२९ ऑक्टोबर, २०१४

Lawyers for Kaci Hickox — released from New Jersey quarantine to quarantine at home in Maine — say she won't do it.

"She doesn’t want to agree to continue to be confined to a residence beyond the two days," said Steven Hyman of the New York law firm McLaughlin & Stern.
Maine health officials have said they expect Hickox to agree to be quarantined at her home until 21 days have passed since her last potential exposure to the virus. Twenty-one days is the maximum incubation period for the Ebola virus....

Another attorney representing Hickox, New York civil rights lawyer Norman Siegel, said she would contest any potential court order requiring her quarantine at home. “The conditions that the state of Maine is now requiring Kaci to comply with are unconstitutional and illegal and there is no justification for the state of Maine to infringe on her liberty,” he said.
Hickox is certainly advancing the debate about quarantine. Her essay was extremely effective in making New Jersey look oppressive and abusive putting her into custody. She made a lot of people think differently about what's right and wrong, but now she's resisting the home-based quarantine, which seemed to many of us to be a respectful and safe enough middle ground.

But she's stepping it up and demanding more. This empowers those who like the extreme approach of state custody, because you can't trust these health-care workers to sacrifice their self-interests to the public's demand for protection. Those who empathized upon reading the essay of one woman abused by government are unlikely to have such warm feelings in response to the words of a bunch of lawyers expounding legalistically.

ADDED: As a number of commenters are prompting, this story needs to be connected with the news this morning that "The city’s first Ebola patient initially lied to authorities about his travels around the city following his return from treating disease victims in Africa, law-enforcement sources said."
Dr. Craig Spencer at first told officials that he isolated himself in his Harlem apartment — and didn’t admit he rode the subways, dined out and went bowling until cops looked at his MetroCard the sources said.

१२४ टिप्पण्या:

tim maguire म्हणाले...

Exactly. Her treatment was wrong, and now her behavior is wrong. If she forces me to choose between the two, I will choose wrong treatment.

KLDAVIS म्हणाले...

Typhoid Mary didn't think she needed to be quarantined, either.

mccullough म्हणाले...

Since its New England, a scarlet E should suffice

Ignorance is Bliss म्हणाले...

I know the 21 day incubation period is from exposure until symptoms. Shouldn't a blood test be able to detect the virus before you start showing symptoms? Anyone have any idea how much sooner?

Shanna म्हणाले...

This lady and people like her are going to piss enough people off that they will all be in mandatory quarantines, instead of self monitoring.

Michael म्हणाले...

Kaci's first and last names are just wrong and I can see how that has turned her into a snarling bitch ready to set those incisors into the slightest perceived wrong. Christ. Just shut up Kaci.

Shanna म्हणाले...

Shouldn't a blood test be able to detect the virus before you start showing symptoms?

My understanding is that they don't because there is not enough virus in the blood for the tests to pick it up.

Wince म्हणाले...

Never mind micro-aggression.

This is a case of microbial aggression.

Shouldn't Hickox have to obtain "affirmative consent" before she approaches anyone?

Ignorance is Bliss म्हणाले...

She said the original airport temperature reading should have been ignored because she was flushed.

Based on the research I've read, the temporal scanners cannot read high because you are flushed. They can read low if your forehead is sweaty, or if you do the scan multiple times ( contact with the cool scanner cools the forehead. )

( It can read high if the place being measured was very recently covered by a hat or by hair.)

After demonstrating her willingness to talk about subjects on which she is ignorant, I really don't trust her judgement on if she should be quarantined.

Larry J म्हणाले...

"It's all about ME! My rights! My wishes! I get to do whatever I want because SHUT UP! I'm such a good person that no one can tell me what to do! Who cares if I could endanger others? They aren't ME so they don't count."

If she does become sick with ebola (and I hope she doesn't), anyone she exposes should sue her sorry ass into financial oblivion.

sane_voter म्हणाले...

This is getting out of control. I also don't see how she can successfully sue in this situation. Additionally she should be sued for all medical costs if she transmits Ebola to someone.

अनामित म्हणाले...

Althouse,

The debate about quarantine is not complete without the NT Post story about how the NYC Doc initially told authorities he 'self-quarantined', until confronted with his Transit farecard and credit card receipts showing some of his travels, while quarantined.

This demonstrates that some good portion of the exposed will lie (e.g. Duncan) when it suits them, regardless of their threat to others.

RecChief म्हणाले...

"because you can't trust these health-care workers to sacrifice their self-interests to the public's demand for protection. "

Read a story today that the "hero" doctor in NYC, intially lied to authorities about whether he stayed home and self quarantined or not.

This comes off as a childish tantrum on her part. I wonder how she treats wait staff if her soup arrives at her table slightly less hot than she wanted?

Meanwhile, the DoD is planning on forced isolation of soldiers who have been in West Africa. to recap, the commander in chief demands New York and New Jersey change their quarantine decisions and SecDef institutes mandatory isolation. While I don't think there is panic over the actual disease, the inconsistency of message is enough to cause concern about how the vaunted government is handling this.

CWJ म्हणाले...

Fort Kent is a small town (pop 4000 and falling) in deepest darkest Canadian Border Maine. It was reported that the locals weren't thrilled to have her back.

Now I have no idea how widespread that feeling actually is. But since the standard news cliche is small town rallies to support heroic local nurse, I suspect the residents may have seen this self-centered attitude before.

Annie म्हणाले...

Now would be a good time for Obama to put up or shut up and give this woman a hug.

lgv म्हणाले...

So, while she was in Africa, did they allow anyone to move freely about and did they enforce quarantines?

If they didn't enforce quarantines there, how did she feel about that? How has that worked out over there?

As a health care worker, under what circumstances does she believe that people can be forced to be quarantined? If the disease is hitting 10% of the population, then is it OK?

