Risk justifies inconvenience of quarantine

No, it was not OK that Dr. Craig Spencer ran around New York City upon his return from treating Ebola patients in Guinea. Among other activities, he took the subways, went bowling in Brooklyn, strolled the crowded High Line park and patronized a meatball joint in Greenwich Village.

True, he was not showing symptoms of the disease and therefore was highly unlikely to have passed it on to others. And yes, when he started displaying signs of illness, he dutifully checked himself in to Bellevue Hospital’s isolation unit.

Still, wouldn’t it have been better had the brave doctor not rushed into the urban swirl right after exposing himself to possible infection? Even if he didn’t do an official 21-day quarantine, Spencer could have stayed indoors for a while, away from the teeming crowds.

Most would agree. That’s why the governors of New York, New Jersey, Illinois and Florida — two Democrats and two Republicans — instituted a mandatory isolation period for medical personnel back from treating Ebola patients in West Africa.

In the face of criticism by national public health officials opposing such measures, New York’s Andrew Cuomo backed down a bit, deciding that remaining at home would suffice.

Make the case, if you want, that forcing the heroic medical workers into isolation for 21 days — the maximum incubation time for contracting the disease — will discourage many from volunteering to treat patients in afflicted countries. But then let’s balance that inconvenience against the inconvenience of having to marshal a city’s resources to track every step the medic took between landing and checking in to a hospital.

New York City sanitized the bowling alley, the meatball shop and Spencer’s apartment, even as city health officials reassured the patrons and Spencer’s neighbors that they were never much at risk. Police were posted outside Spencer’s building.

Again, Ebola is not easily transmitted, and those with it can’t infect others until they show full-blown symptoms — including high temperatures, vomiting and diarrhea. For that reason, Doctors Without Borders tells returning health care workers to stay within four hours of an isolation unit.

But suppose a doctor or nurse with signs of the disease is stuck in an airport or stranded in a snowstorm or attributes troubling symptoms to something else. Following the guidelines, meanwhile, is voluntary. You see the public’s concern.

Kaci Hickox, a nurse who worked with Ebola patients in Sierra Leone, has bitterly complained about being put into mandatory quarantine upon landing in Newark, New Jersey. She has slammed her accommodations as shabby and claims to have been treated like a “criminal.” She now has a lawyer.

The public response has been mixed. Many ask why her much-vaunted compassion couldn’t have been extended to the officials scrambling to address the fears generated by stories of a doctor out and about with Ebola.

Mandatory quarantine is not a punishment. It is a public health tool designed to protect a population from those carrying deadly infectious disease. It is not voluntary by design.

Of course, these brave health care workers deserve four-star lodging and pay for any missed work. And the quarantine system may need fine-tuning to differentiate among the levels of risk to which the workers were exposed. Dr. Anthony Fauci, who heads the National Institute of Allergy and Infectious Diseases, suggested that over the weekend.

But it’s not too much to ask medical professionals who do dangerous work abroad to accept extra precautions when they return home. For the record, many have said they understand the need. Those who feel the rules require too much sacrifice should stay home — and leave the treatment of Ebola victims to sturdier souls.

Froma Harrop is a Providence Journal columnist. Her email address is fharrop@gmail.com.

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