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Hickox at odds over Ebola quarantine

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    Posted: October 30 2014 at 2:50am

State of Maine, nurse who went to Africa at odds over Ebola quarantine

(CNN) -- Not long ago, Kaci Hickox was fighting Ebola in West Africa, doing what she could to treat those with the deadly disease. Now, she's in the middle of a different fight -- this time, in Maine.

Maine health commissioner Mary Mayhew said late Wednesday afternoon that, even as it continues talks with Hickox's representatives, the state is in the process of filing a court order to require the nurse to abide by a 21-day quarantine. Mayhew cited concerns about Hickox's hands-on role in dealing with Ebola patients, as well as "concerns about the lack of reliability and the lack of trustworthiness in the information that has been received."

"You need to be able to have trust and credibility in that information," the state health commissioner said. "That makes her a higher risk."

Mayhew also blasted what she called "the lack of leadership at the federal level" that has created "a patchwork quilt of state-by-state determinations," vowing that "we will not standby and exacerbate the situation in Maine."

Asked what she'd tell Hickox, Mayhew said, "We have been pleading for common sense, for an appreciation for the risks that exists." She pointed to other states such as New Jersey, New York and Illinois that have implemented 21-day quarantines for health care workers returning from West Africa, over objections from some medical professionals and federal officials.

The health commissioner said she "did not understand" why Hickox is challenging what she calls a "common-sense approach" of staying home for three weeks. (That amount of time is significant because it may take that long between when a person gets Ebola and shows signs of it; furthermore, Ebola spreads only via bodily fluids, not through the air.)

"(This is) a reasonable request to ensure -- out of an abundance of caution -- that we are protecting the people of this state," Mayhew said.

Yet Hickox thinks the U.S. Constitution and science are on her side.

And, because of that, she has no intention of staying put.

"I am completely healthy and symptom-free," Hickox said Wednesday night from her front lawn, alongside her boyfriend. "I am frustrated by (the) intention ... to file legal action against me.

"And if this does occur, then I will challenge those legal actions."

Complete coverage on Ebola

Nurse: Won't let 'civil rights be violated when it's not science-based'

Earlier this month, Hickox served with Doctors Without Borders in Sierra Leone, one of the three countries hit hardest by the ongoing Ebola epidemic. She returned to the United States, at Liberty International Airport in Newark, New Jersey, on October 24 -- then was sent to University Hospital in the same northern New Jersey city and put under quarantine.

On Monday, she was back home to her home in Fort Kent, a town of 4,000 people on Maine's northern border.

Hickox insists that, from her arrival through now, she has felt fine and that she's twice tested negative for Ebola. And since people can't spread the virus unless they are displaying symptoms, the nurse believes she doesn't pose a risk to anyone.

One of her lawyers, Norm Siegel, told CNN any measure that restricts his client's movement is "based ... on fear and on myth, not on medical fact."

"The government can't take away your liberty unless there's some compelling basis for it," Siegel said. "It doesn't exist here."

While police officers stand outside -- to "monitor her" in case she leaves the house, according to Mayhew -- local health officials have been checking on Hickox regularly. Talks have been ongoing as well, with Hickox saying she is open to travel restrictions like barring her from public transportation and limiting her to the Fort Kent area.

"So I think there are things that, I know, work. And I know all aid workers are willing to do those things," said Hickox. "But I'm not willing to stand here and let my civil rights be violated when it's not science-based."

Having to defend herself and not being able to hug her friends, especially after four tough weeks in West Africa, is "painful (and) emotionally draining," the nurse said. Hickox also said "it's frustrating to hear nasty things," saying her intentions going to Sierra Leone was to make "a difference in people's lives" and her aim now that she's back is not "to put anyone at risk in this community."

While he didn't mention Hickox's case specifically, President Barack Obama on Wednesday did speak to -- and in support of -- health care workers like her who have risked their lives and livelihoods by going to West Africa to help those in need. He characterized them as "heroes" who "deserve to be treated with dignity and respect."