If it is truly unconstitutional, then does that mean there can NEVER be a quarantine? Or can you draw a line?

HT म्हणाले...

At the risk of commenting prematurely, she sounds awful.

Yesterday, I recounted her story to a nurse who hadn't heard the full story. She rolled her eyes and said medical personnel are the worst offenders in things like this. Ie, least likely to stay put.

"Fort Kent is a small town (pop 4000 and falling) in deepest darkest Canadian Border Maine. It was reported that the locals weren't thrilled to have her back."

Cue comments on villagers with torches.

Honestly, the 'dialogue' in all of this (not talking about here (yet)) can only be classified as piss-poor.

garage mahal म्हणाले...

Quarantines for people who aren't sick is small government at its finest.

Annie म्हणाले...

Her behavior makes one wonder how she treats standard hygiene protocol while at work and between patients - if she is a regular nurse. Will she be permitted back to work and if not, will she sue them too?

wendybar म्हणाले...

Typical liberal government worker thinks the rules everyone else has to follow don't apply to her.

Alexander म्हणाले...

I like the logic that says you only go into ebola quarantine after you've thrown up on the bus or sneezed on lots of people. That seems like a great quarantine.

Also take note how public healthy officials and employees are really, really big on micromanaging how we plebs live our lives... until someone turns around and suggests an inconvenience to them.

Dan Hossley म्हणाले...

The NY train-riding, jogging, bowler doctor with Ebola also told officials he would self-quarantine. He lied.

They can't be trusted.

Beloved Commenter AReasonableMan म्हणाले...

Just another authoritarian right wing governmental over-reach versus left-wing libertarian good government conflict.

Nothing to see here folks, just move along. We see this everyday.

अनामित म्हणाले...

But she's stepping it up and demanding more...

...attention.

Jaq म्हणाले...

Are we sure the Republicans aren't paying her to do this to make Obama look even worse on ebola?

Jaq म्हणाले...

Quarantines for people who aren't sick is small government at its finest.

Thank you garage. I just wish I could get you a national media buy to push that POV.

Jaq म्हणाले...

A "left-wing libertarian" would let me make my own arrangements for health care. But nobody expects honesty out of ARM anyway.

KLDAVIS म्हणाले...

If you like your ebola, you can keep your ebola.

KLDAVIS म्हणाले...
ही टिप्पणी लेखकाना हलविली आहे.
Michael Fitzgerald म्हणाले...

No one has a right to spread deadly communicable diseases. Put this idiot in solitary confinement for 3 weeks.

Shanna म्हणाले...

I like the logic that says you only go into ebola quarantine after you've thrown up on the bus or sneezed on lots of people. That seems like a great quarantine.

Seriously. Way to miss the point of the thing.

Unknown म्हणाले...

"Quarantines for people who aren't sick is small government at its finest."

Quarantines ARE for people who aren't sick (but have been exposed,) don't change the meaning of the word because you don't like it.

"a state, period, or place of isolation in which people or animals that have arrived from elsewhere or been exposed to infectious or contagious disease are placed"
OR
"1. a strict isolation imposed to prevent the spread of disease.
2. a period, originally 40 days, of detention or isolation imposed upon ships, persons, animals, or plants on arrival at a port or place, when suspected of carrying some infectious or contagious disease.
3. a system of measures maintained by governmental authority at ports, frontiers, etc., for preventing the spread of disease."

Jaq म्हणाले...

Seriously. Way to miss the point of the thing. - Shanna

Miss the point, or come to a different conclusion?

Mark म्हणाले...

Libertarianism isn't a suicide pact, contrary to how both the sclerotic Left and Right would protray it.

What governments do best is limit; take things away; incarcerate; deny. Putting away murderers for a good long time isn't nice, but generally speaking most people think it beats letting them run around on the streets.

When the reasons are sound, when such takings are obviously to the benefit of the governed, then government is performing a necessary task.

(Governments can also be very effective in providing discrete benefits to all individuals, with the purpose of improving the lives of everyone. This Libertarian thinks that immunizations should be free to everyone. But that isn't the issue here.)

When the reasons are sound, when such takings are obviously to the benefit of the governed, then government is performing a necessary task.

Kaci chose to go to Africa to treat Ebola patients. If she'd gone to South America to dig wells, build water treatment plants, whatever, infringing on her rights when she got home would have been clearly wrong.

Instead she went (or her own free will) to work with patients with a very contagious and very deadly disease.

In a perfect world no government would have to do anything with Kaci because she'd have the sense to respect the people of her community, and more importantly respect the disease she was treating.

If our health care "professionals" can't be trusted to behave responsibly upon coming home, I see two options: make quarantine mandatory upon coming home (the weaker version) or make it illegal to treat Ebola patients without a special permit, which also would require quarantine when coming home. Anyone breaking quarantine would be subject to loss of their professional license.

Why is it the same people who would take my father's hunting rifles have no problem siding with Kaci on this?

Jaq म्हणाले...

A "left wing libertarian" is somebody who thinks you should be allowed to do anything you want, as long as he thinks is OK. "All the behavior that's fit to condone" so to speak.

Unknown म्हणाले...

For someone in the "public health" field she doesn't really get the fact that in that area, it's not the exclusive province of MD's, nurses and scientists, and even their patients. Once you get into communicable diseases and the methods of transmission, interdiction, intervention, etc., you necessarily get into issues of law and public policy. She was quoted as saying something to the extent of: "This is why you cannot leave health policy up to politicians". Well, her reaction tells you why you cannot leave it up to those with the specific medical and scientific subject matter expertise either.

Birches म्हणाले...

I want to sympathize with this nurse, but come on!

We already have two health care workers with Ebola who we were told couldn't possibly get infected. We are still waiting to see if anyone turns up sick from the flight crew or passengers. Isn't the courteous thing to do to wait it out?

Annie म्हणाले...

