By now almost everybody knows that a new case of ebola infection has appeared in New York. The patient is Dr. Craig Spencer who was a volunteer in Guinea for MSF treating ebola patients. Last night it was incorrectly reported that at the point that he had contacted health authorities he had a temperature on 103. In fact his temp was 100.3. That is just at the screening threshold. He had been following the approved procedure of monitoring his temp twice a day. He was not required to restrict his movements and activities as long as he was asymptomatic. However, as has been the case with the nurses in Texas who contacted infections, there are people claiming that any contact with an infected person in the initial phases of the disease exposes people to risk of infection. This claim is contrary to medical opinion. Never the less this is fueling calls for a total ban on all travel from West Africa and failing that, a mandatory 21 day quarantine for arriving travelers. The government is examining compromise positions on the issue.
New quarantine rules considered for aid workers returning to U.S. from Ebola-stricken region
The federal government is considering altering the protocols for doctors and health-care workers who return to the United States from West Africa, New York Gov. Andrew Cuomo (D) said Friday morning.
“It’s one of the questions the federal government is thinking through,” Cuomo told Fox 5 in New York.
The possible change would come in the wake of Thursday’s diagnosis of Craig Spencer, a doctor who had treated Ebola patients in Guinea, one of the countries at the heart of the Ebola epidemic.
A federal official said that the idea of quarantining medical workers who participated in the Ebola response in West Africa was being considered, but said no decision had been made.
There is broad agreement among epidemiologists that containment and control of the epidemic in West Africa is absolutely essential in order to avoid its spread to the rest of the world. The willingness and availability of health care personnel from other nations to travel to those countries and assist in patient care is a very necessary component of that effort. There has been concern that any policies that restrict their ability to make the trip and then return to their professional and personal lives in their home country will seriously diminish the supply of volunteers.
Not only have many airlines curtailed flights to the three countries most affected by Ebola, Garrett noted, but nearly every major insurance carrier has now canceled medevac coverage for individuals choosing to travel there.
“This whole right of return issue, and circumstances of return, is fluid,” she said. “We’ve hit the point where it is quite obviously affecting the recruitment of volunteer health workers.”
Experts say that the region needs roughly 19,000 health and logistics personnel to contain the epidemic; outside of military personnel, total foreign volunteers now number in the hundreds.
The Obama administration has a difficult line to walk in this situation. The information they are getting from health care professionals about the resources needed in West Africa and the risks to the American public of asymptomatic travelers is in conflict with the rising level of public panic fanned on by the media and some opportunistic politicians.
So far there have been a total of 9 ebola cases in the US. Six of them were people diagnosed in Africa and transported to the US for treatment. All of them recovered. The three cases diagnosed in the US were all related to the situation in Dallas of Eric Duncan, a traveler from Liberia who has died. The other two were nurses who were providing treatment to him at Presbyterian Hospital. None of the people who came into other contact with him have contacted the disease and most have now passed the quarantine period. The two nurses were transferred to biocontainment treatment centers. One of them has recovered and the other one is reported to be doing well.
The biocontainment facilities that treated 6 of the patients were able to do so without incurring any staff infections. This makes it pretty plausible that occasional cases of ebola such as Dr. Spenser can be handled without serious threat to public health. So far it is only health care workers who appear to be at significant risk and they can be successfully protected.