Marco Rubio: Quarantined nurse is a 'hero'

He also criticized those championing policies such as quarantines and travel bans, saying that America should firstly be praising, encouraging and supporting health care workers critical to curbing the Ebola epidemic rather than antagonizing them.

"When I hear people talking about American leadership and then are promoting policies that would avoid leadership and have us running in the opposite direction and hiding under the covers, it makes me a little frustrated," Obama said.

New Jersey governor on lawsuit: 'Get in line'

The nurse told "Today" that she's in good health and does not have symptoms. A person must be symptomatic to be contagious if they have Ebola. But it can take up to three weeks between when a person contracts the virus and they become sick, hence the talk of a 21-day quarantine.

Siegel told the Bangor Daily News that, while Hickox would contest any court order, she will abide by guidelines from the U.S. Centers for Disease Control and Prevention that say she should subject herself to monitoring, such as daily reporting of measured temperatures.

"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," Siegel told the newspaper.

Hickox initially was put in isolation Friday, after landing in Newark, New Jersey.

New Jersey and New York had just started requiring anyone who had contact with Ebola patients in West Africa to be quarantined for 21 days. New Jersey officials additionally said that screeners determined that she had a fever at the airport.

But Hickox, speaking to CNN over the weekend from her quarantine tent at the New Jersey hospital, said she never had a fever.

"They were using a forehead scanner, and I was distressed and a little bit upset, and so my cheeks were flushed," she told CNN's Candy Crowley. The nurse said her temperature was later determined to be normal.

Hickox told "Today" that she witnessed "complete disorganization" at the airport in Newark, New Jersey, and that New York and New Jersey's policies are "not scientifically" or "constitutionally just."

The policies, she says, will be a "big deterrent" for health care workers who want to go to West Africa to treat patients, because they won't want to be quarantined when they return if, like her, they are asymptomatic.

"It's already difficult for people to take time out of their lives to go and respond," she said, though she definitely plans to go back because it's a "privilege to help."

Ebola survivor: Christie is 'playing politics'

New Jersey Gov. Chris Christie said his state agreed to let her go to Maine after confirming she "was no longer symptomatic," but he is unapologetic about New Jersey's quarantine policy. The straight-talking Republican also hit back Tuesday at criticism that the nurse wasn't treated well enough, arguing that she even had Internet access and takeout food.

"Whatever," he said, when pressed by reporters about a potential legal challenge. "Get in line. I've been sued lots of times before. Get in line. I'm happy to take it on."

Christie on possible Ebola lawsuit: 'Whatever'

The debate about how to treat returning health care workers comes amid what officials say is the worst Ebola outbreak in history.

The World Health Organization reported Wednesday that there are more than 13,700 confirmed or suspected cases of Ebola -- almost all in Guinea, Liberia and Sierra Leone. The United Nations' health authority projected about 5,000 deaths from the virus.

And those are only the ones that authorities have been able to count. In a region where health care access and record-keeping are limited, the WHO says the death toll may be especially undercounted. Some ill people who are seen by physicians and counted as Ebola cases may not stay for treatment and die of the disease, and the record-keepers won't know to record their deaths.

The WHO has said that the mortality rate from the current outbreak, starting with the first death in December, is roughly 60% to 70%.

Connecticut girl barred from school amid Ebola fears; family sues

CNN's Ashley Fantz, Ashley Killough and Ray Sanchez contributed to this report

http://www.cnn.com/2014/10/29/health/us-ebola/index.html

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 2:57am
This nurse is clearly a nutjob.  Glad to see the court order coming down. Feel like filing a law suit against her myself. 

One thing that's a little a disturbing is that she lied about having elevated temp. She may have had heat flashes, but whatever the case she had a temp.  Like Spencer, she is a liar I'm afraid.    2 for 2 in my book.  Lies are a pet peeve and bother me.

Hickox is continuing to cast a black shadow on all of MSF.


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Post Options Post Options   Thanks (0) Thanks(0)   Quote coyote Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 3:18am
Yes,me and the wife can't stand her and people here at work feel the same way..She's a selfish snot!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote pheasant Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 3:58am
She has some connection to the CDC, someone said in an earlier post?