Let's all get in the way-back machine and see what St. Louis did to combat the spread of the 1918 Spanish Flu.

On Oct. 5, 1918, the city health department issued this warning: “Avoid persons with colds.”

Dr. Max C. Starkloff, health commissioner, knew that wasn’t nearly enough. Two days later, with Mayor Henry Kiel’s strong backing, he issued an emergency order closing schools, theaters, pool halls, playgrounds and other public places. Starkloff quickly added churches and taverns, and restricted attendance at funerals. Streetcars were limited to seated passengers.

The strategy was known as “social distancing,” and the motive was to fight the Spanish flu that was sweeping the world. The misnamed influenza would kill many more people than the ghastly meat-grinder known as the Great War.

The order was extreme, but it worked — St. Louis’ death rate was the lowest among major American cities....

.....Kiel and Starkloff enforced their quarantine with vigor. Police arrested defiant barkeeps. Colleges and high schools canceled football games. Judges told officers not to arrest people on “trivial” matters, lest sick people infect others in holdover cells.

Business owners howled to City Hall, but city welfare director John Schmoll said, “It is a case of get the dollars and lose lives or save the lives and lose the dollars.” Kiel said he backed Starkloff because, “I do not want a single soul to die.”....

....In the final tally, 31,500 people became ill and 1,703 died. St. Louis’ death rate was the lowest among the nation’s 10 largest cities. It was less than half the rates in Pittsburgh and Philadelphia.

East St. Louis, which followed St. Louis’ example, recorded 342 deaths. Belleville, which didn’t, had one of the highest rates in Illinois.


http://tinyurl.com/qzwtswl

Annie म्हणाले...

We already have two health care workers with Ebola who we were told couldn't possibly get infected.

And Doctor's Without Borders already lost how many, not to mention African doctors and nurses are dropping like flies. Did they have the same attitude as this gal or does WHO and the CDC need to step up their protocols?

viator म्हणाले...

Well here's a narcissist who's certainly doing her part to damage the cause of voluntary and international Ebola treatment.

Meanwhile, our troops get a mandatory 21 day quarantine.

Beldar म्हणाले...

By the standards enforced by the managers and concierges at the Four Seasons, this nurse was severely mistreated.

Only by those standards.

Could her accommodations in New Jersey have been more thoughtful and commodious? Certainly. Would I agree, as a matter of courtesy and propriety, that returning healthcare workers ought be treated well, rather than poorly, while isolated? Of course; who wouldn't?

But I am growing very impatient with discussions over whether the cool kids get a unilateral opt-out from legal quarantine orders.

I have no patience for anyone who suggests that there is in any way a legal dispute, or even a good-faith legal argument, over the general power of both the state and federal governments to make and enforce very broad quarantines. This was well-settled long before the founding of our Republic. This nurse's threatened civil rights lawsuit would have been frivolous (and sanctionable as such, against both client and lawyer).

Will म्हणाले...

For $7 billion a year budget you would think our "Center for Disease Control" would have proactively thought about these issues and issued balanced guidelines that respect BOTH constitutional rights and public health.

Cuomo and Christie have already won this argument. Obama is off in the weeds, spouting BS about "Science" that his own actions contradict.

Now that Cuomo & Christie have taken a position, we can negotiate some reasonable compromise that solves these concerns. Of course people are right about carefully heeding incentives and disincentives to achieving "Cure and Control" on the African end. And of course people are smart to note the actual behavior of Snyderman, Spencer and this dingbat CDC nurse and note that despite being trained medical people they still acted like protocols don't apply to them and they all lied about it.

We will get through this. Thank you to Cuomo and Christie for taking a stand that forced Obama to act. Obama's wait-and-see passivity and pre-existing condition to politicize every single thing, and his "Science" Fiction will be overruled by 80% of the people who believe it is commonsense to be safe rather than sorry while we learn more.

Any objections can be overcome. This is not that hard people!!

Mark म्हणाले...

And of course, poetic justice pretty much requires that she now come down with Ebola. I hope she doesn't, but she really must not have a single superstitious bone in her body.

Brando म्हणाले...

Here's what we need to know:

1) What is the least amount of contact one needs with an infected person to catch Ebola? With flu, for example, it's as simple as sharing nearby air; with HIV, it's exposure to bodily fluids.

2) How long does it take to determine if someone has the virus? What tests, etc. can ensure that a person has or doesn't have it?

3) Considering 1) and 2), what is the most reasonable method of containing the spread? Maybe requiring every person coming off every flight or car into this country to be put in an isolation chamber for a year is too extreme, and simply asking only people flying back from Liberia to fill out a questionnaire is too lax. But what middle ground is necessary to prevent this from spreading?

Until everyone's determined 1) and 2), they're all talking past one another.

Shanna म्हणाले...

Miss the point, or come to a different conclusion?

Miss the point of a quarantine, certainly. A person who has been treating ebola patients in africa is high risk. Full stop. She clearly is uninterested in and incapable of quarantining herself. Let's hope she doesn't get sick or get anyone else sick.

George M. Spencer म्हणाले...

It's the end of the Me Generation.

It's the end of "Do your own thing."

Quarantines were absolutely standard for smallpox, flu, and scarlet fever. During WWI, whole cities would be shut down (i.e. stores and public transport closed) to stop the flu.

Beloved Commenter AReasonableMan म्हणाले...

tim in vermont said...
A "left-wing libertarian" would let me make my own arrangements for health care.


And let you die in the street if you didn't have insurance or couldn't pay.

No one ever wants to follow this logic through to its logical conclusion.

Beloved Commenter AReasonableMan म्हणाले...

Mark said...
she really must not have a single superstitious bone in her body.


Or, have a decent understanding of how this virus works.

Shanna म्हणाले...

Brando, the answers to 1 and 2 are 'It depends' basically. So I'm not sure where you want to go with that.

Beloved Commenter AReasonableMan म्हणाले...

