State-imposed policies that require health workers returning to the U.S. from Ebola-sticken countries to isolate themselves are having a “chilling effect” on humanitarian efforts in Western Africa, according to Doctors Without Borders, one of the major organizations that’s coordinating the effort to treat Ebola patients abroad.
In an email exchange with Reuters, the executive director of the aid group, Sophie Delaunay, said that health workers volunteering with Doctors Without Borders are starting to change their travel plans because they’re concerned about how they’ll be treated when they land in the United States. Some of them are remaining in Europe for extra time to wait out Ebola’s 21-day incubation period to avoid “facing rising stigmatization at home and possible quarantine.”
“There is rising anxiety and confusion among MSF staff members in the field over what they may face when they return home upon completion of their assignments in West Africa,” Delaunay said, referring to her group by the acronym for the French version of its name, Médecins Sans Frontières. “Some people are being discouraged by their families from returning to the field.”
Over the past week, a stand-off between state officials and a volunteer who treated patients in Sierra Leone has highlighted what health workers may encounter upon returning home. When nurse Kaci Hickox landed in New Jersey last Friday, she was detained by airport officials for hours and eventually forced into quarantine in an unheated tent next to a hospital. After three days, Gov. Chris Christie (R) allowed her to return to her home in Maine, where she continues to battle with state lawmakers who are placing restrictions on her movements.
Hickox, who has tested negative for Ebola twice and is not currently displaying any symptoms, is planning to sue the state of Maine for imposing a quarantine on her. “I truly believe this policy is not scientifically nor constitutionally just, and so I am not going to sit around and be bullied around by politicians and be forced to stay in my home when I am not a risk to the American public,” she told NBC this week.
From the beginning of her high-profile disagreement with U.S. governors, Hickox has expressed concern about how this policy will affect her colleagues in the field working to battle the virus at its source.
“I sat alone in the isolation tent and thought of many colleagues who will return home to America and face the same ordeal. Will they be made to feel like criminals and prisoners?” the nurse wrote in an essay published on the Dallas Morning News about her quarantine in New Jersey. “We need more health care workers to help fight the epidemic in West Africa. The U.S. must treat returning health care workers with dignity and humanity.”
In addition to Doctors Without Borders, other major medical associations have come out against state-imposed quarantines for returning aid workers. One of the most prestigious peer-reviewed medical journals in the country, the New England Journal of Medicine, called the policy “unfair and unwise” in a recent editorial. Dr. Anthony Fauci, a top official at the National Institutes of Health, has said that isolating health workers who aren’t displaying any symptoms is “draconian.” The Association for Professionals in Infection Control and Epidemiology, the leading group for doctors working to combat contagious diseases, has emphasized that these quarantines are totally unnecessary because Ebola is not contagious when people are not displaying symptoms.
To address some of the concerns about dissuading people from volunteering in Western Africa, New York officials announced on Thursday more protections for health workers returning from Ebola-infected regions. The new policy ensures that the state will pay for any lost wages that workers incur as a result of being quarantined. Other states continue to grapple with the right way to implement quarantines, but have refused to back down despite pressure from the White House to reverse their rules.
Ongoing fears over Ebola continue to affect the medical community’s ability to conduct its work. On Thursday, Louisiana health officials announced that any health workers who have been in Sierra Leone, Liberia, or Guinea in the past three weeks will not be allowed to travel to New Orleans to attend a major conference on infectious diseases, a category that includes Ebola. The American Society of Tropical Medicine and Hygiene has agreed to abide by that order, but released a statement this week noting that the group “does not agree with the policy.”
“The ASTMH Annual Meeting serves a much larger good, bringing scientists and dedicated professionals together from around the world to further the scientific discourse and ultimately improve the health of those suffering from disease,” the group writes. “We deeply regret that some of our attendees are affected by Louisiana’s travel advisory.”
The international community continues to work to contain the deadly virus in Western Africa, where the worst Ebola outbreak in history has devastated impoverished countries’ infrastructure. Here in the United States, however, there is just one known case of an individual who is infected with Ebola — a Doctors Without Borders volunteer who’s being treated in New York City.