She needs to bone up of this, and the Federal Quarantine laws.

This from the CDC:
-----------------------------------------------------------     
Legal Authorities for Isolation and Quarantine
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Printer-friendly version[PDF - 2 pages]
Isolation and Quarantine

Isolation and quarantine help protect the public by preventing exposure to people who have or may have a contagious disease.

    Isolation separates sick people with a contagious disease from people who are not sick.
    Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

In addition to serving as medical functions, isolation and quarantine also are “police power” functions, derived from the right of the state to take action affecting individuals for the benefit of society.
Federal Law

The federal government derives its authority for isolation and quarantine from the Commerce Clause of the U.S. Constitution.
Federal isolation and quarantine are authorized for these communicable diseases:

    Cholera
    Diphtheria
    Infectious tuberculosis
    Plague
    Smallpox
    Yellow fever
    Viral hemorrhagic fevers
    Severe acute respiratory syndromes
    Flu that can cause a pandemic


Federal isolation and quarantine are authorized by Executive Order of the President. The President can revise this list by Executive Order.

Under section 361 of the Public Health Service Act (42 U.S. Code § 264), the U.S. Secretary of Health and Human Services is authorized to take measures to prevent the entry and spread of communicable diseases from foreign countries into the United States and between states.

The authority for carrying out these functions on a daily basis has been delegated to the Centers for Disease Control and Prevention (CDC).
CDC’s Role

Under 42 Code of Federal Regulations parts 70 and 71, CDC is authorized to detain, medically examine, and release persons arriving into the United States and traveling between states who are suspected of carrying these communicable diseases.

As part of its federal authority, CDC routinely monitors persons arriving at U.S. land border crossings and passengers and crew arriving at U.S. ports of entry for signs or symptoms of communicable diseases.

When alerted about an ill passenger or crew member by the pilot of a plane or captain of a ship, CDC may detain passengers and crew as necessary to investigate whether the cause of the illness on board is a communicable disease.
State, Local, and Tribal Law

States have police power functions to protect the health, safety, and welfare of persons within their borders. To control the spread of disease within their borders, states have laws to enforce the use of isolation and quarantine.

These laws can vary from state to state and can be specific or broad. In some states, local health authorities implement state law. In most states, breaking a quarantine order is a criminal misdemeanor.

Tribes also have police power authority to take actions that promote the health, safety, and welfare of their own tribal members. Tribal health authorities may enforce their own isolation and quarantine laws within tribal lands, if such laws exist.
Who Is in Charge
The federal government

    Acts to prevent the entry of communicable diseases into the United States. Quarantine and isolation may be used at U.S. ports of entry.
    Is authorized to take measures to prevent the spread of communicable diseases between states.
    May accept state and local assistance in enforcing federal quarantine.
    May assist state and local authorities in preventing the spread of communicable diseases.

State, local, and tribal authorities

    Enforce isolation and quarantine within their borders.

It is possible for federal, state, local, and tribal health authorities to have and use all at the same time separate but coexisting legal quarantine power in certain events. In the event of a conflict, federal law is supreme.
Enforcement

If a quarantinable disease is suspected or identified, CDC may issue a federal isolation or quarantine order.

Public health authorities at the federal, state, local, and tribal levels may sometimes seek help from police or other law enforcement officers to enforce a public health order.

U.S. Customs and Border Protection and U.S. Coast Guard officers are authorized to help enforce federal quarantine orders.

Breaking a federal quarantine order is punishable by fines and imprisonment.

Federal law allows the conditional release of persons from quarantine if they comply with medical monitoring and surveillance.
Federal Quarantine Rarely used

Large-scale isolation and quarantine was last enforced during the influenza (“Spanish Flu”) pandemic in 1918–1919. In recent history, only a few public health events have prompted federal isolation or quarantine orders.
Specific Laws and Regulations Applying to Quarantine and Isolation

Visit the Specific Laws and Regulations Governing the Control of Communicable Diseases page.
Guidance for Importation of Human Remains into the United States for Interment

http://www.cdc.gov/quarantine/aboutlawsregulationsquarantineisolation.html
-----------------------------------------------------------------

On a side note, state powers regarding this matter is clear: States have far reaching, immediate, authority to deal with a contagion that is a potential threat to their citizens.