Why is it that the same people who want to lock up healthy health care workers insist that guns protect us from governmental over-reach.

Owen म्हणाले...

"Fort Kent is a small town (pop 4000 and falling) in deepest darkest Canadian Border Maine. It was reported that the locals weren't thrilled to have her back."

I have an idea for a new small-town Community Experience. A "fencing bee." Kaci wakes up tomorrow to find that her neighbors have erected a razor-wire enclosure around her house. With no gate.

David म्हणाले...

This empowers those who like the extreme approach of state custody, because you can't trust these health-care workers to sacrifice their self-interests to the public's demand for protection. Those who empathized upon reading the essay of one woman abused by government are unlikely to have such warm feelings in response to the words of a bunch of lawyers expounding legalistically.

It's "warm feelings" that we are trying to avoid. 101 degree fever and all that.

Now I have no idea whether quarantine is warranted or not. But neither does this lady.

Jaq म्हणाले...

And let you die in the street if you didn't have insurance or couldn't pay.

Exactly right my point, even you admit that you are being dishonest when you call yourself a libertarian.

I don't claim to be one. I happen to think that a person who chooses to go without coverage ought to be treated and face bankruptcy, if he has unwisely left himself that exposed.

Nor do I think the poor should be left without options. You know, kind of the way it was before Obama forced the statist solution you admire so much on us.

David म्हणाले...

AReasonableMan said...
Why is it that the same people who want to lock up healthy health care workers insist that guns protect us from governmental over-reach.


Why is it that the same people who think government regulation is the solution to problems insist that a person potentially contagious with a deadly disease should not be restricted?

Readers can decide which is the more relevant question.

Sydney म्हणाले...

Re: Ebola blood tests. The test isn't positive until 3-5 days after symptoms appear due to the need for a certain amount of virus to be active in the bloodstream. Even then, the initial test is often negative and has to be repeated in a couple of days to confirm it isn't Ebola.

Isn't she going to feel stupid if she comes down with Ebola after all? She should refrain from commenting until her 21 day incubation period is up.

Loren म्हणाले...

Seriously. Way to miss the point of the thing. - Shanna

Check your sarcasm detector, it has fallen our of alignment.

Wisco म्हणाले...

I think the essential question here is "Who's the more credible expert on Ebola, a nurse with experience in fighting the disease or Chris Christie?" Put that way, the answer is clear.

And "you can't trust these health-care workers to sacrifice their self-interests to the public's demand for protection"? Yeah, going over to West Africa to fight a plague of hemorrhagic fever is a great demonstration of a selfish character.

It's not like people who've been exposed to Ebola have never come back to America before. They weren't quarantined, no one freaked out, and most importantly, no one got Ebola from them. This is a fearmongering fad that will die off soon enough, as the media finds some other shiny object to obsess over.

The current demands for universal quarantine of all returning volunteers borders on superstition. These people returning from West Africa don't want unnecessary limits on their freedom just to make ignorant people feel better. Can't say I blame them.

Mark म्हणाले...

Or, have a decent understanding of how this virus works.

You see, ARM, this is why you're so annoying. A real scientist (or at least a person who actually knows something about science) understands that a "decent" understanding of how this virus works is categorically NOT the same thing as being sure how the virus works.

The two Ebola nurses in Texas had a decent understanding of how the virus worked, and caught it anyway.

Doctors Without Borders has lost a large number of medical workers in Africa who had decent understandings of how the virus works.

I'm sure both our Noble Medical Heroes who couldn't/can't be bothered to self-quarantine have a decent idea how the virus works.

A real scientist always asks first "what if I'm wrong" and then works from there to find if they are wrong.

If Kaci finds out she's wrong a whole lot more people will lose (at the least) 21 days of their lives.

So she's either a shitty scientific thinker or she's a shitty person. Or both.

Joe म्हणाले...

Hypothetical. Let's say Kaci turns out to have Ebola and had infected another person. That person dies. Could Kaci be tried for manslaughter?

Sydney म्हणाले...

And Another Thing: This virus should not be taken lightly. The number of viral particles required to cause an infection is only 1-10. VERY SMALL! That's why so many healthcare workers who get it can't recall their exposure. It was probably some microscopic amount of fluid they touched. I wonder if that nurse knows this.

Unknown म्हणाले...

"It's not like people who've been exposed to Ebola have never come back to America before. They weren't quarantined, no one freaked out, and most importantly, no one got Ebola from them."

It's not like people who've been exposed to Ebola have never come back to America before and died from it. Oh wait...

RecChief म्हणाले...

"And let you die in the street if you didn't have insurance or couldn't pay."

Except you are presenting it as a binary choice, and it's not. Just because you wouldn't come to his aid without compulsion from the state, doesn't mean everyone in his town, or even on his street, wouldn't either.

अनामित म्हणाले...

ARM writes;

"And let you die in the street if you didn't have insurance or couldn't pay. "

This is why progressives want the government to run everything.

Because they can't conceive of people who are charitable with their money. They've never heard of Churches, for example, that help pay for their parishioners medical care when it's needed. They've never heard of Shriners Childrens Hospitals that are 100% free to their patients, thanks to donations of Free Mason's around the world.

They must assume that everyone is like them. IE: They won't give a dime unless it's pried from their fingers from a government more powerful than them.

Very sad.

Tyrone Slothrop म्हणाले...

I'm kind of surprised how even this controversy breaks down on left/right lines, but let me clarify something for ARM and garage. Libertarians do not believe in zero government. Zero government is anarchy, and libertarianism is not anarchy. Do you follow me so far? Libertarians believe government should be restricted to very specific activities which actually protect the common good. Quarantines by definition protect the common good. Ergo, small governments should enforce quarantines. It's the sort of thing governments must do do justify their existence.

Matt Sablan म्हणाले...

Sigh.

This is why we can't have nice things.

