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“Losing Services Of Many People”: The Media’s Overreaction To Ebola Is Sending A Chill Through My Coworkers At Doctors Without Borders

One of my colleagues is ill with Ebola that he contracted while working in West Africa for Medicines Sans Frontiers, otherwise known as Doctors Without Borders. Dr. Craig Spencer is having a hard enough time fighting the disease, but it’s only been made worse for him and his family by the criticism and outrage that was heaped upon him by the press, including The New Republic. It has sent a chill through other MSF field workers, whose job is challenging enough without the added burden of facing similar treatment upon return home.

It is neither fair nor accurate to accuse Dr. Spencer of moral failings for not quarantining himself on his return. He did not run about New York while “sick,” as Julia Ioffe contends, and did not put people in danger. As has been made clear since the beginning of the outbreak, only people with symptoms can transmit Ebola. At the first sign of illnessa fever on October 23, when he still would have represented only a minimal risk of contagionhe contacted the MSF office, which then alerted city health authorities. He was then taken directly to Bellevue Hospital, well before he posed a threat to the public.

Armchair physicians note that a couple days before this, Dr. Spencer was feeling “sluggish.” This is not the onset of Ebola, this is the normal condition of those who have been working around the clock for weeks in a stressful setting prior to travel across several time zones. Nor should one read into his abstaining from work a need to protect his patients. He needed rest. MSF advises all aid workers back from the field to get rest before going back to work, and it goes further with people working in Ebola projects, mandating that they not return to work for three weeks to reduce their exposure to sick people from whom they might catch something that might be confused with Ebola and cause unnecessary alarm.

Howard Markel implies that Spencer presumed he would never get Ebola and therefore took a risk with himself and others. MSF does not send people like that to the field. Everyone who departs on an Ebola mission with MSF is made very aware of the risks involved and how to manage them. What’s more, Dr. Spencer worked with a team that had seen people dying from Ebola every day, and this includes MSF staff. MSF has lost thirteen staff members during this outbreak, and two international staff members like Dr. Spencer had to be evacuated from the field after contracting Ebola. No one who works for MSF in the field thinks Ebola could not happen to them or is unaware of its risks to others. No one.

Noam Scheiber is mistaken in writing that “it’s become our policy in this country to quarantine anyone who had direct contact with an Ebola patient.” This was not federal or state policy when Scheiber wrote his story, nor is it MSF policy. If the public feels that things should have been done differently, they should direct their complaints at MSF, not at Dr. Spencer. We are happy and ready to have this conversation. MSF have been bringing people back from Ebola outbreaks for almost 20 years, and we have an evidence-based policy for how they should protect the public on their return; it does not involve self-quarantine. The World Health Organization does not mandate quarantine for their staff, either. Nor does the CDC feel this is warranted. Only now, after Dr. Spencer’s diagnosis and the excessive reaction to it, are some states beginning to require this, even though public health experts know this is a bad idea. Our colleague Kaci Hickox had the misfortune of arriving back in the U.S. just as the new quarantine requirement was announced, and her haphazard and harsh treatment will not be encouraging to others.

Thus far, MSF has had great fortune finding people willing to go to West Africa to fight Ebola. They have set aside fears, reassured their families, and obtained leave from their ordinary responsibilities to join us. This speaks to the character and commitment of the people who work with uspeople like Dr. Spencer and Kaci Hickox. If they are discouraged by the prospect of three weeks of near total isolation on their return, we may lose the services of many good people. That will damage the effort to counter the outbreak at its epicenter, which remains the best way to protect the public at large, in any country.

 

By: Dr. Armand Sprecher, Public Health Specialist at Médecins Sans Frontières in Brussels; The New Republic, October 30, 2014

October 31, 2014 Posted by | Doctors Without Borders, Ebola, Health Care Workers | , , , , , , | 1 Comment

“Paging Dr. Christie, Dr Cuomo”: When Did Chris Christie And Andrew Cuomo Go To Medical School?

Just when you thought the Republican slime-ballers had run out of muck, you discover, no, they have more mud to throw at honorable people. And they are not just smearing Barack Obama. This time, they are disparaging the doctors and scientists at the National Institutes of Health and depicting them as weak-willed tools of the Democratic Party. If Americans fall for this, they may get the government they deserve—stripped of honest science and trustworthy decisions.

Republicans are not stupid, but they are shameless. They know people are rattled by the stealthy emergence of Ebola and that media hype has reflexively pumped up the danger and public confusion. NIH experts calmly explained what has to be done to defeat the disease and assured nervous citizens that healthcare teams are on the case. The GOP saw opportunity in unfolding tragedy and rushed to exploit it.

A political hack named Ed Rogers, corporate lobbyist and White House insider under Republican presidents, chortled gleefully over the political twist. His op-ed in The Washington Post hailed the brave governors of New York and New Jersey—Democrat Cuomo and Republican Christie—for intervening with a common-sense response. Any doctor or nurse who had gone to West Africa to treat Ebola victims should be automatically locked up in quarantine when they return home.

Rogers boasted, “If there is a Republican wave in the elections next Tuesday, pundits may well claim that it fully formed when Christie and Cuomo decided to go their own way with an Ebola strategy, despite objections from the White House.” People will be reassured by their common-sense intervention, he said, because “voters don’t trust the president to do the right thing and they are less likely to vote for those who echo the president’s blasé response.”

