Yesterday I mentioned the official cult of hero worship that has grown up around doctors and nurses who went to Africa to do battle against Ebola. This hero worship is so pronounced among political and media elites that they pre-emptively snarl at the benighted public for even daring to think about Ebola fighters as less than super-heroes, as though the elite had searched the insides of every proletariat skull in America and found a disturbing lack of reverence for the returning medical staff. Thus, the rest of America reasonably asks if it might not be a good idea to keep people who had direct and sustained exposure to the poor souls who died of Ebola isolated for a while, until we're absolutely certain they're not contagious, mindful of how the first few efforts to contain Ebola were executed very poorly by the authorities... and the response amounts to government health officials and media bigshots screaming in our faces, "How DARE you question the heroism of these noble, self-sacrificing medical professionals!"
One of the reasons for this attitude has been made plainly by government officials, including President Obama: they're worried that doctors and nurses might be discouraged from putting themselves at risk in the Ebola hot zone. The degree of concern about the fragile feelings of prospective Ebola fighters seems absurdly exaggerated. Once again, the elite sit back on "conventional wisdom" with their arms folded, while the rest of us wonder if someone prepared to live among African Ebola victims in a tent for months is really going to balk at making that sacrifice because they might be asked to isolate themselves, and undergo periodic testing, for three weeks after they get home.
The notion of isolation and mandatory testing as some kind of insult has been taken to fetish levels by nurse Kaci Hickox, who has become something of an anti-isolation activist. Released from a few days of unnecessarily unpleasant quarantine in New Jersey, she's back in her home state of Maine, which expected her to voluntarily isolate herself at home for 21 days. Hickox enlisted some high-powered lawyers to make the point that she, and she alone, will decide how "isolated" she needs to be, and for how long. The government of Maine responded with a somewhat more nuanced definition of the term "voluntary" - as in, if you don't voluntarily isolate yourself, we'll go to court and force you to volunteer. Fox News reports:
Maine health officials said Tuesday that they are prepared to go to court to force nurse Kaci Hickox to comply with the state's "voluntary" 21-day quarantine period for health care workers who have treated Ebola patients.
Department of Health and Human Services Commissioner Mary Mayhew declined during a news conference to comment specifically on Hickox, who was confined against her will at a New Jersey hospital before traveling home to Maine. But Mayhew said her department and the attorney general's office were prepared to take legal steps to enforce a quarantine if someone declines to cooperate.
"We do not want to have to legally enforce in-home quarantine," she said. "We're confident that selfless health workers who were brave enough to care for Ebola patients in a foreign country will be willing to take reasonable steps to protect residents of their own country. However we are willing to pursue legal authority if necessary to ensure risk is minimized for Mainers."
Hickox's lawyer insisted Tuesday that she was not under quarantine and said she was seeking time to decompress at an undisclosed location in Maine.
Note the HHS Commissioner taking care to make the ritual declaration of admiration for the selfless bravery of Ebola health workers, even as she announces that this particular selfless and brave nurse might be compelled to take steps that will minimize the risk to Mainers. No dice, says her legal team. "Going forward, she does not intend to abide by the quarantine imposed by Maine officials, because she is not a risk to others," declared one of her attorneys. "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," said another. Great - Ebola has civil rights now. I've been warning since Day One that we have to stop it before it reaches Washington D.C. and hires lobbyists.
Er... wouldn't a court action to force Hickox into isolation last for the better part of 21 days, if not beyond? Also, "decompressing at an undisclosed location" sounds a lot like Hickox is prudently isolating herself without admitting she's doing it. An awful lot of this flap, stretching all the way back to the plastic-shrouded Port-a-Potty in New Jersey, seems like theater to me. I suspect the public is growing tired of Ebola Theater. Far from having a neurotic obsession with Ebola, the general public would very much like this story to go away, especially as the holiday season is approaching. But to paraphrase Michael Corleone's complaint about the difficulty of quitting mob life, just when we think we're out of the Ebola story, arrogant, bumbling authorities pull us right back in.
The New York Post reports that the "Bowling for Ebola" doctor, Craig Spencer of New York City, was less than honest with the police when they first tried to establish his movements on the days before he became symptomatic:
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.
???He told the authorities that he self-quarantined. Detectives then reviewed his credit-card statement and MetroCard and found that he went over here, over there, up and down and all around,??? a source said.
Spencer finally ???fessed up when a cop ???got on the phone and had to relay questions to him through the Health Department,??? a source said.
Officials then retraced Spencer???s steps, which included dining at The Meatball Shop in Greenwich Village and bowling at The Gutter in Brooklyn.
If that report is true, the man lied to the cops about his movements, presumably because he thought he'd look like an idiot if they knew he enjoyed a night on the town while feeling less than 100 percent after returning from the African hot zone. Shouldn't such behavior put his medical license in jeopardy? I cannot imagine any combination of traditional medical ethics and CDC guidelines that would make it acceptable to mislead the authorities about potentially exposing others to Ebola. Would it surprise anyone to learn that he justified trying to conceal these details because he's an Ebola expert, he's still confident he wasn't contagious on bowling night, and he doesn't think a bunch of New York City cops have any business challenging his judgment?
The Washington Times reports that an internal memo provided to Congress shows "the State Department has quietly made plans to bring Ebola-infected doctors and medical aides to the U.S. for treatment," because "the only way to get other countries to send medical teams to West Africa is to promise that the U.S. will be the world???s medical backstop." In other words, there are evidently countries refusing to send doctors into the hot zone unless they receive assurances infected doctors will be brought to the United States for treatment, rather than returning to their countries of origin. This was estimated to cost about half a million dollars per patient, although the article doesn't make clear which nation's taxpayers would be covering it. The State Department now says this plan has been "shelved."
It's troubling that it ever came off the shelf, not only because the American public would be less than thrilled at the notion of deliberately importing more Ebola patients, but because other nations were saying their doctors wouldn't help fight Ebola unless they were promised treatment in the U.S. Isn't this disease supposed to be incredibly difficult for well-protected medical staff to catch? I thought medical authorities understood Ebola so perfectly that they can time infection windows with a stopwatch.
Look, I know all of the above is going to sound very harsh toward health care workers voluntarily putting themselves at risk to fight Ebola in Africa. I considered beginning this post with a disclaimer about how harsh it would sound, but that seemed pusillanimous, and the point I'm trying to make is that proper appreciation for the sacrifices made and risks taken by these doctors and nurses as a group should not put individuals above criticism for particular actions. That's never a good idea with anyone. Brilliant people make dumb mistakes. Noble people can fall prey to arrogance. One especially seductive species of arrogance is the disdain educated professionals feel for laymen who lecture them about how to do their jobs. The argument between government officials, medical authorities, and the general public is heavily laced with that arrogance.
All the public is really saying is, "we've been told it takes three weeks from the last exposure to Ebola before you're totally clear, so we think people coming back from the outbreak area should exercise that abundance of caution we keep hearing about and take sensible precautions." They don't see why those sensible precautions have to place an undue burden on the returning doctors - surely a filthy-rich government staffed by geniuses can work out reasonable accommodations? - and they sure as heck don't understand why any of the doctors and nurses would interpret the public's concern as an insult. The longer this argument drags out in the media... or, God help us all, the courts... the longer it will take for the public to achieve a comfort level with how our government and medical systems are handling the Ebola threat. I think we really want to reach that comfort level, ASAP. Help us out here, government and media. Throw us a bone. Stop responding to public concerns by screaming in our faces that we're foolish to have them.