Shanna म्हणाले...

Check your sarcasm detector, it has fallen our of alignment.

I think you may have missed my point, but since all you did was leave a snarky comment I can't say for sure.

RecChief म्हणाले...

Tyrone Slothrop said...
I'm kind of surprised how even this controversy breaks down on left/right lines, but let me clarify something for ARM and garage. Libertarians do not believe in zero government. Zero government is anarchy, and libertarianism is not anarchy. Do you follow me so far? Libertarians believe government should be restricted to very specific activities which actually protect the common good. Quarantines by definition protect the common good. Ergo, small governments should enforce quarantines. It's the sort of thing governments must do do justify their existence.


If you're expecting some kind of thoughtful acknowledgement of your position, followed by an equally thoughtful discussion where either one of those two presents a well reasoned argument trying to persuade you to their point of view, reality probably won't meet that expectation.

HT म्हणाले...

As I strongly suspected, according to this article, this is not the first time that a VHF has been in the US.

http://www.slate.com/articles/health_and_science/medical_examiner/2014/08/ebola_in_united_states_research_on_deadly_hemorrhagic_fevers_lassa_marburg.html

"Second, you might not know that we’ve already experienced patients coming into the United States with deadly hemorrhagic fever infections. We’ve had more than one case of imported Lassa fever, another African hemorrhagic fever virus with a fairly high fatality rate in humans (though not rising to the level of Ebola outbreaks). One occurred in Pennsylvania, another in New York just this past April, a previous one in New Jersey a decade ago. All told, there have been at least seven cases of Lassa fever imported into the United States—and those are just the ones we know about, people who were sick enough to be hospitalized, and whose symptoms and travel history alerted doctors to take samples and contact the Centers for Disease Control and Prevention. It’s not surprising this would show up occasionally in the United States, as Lassa causes up to 300,000 infections per year in Africa."

NotWhoIUsedtoBe म्हणाले...

Sounds like an episode of "House."

People lie.

Scott म्हणाले...

A left-wing libertarian = a socialist who wants to get high

Brando म्हणाले...

"Brando, the answers to 1 and 2 are 'It depends' basically. So I'm not sure where you want to go with that."

Well, that's exactly what we'd have to take into consideration--all such measures have a cost and we have to determine how effective the measures will be against the possible harm of not doing them. To the extent we don't know just how Ebola can spread, it'll be a judgment call.

अनामित म्हणाले...

Terry Cannan: I think the essential question here is "Who's the more credible expert on Ebola, a nurse with experience in fighting the disease or Chris Christie?" Put that way, the answer is clear.

Neither one of these people qualifies as any final "expert on Ebola", so if you think the above formulation is "the essential question", well, I hope you don't have a job anywhere near public health decision-making.

Yeah, going over to West Africa to fight a plague of hemorrhagic fever is a great demonstration of a selfish character.

We're a mixed lot, we humans. It isn't rare for less savory character traits to appear with more admirable ones. Possessing the latter isn't going to get you a free pass if you start annoying people too much with displays of the former.

Btw, Terry, it is politicians who in the end have to make the call on implementing disease control measures. These decisions are always made amidst a welter of conflicting interests and incomplete scientific information - and "conflicting interests" covers a great deal more than "Science vs. Ignorance". Their responsibilities are different from those of health care workers, heroic or otherwise. They may turn out to be wrong, they may personally be run-of-the-mill scummy politicians. But it's pretty ignorant to dismiss the decision to impose quarantines as nothing but pandering to the "superstitious". (And as far as I can see, the only place where superstitious yokels "freaked out" by Ebola exist is in the imaginations of hysterical political hacks and hack reporters.)

अनामित म्हणाले...

This woman is beyond selfish. How tough is it to self-quarantine in you own home for three weeks. Stock up on Scotch, pizza making supplies, fire up the internet, read several good books, pray to God, call all your friends, write your memoirs. This is Fort Kent, Maine where winter isolates everyone, this shouldn't be new to her.

As to the usual leftists in the crowd here, you are being beyond stupid but you know that.

Shanna म्हणाले...

As I strongly suspected, according to this article, this is not the first time that a VHF has been in the US.

This is not a secret, but none of them were ebola. Marburg outbreaks have been really small compared to ebola. They are in the same family, but different diseases with different infectious rates. So I don't really see how this much matters in the discussion of how to treat this particular disease.

Also in the same family of diseases? Polio and Entrovirus D68, BTW. Maybe we should respond to the entrovirus outbreak as we did to polio.

Megaera म्हणाले...

Consider: Kaci Hickox, for all her ranting, has been rather reticent about the exact nature of her work in Sierra Leone. She is a CDC employee, not a "heroic volunteer", and CDC has no patient treatment remit in Africa, so her actual patient contact may have been nil. Which might explain all the self-righteous indignation--if she indeed had no physical exposure because as an EIS all she was doing was processing files in an office to track patient records, she might feel justified in the assumption that she was safe from exposure. Of course, Ashoka Mukpo made the same assumption, and look where that got him.

Krumhorn म्हणाले...

Why is it that the same people who want to lock up healthy health care workers insist that guns protect us from governmental over-reach.

You seem awfully sure of yourself that that (i) "healthy health care workers" who have been treating Ebola patients are not infected health care workers and (ii) a 21 day quarantine is "governmental over-reach".

Have you given any thought to what if you are wrong about either proposition?

Lefties always insist on the authoritarian right to dictate the most minor details of our lives, without regard to consequences, merely because they they feel so strongly about the virtue of their ideas.

The rest of us just want government to do those things that it reasonably does best. Until there is more concrete data, most people would agree that it would be reasonable to briefly quarantine those who have been clearly exposed to the Ebola virus.

When a leftie wants to use the power of government....such as through... oh...say...the IRS... to achieve his collectivist social and economic objectives, it's time to reach for the guns.

See the difference?