Actually, this know-nothing attack was launched by two well-known cynics of politics, both of whom lust after presidential ambitions. What Ed Rogers left out of the slime ball aimed at Obama is that it actually smeared some of the most experienced, knowledgeable and principled employees of the federal government. The real question at stake is whether the GOP demagoguery will succeed in destroying yet another citadel of advanced science and public values.

Dr. Anthony Fauci, who played a significant role in the successful war against AIDS/HIV, has explained patiently and repeatedly why rigid quarantines of healthcare workers would actually increase the dangers. “The best way to protect the US is to stop the epidemic in Africa and we need those healthcare workers so we do not want to put them in a position where it makes it very, very uncomfortable for them to even volunteer.”

If political pollsters were more devoted to the public interest than their political clients, they would ask people this question: Whom do you most trust to handle the battle against Ebola—Dr. Fauci, the longtime leader of the national Institute of Allergy and Infectious Diseases, or Chris Christie, the author of political vendettas against Jersey mayors who failed to support him? Or do people think Andrew Cuomo knows more than Anthony Fauci about how to organize the global counterattack against this dread disease?

The questions sound ludicrous, but they need to be asked. Once these guys finish with New York and New Jersey, they want to run the country. Let me restate the question in a harsher way people can understand: Who do you think will manage to kill more people with Ebola—Dr. Fauci or Governors Cuomo and Christie, the political twins?

Senator Elizabeth Warren, as she often does, is pushing back hard against the irresponsible politicians. On CBS This Morning, she said Christie “should bring out his scientists who are advising him on that because we know that we want to be led by the science. That’s what’s going to keep people safe—science, not politics.”

She went further and suggested the Republican party may have blood on its hands because it has pushed hard to cut NIH spending and thus research on the Ebola virus. “So now we’re in a position where instead of making those investments upfront, we wait until people die and now we’re going to spend billions of dollars and some real risk to our country.”

Good question. Why don’t reporters ask Dr. Christie and Dr Cuomo?

 

By: William Greider, The Nation, October 29, 2014

October 31, 2014 Posted by | Andrew Cuomo, Chris Christie, Ebola | , , , , , , , | Leave a comment

“Christie’s Questionable Judgment”: The Curious Case Of Kaci Hickox’s Quarantine

On Friday, Kaci Hickox, a Doctors Without Borders nurse, arrived back in the United States after helping treat patients in West Africa. It was not a happy return: after arriving at an airport in New Jersey, officials put her in quarantine.

Hickox’s isolation is the result of a new policy endorsed last week by Govs. Chris Christie (R) of New Jersey and Andrew Cuomo (D) of New York, who announced new guidelines requiring 21-day quarantines for those arriving from West Africa – whether they’re showing symptoms or not.

The result is a scenario that seems hard to believe: New Jersey has effectively detained a nurse in a tent with no shower, not because she’s showing symptoms of the Ebola virus, but because officials fear she might at some point show symptoms of the Ebola virus.

Christie defended the mandatory quarantine, saying the nurse was “obviously ill.” This was apparently obvious only to the governor – who has no background in medicine or public health – and was clearly not obvious to Hickox herself.

Christie boasted on one of the Sunday shows yesterday, “I absolutely have no second thoughts about it,” adding that he expects his policy to soon become “a national policy.” A few hours later, however, second thoughts emerged.

Facing fierce resistance from the White House and medical experts to a strict new mandatory quarantine policy, Gov. Andrew M. Cuomo said on Sunday night that medical workers who had contact with Ebola patients in West Africa but did not show symptoms of the disease would be allowed to remain at home and would receive compensation for lost income. […]

After Mr. Cuomo’s announcement, Mr. Christie issued a statement saying that, under protocols announced on Wednesday, New Jersey residents not displaying symptoms would also be allowed to quarantine in their homes.

The shifts came on the heels of White House pressure on Cuomo and Christie, urging them to adopt policies more in line with science. It’s unclear whether the revised approach will allow Hickox to leave her state-mandated tent.

There are a few angles to this to keep in mind, not the least of which the dubious legality of New Jersey imposing a mandatory quarantine on a woman who’s reportedly asymptomatic. Forcing medical professionals to remain in their homes for 21 days is marginally better, at least with regards to their personal convenience, but remains problematic. Indeed, by the same reasoning, states would have to impose similar penalties on doctors and nurses treating an Ebola patient in the United States.

Dr. Anthony Fauci, the top Ebola expert at the National Institutes of Health, warned on “Meet the Press” yesterday of “unintended consequences” – the more we discourage public-health workers from treating Ebola patients, the worse the threat becomes.

This isn’t complicated. The best way to deal with Ebola is to treat the problem at the source: West Africa. There are American medical professionals who are willing to make an enormous sacrifice by traveling abroad to address this crisis, but if the United States discourages them, they’ll help fewer patients, the virus will spread, and the threat will become more severe.

In other words, a policy intended to keep Americans safe will likely put Americans at greater risk.

As for the politics, about a week ago, Christie seemed eager to be one of the more sensible voices in his party, warning of unnecessary “hysteria” surrounding Ebola. To be sure, the governor hasn’t devolved into Rand Paul-esque nuttiness, but Christie unilaterally locking up a healthy nurse for three weeks raises credible questions about his judgment.

 

By: Steve Benen, The Maddow Blog, October 27, 2014

October 29, 2014 Posted by | Chris Christie, Ebola | , , , , , , , , | 1 Comment

   

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