When I went to nursing school, it was called isolation. When HIV became better known, ‘universal’ precautions were implemented. Every patient was treated as though they were HIV positive and they still are. Now, there’s that pesky little Ebola bug and it is causing nothing if not widespread fear and panic. It’s not blood borne and at this juncture, isolation precautions are being threatened.
Unlike HIV, Hepatitis and other blood borne diseases, nobody is able to state with complete certainty that there is no risk of exposure from casual contact with an Ebola infected patient. The odds are clearly in favor of no infection but someone wins the lottery against staggering odds every week or so. A very low risk is not the same as no risk.
We are Americans and we want absolutes; unwavering positions, assurances and guarantees. We want answers before we ask the questions and we do not sit well with not knowing.
Lacking absolutes, we conjure up every possibility in the universe. Fear sells. Anxiety is contagious. If you want to sell a newspaper, write about something frightening.
On the other hand, if you are a politician seeking reelection, preventing widespread panic and fear is the way to go. The end result is that Americans get mixed messages and trust is eroded.
Where we stand now is between the press and the politicians with two very different agendas and neither of them is completely trustworthy. It is for this reason that it’s reasonable to ask those people who have been in contact with Ebola patients to lay low for a couple of weeks until the period of incubation has expired. The risk may be very low (as per the politicians) but the consequences are dire (according to the press). It is in that measurement between risk and consequence that decisions are being made.
Kaci Hickox, a nurse, is bound and determined to convince us all that mandatory quarantine is barbaric and illegal. She knows that if she goes out in public, the fears of the community will escalate but strangely that is exactly what she wants to do. She is basing her position on science but science has not revealed all there is to know about Ebola as yet. She is forgetting that science is only half of the ingredients of a good nurse – the other half being compassion. Where is her compassion for those individuals, perhaps thousands, who will lose sleep if she breaks quarantine? Where is her compassion for her neighbors who will voluntarily isolate themselves out of fear?
I gather Kaci Hickox, who took care of Ebola patients for 4 weeks in Sierra Leone, is so utterly confident in her own isolation techniques that she believes it to be impossible that she is sick with Ebola. I have seen that kind of confidence before and it never ends well.
In comparison, Nina Pham and Amber Vinson took care of an Ebola patient in a US Intensive Care Unit – a far cry from the facilities available in West Africa. Maybe Kaci Hickox is a much better nurse than the Dallas crew or maybe she is just selfish.
Her lawyers are falling back on a supreme court opinion that says that quarantine cannot be enforced based on fear alone. One look at the number of cases in West Africa and the trend would scare the Supreme Justices, too. Just for fun, check out this graphic from the Economist.
I wish I had all the answers. This much I know…. If I had been in Sierra Leone taking care of Ebola patients and then flew home to the US, I would be tired. Jet lag is a killer all by itself. If someone offered to bring me food and told me to hang out at my house for a couple of weeks, I could live with that. I could appreciate that even though the risk of spreading the virus is very low, the risk of frightening my neighbors is very high and I do have compassion for most of my neighbors.
Maybe Kaci Hickox is fearless and brave but a new mother who ran into Ms. Hickox at the mall with her infant child might very well live in frank, abject fear for weeks when she is already tired and cranky. A corner grocery store where people shop might suffer enormously if Kaci Hickox showed up there.
None of this matters to Kaci Hickox. I am not used to nurses being selfish. She is like a three year old who wants to go out and play and doesn’t quite get that none of the other children want to play with her. I understand that the fear is out of proportion to the risk but fear is as ruthless as Kaci Hickox appears to be.
A greater concern is the fact that she is forcing the hand of authorities to use a higher level of vigilance than would be necessary if she took a break from the ‘all about me’ attitude. She is taking the attention away from where it needs to be which is on the virus and it’s prevention and cure and bringing it to herself and her own desires to wander around aimlessly regardless of how uncomfortable her presence makes others feel.
If any of you are brave enough to go to Sierra Leone, have no fear. You will have our undying support. Blog readers everywhere will make you wish you were isolated even longer so you could bask in our undying admiration for you. But, please do not go if you are not prepared to lay low and err on the side of safety when you return if you err at all. We don’t want to hear about your ‘rights’ when the consequences are so great even though the risk is small.
When science tell us there is zero chance of spreading the disease, we will come and hug you but until the guarantee is in place and supported by evidence, we’ll worship from afar.