- Krumhorn

kcom म्हणाले...

"If she does become sick with ebola (and I hope she doesn't), anyone she exposes should sue her sorry ass into financial oblivion."

I hope she does. It's clearly the only possible cure for her colossal arrogance. Lots of doctors over the years have said they didn't realize what being a patient was like until they became sick themselves. It's a lesson in humility she could use.

Whoever mentioned affirmative consent above was a genius. That's the case here. Ask the bridal shop owner whether she would have appreciated a heads up before someone walked into her store with Ebola exposure, now that it's been shut down for weeks.

If the fencing bee doesn't work out I think an alternative would be to have volunteer town cries follow her whenever she leaves her house and announce her presence through bullhorns to anyone she was inconsiderate enough to approach without asking for affirmative consent.

Contrast her attitude to the humility of the SIM volunteers who recognize their responsibility not just to their African patients but to their fellow citizens. They follow a quarantine policy voluntarily because they think it's prudent.

MeatPopscicle1234 म्हणाले...

How is someone supposed to vote if quarantined?

kcom म्हणाले...

Speaking of lassa, those people came back with no known exposure. If they came back with known exposure, do you think they would have been treated differently? Should they have been?

Getting lucky is not the same as being proactive.

Mark O म्हणाले...

If she's lucky, no one will be infected; if not, she should go to jail for attempted murder and be sued senseless.

Paul म्हणाले...

Now from a humanitarian standpoint, I do believe in helping people from ANY country.

But we could outfit a SHIP to treat them offshore and not bring them physically into the country.

Mercy Ships does huge work for the good in Africa, and to take that idea and outfit a hospital ship just for this would be a much better idea. The US government spends tons of money on really stupid studies and could instead focus 50 million on outfitting a quarantine ship.

As for the nurse, there are LAWS allowing the quarantine.

http://sites.temple.edu/lawreview/article/80-1_batlan/

http://www.cdc.gov/quarantine/historyquarantine.html

So the true is, if they suspect she might be contaminated, they should quarantine her.

Beloved Commenter AReasonableMan म्हणाले...

So, here's a surprise the faux-libertarians want to define libertarianism in a way that makes wingers feel comfortable.

If you think it is OK for the state to lock up a healthy person in a parking lot with a porta-potty you are not a libertarian's ass-hole.



Achilles म्हणाले...

AReasonableMan said...
tim in vermont said...
"A "left-wing libertarian" would let Yes me make my own arrangements for health care.

And let you die in the street if you didn't have insurance or couldn't pay.

No one ever wants to follow this logic through to its logical conclusion."

I do. On one side the state controls health care. It does a poor job of distributing resources like it always has. The cost of health care goes up. A two tiered system develops where the average citizen has shitty expensive care and rich people have top of the line very expensive care. In general there is less health care for the amount of.resources applied to the industry. Insurance companies and administrators make most decisions guided by a bloated administrative state.

On the other side you have free markets. Right now this is represented by cosmetic and lasik surgery because they are elective and not interfered with by medicare or other government meddling. Because there is rarely a third party payer people who purchase these services pay cash. Cosmetic surgery clinics and lasik clinics have very few administrators in them. Nobody at the government gets paid deciding who gets to do what. The price of elective eye surgery and cosmetic surgery keeps getting lower and more and more people can afford it. Charities start up to get truly indigent people access to these procedures. It is far easier to get lasik surgery done than it is to get a regular appointment.

You can say it only takes a 100$ copay or 500$ deductible to get something done. But those costs in the back end are always paid by someone and it always leads to less productivity which is less health care. If you want more people to get more health care you go with the free market. If you want more people to have insurance but less health care so they can support an army of administrators and bureaucrats and have limited access to actual health care get the government involved whether it is through obamacare or single payer.

paminwi म्हणाले...

To ARM via Eric: let's not forget that the government could not find new housing for the family of Thomas Eric Duncan. So guess what the government had to do? They had to reach out to the faith community who came up with a house free of charge for the family to live in during their quarantine.

Those damn Christians!

Brando म्हणाले...

What the hell is a "left wing libertarian"? There are libertarians and collectivists. Anything in between is a moderate form of one or the other, and sometimes you can be libertarian on some issues (the economy, social policy, defense) and collectivist on others.

FullMoon म्हणाले...

Hasn't ebola been kind of a yearly thing in Africa? How is it possible we have never had a case in USA prior to this year with unregulated travel to and fro?


Achilles म्हणाले...

AReasonableMan said:

"If you think it is OK for the state to lock up a healthy person in a parking lot with a porta-potty you are not a libertarian's ass-hole."

The problem with statist is you have to remove due process from every conversation. There needs to be a process for dealing with situations like the ebola outbreak. This would normally start with a government agency that has limited powers and is only applied to certain situations where you have clear need. The Ebola outbreak in west Africa meets this.

First you implement travel restrictions. Anyone who was in the affected zone needs to return to a centralized area. Someone with actual working knowledge of the disease and incubation times sets a quarantine time. The facilities should be appropriate. And most importantly there needs to be due process. When the need is over the restrictions go away. The problem you have is you are used to abusing these kinds of powers.

The problem with the CDC is it goes off to find things to do when there is nothing for it to do. When a situation like this comes up it has all its people working on the disease of gun violence and obesity.

You equate my opposition to the CDC going off on progressive spending sprees with anarchy. Immediately after that you call quarantines on people from affected areas fascist over reach. You are a joke.

Shanna म्हणाले...

Hasn't ebola been kind of a yearly thing in Africa? How is it possible we have never had a case in USA prior to this year with unregulated travel to and fro?

Ebola has had several smaller outbreaks since we discovered it in the 70's, but none have been as big as this one. This outbreak has infected/killed more people than all previous outbreaks since we learned of the disease.

For comparison, larger outbreaks killed 250-300 people and we are 4k+ and counting deaths in this one.

