Sunday, 26 October 2014

Isolated nurse slams Chris Christie's Ebola quarantine policy


Medical workers wearing protective suits handle a protective stretcher as they conduct a training exercise on dealing with suspected Ebola case.
Medical workers wearing protective suits handle a protective stretcher as they conduct a training exercise on dealing with suspected Ebola case. Photograph: AP
The first nurse to be isolated under New Jersey’s new Ebola rules has slammed governor Chris Christie’s decision to quarantine health workers returning from west Africa, saying he is “not a doctor” and calling the policy “poorly planned” and “not evidence-based” .
Her remarks came as it emerged White House officials were pressing Christie and the governors of New York and Illinois to reverse plans to quarantine all health workers returning from west Africa who have had direct contact with people suffering from Ebola.
Kaci Hickox, who spent a month in Sierra Leone, was quarantined when she arrived at Newark Liberty airport on Friday and on Sunday was still in an isolation unit at University Hospital in Newark. On Saturday, a spokesperson for the New Jersey department of health told the Guardian: “In general, home will be first choice‎ for quarantining asymptomatic individuals whenever possible.”
On Saturday, having tested negative for Ebola, Hickox criticised her detention in a piece for the Dallas Morning News.
In response, Christie said Hickox was “obviously ill” and added: “I’m sorry if in any way she was inconvenienced, but the inconvenience that could occur from having folks who are symptomatic and ill out and amongst the public is a much, much greater concern of mine.”
On Sunday he defended his decision to impose 21-day quarantines even in cases when no symptoms of infection have been shown.
Speaking to Fox News, Christie said: “I don’t think when you’re dealing with something as serious as this you can count on voluntary system. This is the government’s job.”
The likely candidate for the Republican presidential nomination in 2016 added: “I think this is a policy that will become a national policy sooner rather than later.”
Later, the governor of New York, Andrew Cuomo, told a radio station it was “highly unlikely” a doctor coming back from West Africa would not cooperate with a quarantine. “But if you had someone that didn’t want to cooperate you can enforce it legally,” he said. “There’s no doubt about that.”
Speaking to CNN, Hickox said her treatment had been “inhumane”. She added: “I also want to be treated with compassion and humanity and I don’t feel I’ve been treated that way in the past few days.”
“This is so frustrating for me. First of all I don’t think he [Christie] is a doctor, secondly he’s never laid eyes on me and thirdly I have been asymptomatic since I’ve have been here. I feel physically completely strong and emotionally completely exhausted.”
She said she wished Christie would be “more careful” in his public statements. “I am not ‘obviously ill’,” she said. “I am completely healthy and with no symptoms. And if he knew anything about Ebola he would know asymptomatic people are not infectious.”
Hickox said she had been tested at the hospital, was negative for Ebola and did not have a temperature. She had displayed a high temperature at the airport, but she said: “I truly believe it was an instrument error.”
“They were using a forehead scanner and I was obviously distressed and a bit upset and so my cheeks were flushed. I think there has been some evidence that that machine is not very accurate in those kinds of situations.”
New York Governor Andrew Cuomo, left, listens as New Jersey Governor Chris Christie
New York governor Andrew Cuomo, left, with New Jersey governor Chris Christie talks at a news conference. Photograph: Mark Lennihan/AP
She said she had spoken to New Jersey’s assistant health commissioner, Christopher Rinn, at 6pm on Saturday and had yet to hear a clear plan from him by midday Sunday. “No one has told me how long it will last,” she said. “I don’t know if I am going to be retested and if so why I would be retested. I am completely asymptomatic and the test is not even accurate if you don’t have symptoms.”
Hickox said the quarantine rules were “not based on any clear public health evidence and it is not the recommendation of public health and medical experts at this point. We have to be very careful about letting politicians make medical and public health decisions and all of the evidence about Ebola shows that if you are not symptomatic, you are not infectious.”
Hickox has retained a well-known civil rights lawyer, Norman Siegel, to challenge the quarantine order and get her out of isolation. Siegel told the New York Times her quarantine “raised substantial civil liberties issues”, and added: “The policy infringes on Kaci Hickox’s constitutional liberty interests.
“The policy is overly broad as applied to Ms Hickox and we are preparing to challenge it on her behalf.”
White House officials also told the Times they had been pressing Christie and Cuomo to reverse the quarantine rules. An administration official called the decision by the governors “uncoordinated, very hurried, an immediate reaction to the New York City case [of Dr Craig Spencer, in isolation at Bellevue hospital] that doesn’t comport with science.”
On Sunday Dr Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, and the Republican congressman Darrel Issa, chairman of the House oversight committee, added their criticisms of the quarantine policy which was also announced in Illinois, home to Chicago O’Hare, the sixth-busiest airport in the world. On Saturday Florida governor Rick Scott ordered twice daily monitoring for anyone returning from west African countries.
Patient Nina Pham is hugged by Dr Anthony Fauci
Recovered patient Nina Pham is hugged by Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Photograph: Pablo Martinez Monsivais/AP
Fauci said the new quarantine rules threatened to discourage US health workers from tackling the disease at its source.
“The best way to stop this is in Africa,” he told CNN at the start of a tour of the Sunday morning political talk shows. “Health workers needed to be treated in a way that doesn’t discourage them from going to Africa.
“Our first goal is to protect the American people but you want to do it in a way that has a scientitfic basis to it. The best way to protect the American people is to stop the epidemic in west Africa.”
Sophie Delauney, the US executive director of Doctors Without Borders, the charity for which Hickox and Spencer worked in Africa, also criticised the new quarantine rules, telling NBC: “Quarantine measures or coercive measures against aid workers could give a superfluous sense of security, while the most important [thing] is to tackle the epidemic at its source.”
On Fox, Christie said: “Folks that are willing to take that step and willing to volunteer also understand that it’s in their interest and in the public health’s interest to have a 21-day period thereafter if they’ve been directly exposed to people with the virus.”
Fauci said scientific evidence showed that people who are not ill, do not have symptoms, and have not come into contact with the bodily fluids of Ebola patients do not transmit the disease. He was backed about the quarantine by Issa.
Issa, however, added: “I think governors of both parties are reacting to an absence of leadership, an absence of belief that the federal government really knows what its doing.”
Christie is a Republican; Cuomo, himself mentioned as a potential 2016 presidential candidate, and Illinois governor Pat Quinn are Democrats.
Issa said: “Science has told us, if we are to take them at their word, that if someone does not have an elevated temperature or the other leader symptoms then we can rely on them not being contagious. If that’s true then immediate isolation of people for 21 days is not the answer. Again, trust matters.”
Of President Barack Obama’s handling of the crisis, which has included sending UN ambassador Samantha Power to the African nations worst hit and the appointment of Ron Klain as an “Ebola czar”, Issa said: “He’s appointed a lawyer. If this was an election problem, I’d be a little less worried.
“The fact is I’d rather he had found a four-star general or admiral to co-ordinate these people who have said things that didn’t turn out to be accurate, who have made mistakes and didn’t want to admit them.”
Craig Spencer, the doctor who contracted the disease in Guinea and tested positive on Thursday night, remained in isolation in New York’s Bellevue hospital. His condition was reported to have worsened, as expected.

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