Please don't ask me to cite it, but if i remember correctly, states may enforce to a "stricter degree" federal laws, but never lessen them. In other words, a state can increase penalty, or stiffen penalty, or impose more stringent guidelines.   

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 5:23am
Good job Pheasant, the Fed quarantine laws escaped me.  You're absolutely correct.  

Let's hope MSF doesn't face legal action if this continues.   What a disaster that Spencer and Hickox are doing these things.   The backlash heading their way is probably not going to be fair, but it's almost unavoidable now that containment is lost in W. Africa.   There will be a lot of blame going around soon. 

One thing is for sure, these two heroes of Spencer and Hickox sure lack integrity with their lies.   It's disappointing.   If you hear about cases decreasing in W. Africa, well, that would be an MSF lie.  At this point, unfortunately can't draw any other conclusions.   What a shame.

We haven't heard anything about Spencer in awhile.  Wonder if Brantley and others are refusing to give blood?  Whatever the case, the odds say he may not make it despite treatment as a certain amount will die regardless.   As mean as I am, I sincerely hope he pulls through.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Jen147 Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 5:33am
Are we expecting the judge to sign the order?  Is there any thought that he might not?
 
She had a LinkIn account that she deleted that told of her employment with CDC.
 
Yes funny how the media is not reporting on that temp that she registered at the airport.  She was fighting the detainment even then... even when she'd registered that temp!!  That tells you how selfish she is, before she even knew there had been a mistake in her temp she was already pitching a fit.
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Post Options Post Options   Thanks (1) Thanks(1)   Quote CoderOne Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 5:33am
This nutjob is a typical Liberal Dogooder. These doctors and nurses have no business being in Africa in the first place. How many other diseases have these people brought back to the U.S. in the past.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 5:36am
MSF is the group against banning outgoing flights.  Guaranteed 100%.   This outbreak in W. Africa has far outgrown what MSF can do and they're losing influence rapidly now.  This thing is coming apart. 


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Post Options Post Options   Thanks (0) Thanks(0)   Quote pheasant Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 6:56am
The lady who came back at the same time as Brantley is giving blood to Spencer i believe.

Second, If i understand the process correctly: A judge can sign, meaning the "legal due process form of quarantine", or the state can unilaterally quarantine her "no due process" kind of like martial law concept, where the judicial is waived.

Someone can correct me if my interpretation is off.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Satori Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 7:03am


Kaci Hickox and boyfriend leave home on bikes


http://www.centralmaine.com/2014/10/30/kaci-hickox-and-boyfriend-leave-home-on-bikes/


ok

the state is all hot and bothered and is ready to file legal action

but then we have this ???


"Hickox, who returned to the United States on Friday, was visited by a health official Wednesday afternoon. The woman was met outside the house by Wilbur, who had said he was waiting for a representative of the “health department.”

The woman was escorted by a Maine State Police trooper who had been stationed at the house since early Wednesday morning. She entered by a side door, remained inside for two or three minutes, then left.

The woman was not wearing any protective clothing when she entered and left the house.'


a representative of the state "not wearing any protective clothing"

really ?


and the state is worried about Hickox ?


apparently they are not all that concerned are they ???


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Satori Quote  Post ReplyReply Direct Link To This Post Posted: October 30 2014 at 8:02am


Kaci Hickox Embarks On A Life Of Crime: LePage Caves


http://www.dailykos.com/story/2014/10/30/1340269/-Kaci-Hickox-Embarks-On-A-Life-Of-Crime



Bellevue Employees Face Ebola at Work, and Stigma of It Everywhere

http://www.nytimes.com/2014/10/30/nyregion/bellevue-workers-worn-out-from-treating-ebola-patient-face-stigma-outside-hospital.html?ref=us&_r=2


can you imagine how the public is going t behave during a flu pandemic ???


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