So this is kind of a bigger deal.

FullMoon म्हणाले...

You know what? Maybe we have had ebola and nobody recognized it?

~ Gordon Pasha म्हणाले...

They are both health care workers and held to a higher standard of behavior than the general public. File a complaint with their respective State licensing boards.

Beloved Commenter AReasonableMan म्हणाले...

Steven said...
File a complaint with their respective State licensing boards.


Right-wing "libertarianism" in action.


Julie C म्हणाले...

Full Moon
The smaller outbreaks occurred in small villages in central Africa that had limited contact with outsiders. Those villages self-quarantined. Some of those earlier strains also killed up to 90% of the infected so it tended to burn hot and burn out quickly.

The current outbreak began in an area of Guinea which borders Sierra Leone and Liberia. And there is more mobility in that area - people cross the border to visit relatives, sell goods at market, etc. Once it got out of the isolated village context, all hell broke loose. Couple that with two countries (Liberia and Sierra Leone) that are recovering (slowly) from devastating civil wars and thus have very poor medical infrastructures, and you have a perfect storm. And this outbreak tends to kill at maybe a rate of 70%, so it can spread farther.

Jaq म्हणाले...

If you think it is OK for the state to lock up a healthy person in a parking lot with a porta-potty you are not a libertarian's ass-hole. - ARM

Did that happen or are you getting your info from your usual echo chamber?

According to Christy today, she was in an isolation tent inside a hospital and had wi-fi, her cell phone, and take out food of her choice.

Is he a liar? Or is somebody you trusted for information a liar?

Julie C म्हणाले...

And on a related note, compare and contrast the behavior of Kaci Hickox and Kent Brantley.

I guess we know why Kent Brantley got Ebola: so he could live to donate his blood so that many others could successfully fight off this disease. And to provide an example of actual selflessness and humility, as opposed to Kaci Hickox's self-centered braying.

Shanna म्हणाले...

Julie, contrast her behavior with some of the earlier doctors who came home and voluntarily stayed put for 21 days so no one would get sick, just because it was the right thing to do.

Beloved Commenter AReasonableMan म्हणाले...

tim in vermont said...
Did that happen or are you getting your info from your usual echo chamber?


Are you familiar with the use of Google?

Looks like a tent in a parking lot with a porta potty to me.

Achilles म्हणाले...

AReasonableMan said...
Steven said...
"File a complaint with their respective State licensing boards.

Right-wing "libertarianism" in action."

I know you can't deal substantively with these issues. Must be the statist inability to follow logic to logical conclusions.

Achilles म्हणाले...

AReasonableMan said...
"tim in vermont said...
Did that happen or are you getting your info from your usual echo chamber?

Are you familiar with the use of Google?

Looks like a tent in a parking lot with a porta potty to me."

If the CDC spent its money on quarantine areas at regional hospitals instead of anti-gun campaigns she might have decent quarters to live in during her quarantine.

Bob Ellison म्हणाले...

Annie said, "Her behavior makes one wonder how she treats standard hygiene protocol while at work and between patients..."

Nurses and doctors are not good at science. Protocol is a political word.

This woman, Hickox, is behaving like an ass.

Jaq म्हणाले...

I looked at your article. I don't see a single picture of a tent in a parking lot. I see a headline that claims it, and a picture of the isolation tent that is clearly inside a building.

Bob Ellison म्हणाले...

AReasonableMan said "So, here's a surprise the faux-libertarians want to define libertarianism in a way that makes wingers feel comfortable."

AReasonableMan, can you define "winger"?

It's a leftist term. (I'm just telling you that to give you little help.)

Bob Ellison म्हणाले...

Mind you, this is not a trap.

damikesc म्हणाले...

It's like every group humanly possible is trying to kill their trust-worthiness as quickly as possible.

And I'm glad Obama named an Ebola czar. He's been quite helpful since his naming. Really, he's ON TOP of this thing!

jr565 म्हणाले...

At the same time the dems are going after Christie the administration is quarantining all soldiers that deal with Ebola patients. And liberal CA Is implementing the same policy.
Why is the administration implementing such a double standard?

अनामित म्हणाले...

Dr. Liar, MD.

Sack of shit.

Browndog म्हणाले...

She works for the CDC, Not Doctors Without Borders.

Her job was NOT to treat patients, but observe.

I cannot believe the amount of disinformation that is allowed to to be cast in stone among the "educated".

Beloved Commenter AReasonableMan म्हणाले...

tim in vermont said...
I don't see a single picture of a tent in a parking lot.


It is a parking garage. They are quite common in built-up areas of the country.

Beloved Commenter AReasonableMan म्हणाले...

Browndog said...
I cannot believe the amount of disinformation that is allowed to to be cast in stone among the "educated".


Oooohhh! Ebola! -> Brain ceases to function.

It happens quite regularly around here. It is accompanied by a desire for the cessation of all civil liberties.

Hagar म्हणाले...

According to Obama and Josh Earnest, they are quarantining the military because they can; not for any medical reasons.

And they do not think nurse Hickox needs to be quarantined because she is highly educated and works for liberal causes. Likewise Docs Snyderman and Spencer.

Jaq म्हणाले...

The truth of the matter wasn't good enough so you had to exaggerate?

I see it widely reported that she was kept in an "unheated tent" in a "parking lot." Both wrong.

Dawn Thomas, spokeswoman for the New Jersey Department of Health, was asked to confirm details of the nurse’s quarantine, including a report in the Wall Street Journal that the nurse’s mother and Doctors Without Borders said she was being held in an unheated tent with a portable toilet and air system but no shower, no books, magazines or television.

“The location is an extended care facility inside a building that is part of the hospital,” Thomas said in an email. “We understand that this is an inconvenience but our primary concern is the health of the patient.”
- Dawn Thomas, spokeswoman for the New Jersey Department of Health

First rule of holes, ARM, is to stop digging. That's what I do, when I am wrong, I admit it and move on. It is healthier.

