarantine may prove to be unnecessary once the disease is under control, once we know a lot more about how its first symptoms become manifest.

Of course, doctors who are not allowed to work due to work-related "injury," in this case exposure to the ebola virus should be eligible for worker's comp. And they should be given free assistance during their quarantine period. Eligibility will probably depend on the state, but worker's comp and free assistance with things like grocery shopping is the least our society can do for these heroes.

Of course, people on DU have assured me that ebola is not all that contagious, so everything should go smoothly.

[Yo_Mama]

10. I think this is unlikely, and it may encourage more volunteers

If the real possibility of infection doesn't stop the person, then a three-week isolation period on return isn't likely to stop them. Ebola is a life-threatening disease.

As it now is, no health care facility will permit a returned HCW to treat patients before the three week period is up for fear of liability, so the HCWs going should know that there is an issue.

It may encourage some volunteers who don't have a place to isolate themselves - most people are more easily able to accept risk for themselves than the possibility of a very small risk for their families. If the authorities are going to give you that security, then it's a level of reassurance. The HCW at the Dallas hospital asked for rooms at the hospital after news of the first HCW infection.

[Erich Bloodaxe BSN]

11. I suppose it's possible. Just about anything is possible.

But someone who is determined enough to take the time to travel to Africa to treat ebola patients with inadequate resources doesn't sound to me like the kind of person who's going to say 'Oh, wait, you mean I'm going to have to sit on my rear for 3 weeks when I come back to the US? Well that changes everything! Screw the people with ebola, I can't imagine having to stay in isolation for three weeks!'

That just doesn't sound all that reasonable.

[oberliner]

16. Wbat a ridiculous argument

A quarantine would dissuade Ebola volunteers?

Wouldn't the actual risk of getting Ebola be a much more significant potential deterrent?

[bobclark86]

17. Well...

"If people are forced to quarantine for three weeks that means most of them will not be able to do any sort of work."

So, someone who was in close contact with someone with Ebola won't be able to be in close contact with patients (the majority of whom are probably elderly or immunocompromised from disease or cancer treatments)? Please explain to me how that's a bad thing.

You know the CDC reports someone can actually show flu-like symptoms (i.e.: contagious) for three days before they test positive for Ebola, right? Go look it up -- it's in most of the articles I've seen about the quarantines.

BTW:
"that means essentially lost income."

Benefits and Opportunities of Doctors Without Borders

Starting gross monthly salary is approximately $1,731.

You don't do Doctors Without Borders for the money. That's a day's work for a NYC private practice doctor. You do it because you want to help.

[RobertEarl]

21. Obama should rent a first class Hotel

And put up all those who return from fighting Ebola with first class all expenses paid vacation in that hotel that has medical staff and all the luxuries one could ever need.

These are living, breathing heroes and we should take care of them, even paying their other expenses.

It would be cheaper to do that that chase down all the contacts and other medical bills.

And would probably get more volunteers to take the risk.

[madville]

23. Government is reactive

Not proactive, it would make way too much sense to get ahead of anything or prevent it. It would also cost way less than reacting to new cases that get out into the public.

[Travis_0004]

35. that makes even less sense

If they quartine at home they dont come into contact with a lot of people. At a hotel they need room service every day, somebody to do their laundry etc. I would much rather be at home vs stuck in a small hotel room. Plus, Im sure most doctors have a nicer home than I do.

Also, I doubt you would find many hotels that would want to quartine ebola doctors, because bookings from other guest would go down.

[CAG]

26. I'm going to believe the epidemiologists and Anthony Fauci who's job is to protect

the US public health WAAAAYYYYY before a fear-mongering politician pandering for my vote out of fear of Ebolagazigate.

[candelista]

37. Anthony Fauci lied about AIDS.

He wrote an editorial for the Journal of the American Medical Association claiming that routine casual contact could spread AIDS. He did this to "revive" this theory, which had previously been refuted by mainstream AIDS researchers. His comments sparked a lot of unfounded and unnecessary fear. And you are going to believe him no matter what?

http://books.google.com/books?id=3XnWAAAAQBAJ&pg=PA145&lpg=PA145&dq=fauci+aids+casual+contact&source=bl&ots=aSkkYkC7u1&sig=y3VhgpKpxWEJiPaVU9qeeDzsgns&hl=en&sa=X&ei=sHVNVKeuEeHVmgXG4YLwAw&ved=0CB8Q6AEwAA#v=onepage&q=fauci%20aids%20casual%20contact&f=false

[CAG]

45. Your own link doesn't support your "lie" assertion, and it was in 1983, for gawds sake, at a time

when the medical community was still arguing whether AIDS was caused by bacteria, virus, drug, or other means. This was even when the Red Cross was in denial and kept refusing to take common sense measures to protect the nation's blood supply. HIV, or LAV and HTLV III, was not discovered until 1984 by Montagnier at Pasteur Institute and (controversially) by Gallo at NIH.

Fauci has done a remarkable job leading the NIH, and hundreds of thousands of patients with HIV, cancer, etc, have benefited by the NIH research with Fauci at the helm.

[candelista]

46. Those who click the link can decide whether my comment is correct.

But your strange devotion to Tony Fauci is puzzling. He knew or should have known that he was wrong, but he said it anyway, reviving an already discredited folk-theory.

[CAG]

47. You take his 1983 comment which i've

Placed in appropriate context and i'll take his body of work for the last 30 years. My fellow infectious diseases healthcare workers would pretty much unanimously support my stance. It has nothing to do with your smart&@;ed "devotion" comment but with defending a man thats devoted his life to advancing the clinical care of those with infectious diseases and malignancies from vicious unwarranted attacks that would make Ted Cruz proud.