The Cracker Emcee Refulgent म्हणाले...

A left-libertarian is a libertarian who works in academia or blue-state government. The "left" part is a social smokescreen.

Jaq म्हणाले...

Also, the UK has different rules about fact checking than the US. Never trust them because they don't double check. Not part of their culture.

I like reading them myself, but I never assume they have their facts straight.

Achilles म्हणाले...

AReasonableMan said...
"tim in vermont said...
I don't see a single picture of a tent in a parking lot.

It is a parking garage. They are quite common in built-up areas of the country."

Because the CDC misappropriated its budget to anti-gun campaigns instead of setting up regional quarantine sites.

Jaq म्हणाले...

Incidentally, I hope she keeps screaming and yelling and getting lots of press for how Obama has quarantines right and Maine has it wrong!

Drives turnout! Same as bashing Palin does.

Julie C म्हणाले...

Browndog - "her job was not to treat patients but observe."

Oh right. And that NBC cameraman who got Ebola, his job was to observe too. Check.

CatherineM म्हणाले...

Briefly listened to uber lefty lawyer Ron Kuby this morning faulting the cops for checking on Dr. Spencer and letting the public know he lied. In Kuby's world, he lied for the greater good. He is a saint who knows better than to panic stupid NYC public with the truth. Kuby called him a saint who knows better than the cops (who are in the wrong he says) who investigated his story.

This is the kind of elitist asshole arrogance we get from Di Blasio, Obama and all others like them. We know better than the you. Shut up. How dare you question us?

Be म्हणाले...

Ms. Hickox sort of reminds me of the ex's cousin who could never quite articulate why customs agents at the pre DHS time were "Ignorant" for asking her if she'd been on a farm outside the US.

(Again - Public Health. Also Northern Maine. Inbreeding, maybe? Ex's cousin was also a redhead with a temper.)

Kirk Parker म्हणाले...

Annie,

"Now would be a good time for Obama to put up or shut up and give this woman a hug. "

Didn't he kiss that other babe? Equal treatment for Kaci (even if she does have a porn-star name, or spelling.)

MadisonMan म्हणाले...

Let's say she comes down with Ebola, and has infected someone during her time away from quarantine.

Is she (or her estate) liable for damages?

William म्हणाले...

The path of righteousness leads the just to the palace of self righteousness.

HT म्हणाले...

So we know it's not just fluids right?

"Ebola virus can be transmitted by direct contact with blood, body fluids, or skin of EVD patients or persons who have died of EVD.3"

http://www.cdc.gov/vhf/ebola/transmission/human-transmission.html

HT म्हणाले...

Browndog, I agree. Everytime I see "libertarian" "progressive" "liberal" "right-wing" in these discussions, zoom, I just scroll right on through. People who are interested in politicizing it I find, are not that interested in the truth and facts and evidence to date. It's complicated and it takes boring old attention to deal with it (though I bet we disagree about Nurse Huff n Stuff).

I am sorry for the length of this, but I came across this interesting med journal piece from over 10 years ago. I picked out some highlights. Especially the second paragraph. Large-scale medical staff deaths are not new.


+++++++++++++++
What then were the major routes of transmission? Nonhuman primate studies [66] found conjunctival and oral routes of infection to be possible. It seems likely that the increased risk from late-stage patients [54] reflects increased virus excretion as the disease progresses, similar to that seen in monkey models [50]. Thus, mucous-membrane exposure, pharyngeal contamination during swallowing, inoculation via small skin breaks, or even infection from swallowed infectious material may all contribute to virus transmission.

The epidemic in Kikwit posed certain serious problems. The medical infrastructure was poor to begin with and suffered greatly from the epidemic. Hospitals were closed, and 30% of the physicians and 10% of the nurses contracted EHF. The city, with a population of >250,000, had no regular transportation, a paucity of vehicles, no newspaper or radio station, and no reliable electric power. Because of fear and of stigmatization, new cases were cared for at home and often in secrecy. It became urgent to rehabilitate the medical infrastructure and to convince patients to come to the hospital, where they could be isolated and their families could be observed. This contrasts with the 1976 outbreaks, which occurred in villages where leaders enforced quarantine in local houses.

In any case, the infection of health care workers [69, 55] ended with the arrival of proper patient-isolation supplies and training in barrier-nursing techniques [55, 69, 92]. The coordination of medical logistics and plans for rational triage of the patients were key in the effort [93, 94].

The lesson is obvious: The hospital is the link that must be strengthened.

The finding of copious amounts of Ebola virus antigen in skin opened the way to confirm cases by taking simple skin biopsies, which could be placed in formalin and analyzed later by immunohistochemistry [53, 92].

http://jid.oxfordjournals.org/content/179/Supplement_1/ix.long


Clyde म्हणाले...

It's stupid assholes like this woman who are going to eventually end up spreading the epidemic.

As a tweet on Twitter said, the Apollo 11 astronauts were quarantined for 21 days on their return to Earth from the moon, and they didn't bitch about it like some of these whiny do-gooders have.

Lawyer Mom म्हणाले...

TWO -- two -- of our US healthcare workers were infected w/Ebola by taking care of Thomas Duncan in the best of circumstances (a nice, clean, air-conditioned hospital on US soil). This necessitated that their caretakers also had to be quarantined.

Wild Nurse Hickock similarly took care of infected E patients, but in an undeveloped, foreign country, in thick tropical heat.

So tell me again -- what is her objection? What is she protesting? Is her argument that she is too smart to get infected? That two of her own colleagues in the US, working under much better conditions, did get infected because they just aren't as clever as she is? Serious Q: what is her argument?

(That said, we ought all be wary of and alert to widespread, forced quarantines here. Forced QTs tend to become roach motels where the healthy go in, get exposed, and never leave).