POLL: Should Kaci Hickox have to Quarantine?

Feel free to comment after you vote. 

No one deserves to get Ebola, but there is a close maybe...

"Hero" seems like a strong word.  Sure, taking care of ebola patients is admirable.  But that doesn't make it okay to put American citizens at risk because she's, apparently, so arrogant that she knows better then CDC (who doesn't know everything about ebola!)

What I find so sad is how much her attitude is mirrored in society. It's all about her. There is no compassion for others. She could care less about those around her. And anyone fighting for her feels the same way.

I really hope the authorities can get things in place before any more cases pop up.

You should only quarantine people that are contagious.  Do you think anyone that treats someone with tuberculosis should be quarantined.   The answer is no by the way.  

(Yes) but I hope Hickups doesn't get ebola. (Its bad enough to have a name that is a symptom of Ebola). But I do think she should now be quarantined in a facility with no TV, Internet etc. and maybe a little prison food. She's clearly saying that none of the returnees should self quarantine at all or have it forced on them. For that stupid and reckless and dangerous attitude she should be put in jail or at least spanked real good.

Don,

She is bucking a system put in place to protect 300 million people.
Maybe she doesn't have Ebola.
Maybe the next high risk person WILL have Ebola, and will refuse quarantine because the nurse got away with it.
She is basically telling us her personal liberty and social life outweigh the lives of future victims.
She doesn't know if she has or has not been infected (3weeks incubation) but she doesn't care, because her 'right to party' is more important than the precedent she's setting.

This is a crucial time in determining if the control measures of public health will work.

You can't get spread it unless you are symptomatic!!!!!   she is not hurting anyone!!!  she has been tested it was negative!!!

Don wrote: You should only quarantine people that are contagious.  Do you think anyone that treats someone with tuberculosis should be quarantined.   The answer is no by the way.

"Infectious TB cases can, and are, quarantined"

You avoided the question.   Yes people with active infectious TB can and should be quarantined.  If you are sick with an infectious disease  you need to be keep away from others.    However... do you guarantee everybody that has had even casual contact with a case?

At least the present moment we have no evidence of community spread of ebola in this country.   We also have very little evidence that you are contagious if you are not sick.   Over 70 health workers where exposed to Duncan.      If you force guarantee every health profession you will crush our health care system.

It might be prudent, out of an abundance of caution to isolate this particular nurse... but if we have more than just a couple cases it quickly becomes unmanageable.

Nobody will argue that you shouldn't isolate sick people.   However healthy people in this country are supposed to have certain rights.

The problem is that some missionaries may be mentally ill with the hero syndrome.  Looks like Hickox got bit by the Hero Complex bug.

Tips from another missionary:

You're Not a Hero.

First of all, before you go and when you get there, your team must commit to getting rid of the hero complex. Developing countries do not need short-term heroes.They need long-term partners. And if your group just wants to be a hero for a week, then you may be doing more harm than good.

http://www.relevantmagazine.com/reject-apathy/things-no-one-tells-you-about-going-short-term-mission-trips

The hero syndrome is a phenomenon affecting people who seek heroism or recognition, usually by creating a desperate situation which they can resolve. This can include unlawful acts, such as arson. The phenomenon has been noted to affect civil servants, such as firefighters, nurses, police officers, programmers, and security guards. Acts linked with the hero syndrome should not be confused with acts of malicious intent, such as revenge on the part of a suspended firefighter or an insatiable level of excitement, as was found in a federal study of more than 75 firefighter arsonists.^[1] However, acts of the hero syndrome have been linked to previously failed heroism. The hero syndrome may also be a more general yearning for self-worth.^[2]

http://en.wikipedia.org/wiki/Hero_syndrome

Hello Guest.

I disagree and feel I answered the question clearly, please reread my last post more carefully. I was not just talking about symptomatic infected ill people.

I asked poient and basic questions about the Ebola virus.

1) I asked about genetic and immunological susceptibility, ( are there genotypes or phenotypes at increased risk ) if exposure to someone who still has low undetectable viral loads.

2) Importantly whàt is the role of asymptomatic carriers, and naturally immune hosts, what is their potential to infect both healthy and immunocompromised individuals.

3) I asked about the generation of false negatives, PCR looks for virus in blood, why does that not always correspond to antibody titres taken weeks later.

4) I also asked about the incubation period vs latency period and how this differs on route of infection, blood vs mucosal etc,

5) what about mechanisms of pathology of the virus ?

6) can you breakdown of the viral RNA, what does it all code for.

7)What is its behaviour of transmission under different selective conditions, and within different ethnic groups.

9). Can the virus remain dormant in cells, undetected and causing no symptoms, if so what conditions activates its transcription.

Scientifically these are not advanced questions, they are basic bread and butter information, that ....WE DONT HAVE YET on this virus. If we can answer these then we can start deciding if quarantine can be lifted.

For people to base an argument against quarantine on the few cases that have been in US so far, is just plain silly. Our knowledge is so sparse we do not even know the natural host or its geographic range. These facts matter.


If we listen to what the CDC are actually saying. Their statements all revolve around the get out clause " What we know at present".

In contrast the 2 doctors from our health board who returned from Sierra Leone self quarantine for 25 days ( they based this on the 4% study).   All the UK NHS staff generally do it without even being asked, just common respect and understanding.   There is no fuss, no fanfare, no media circus. One of the doctors is back in Sierra Leone in February next year (not in Ebola this time but maternity services). Staying at home for 25 days didn't deter her at all. I think she feels the needs of the people she helps in Sierra Leone, far outweighs any inconvenience she has to face when isolating herself back home.

If as Dom correctly highlights in their last post that " having to undergo 21 days quarantine" would be a deterent to potential volunteers. Well perhaps it filters out those that would not be suitable to go there. Medics with this attitude don't sound like very resilient responsible characters do they, probably need volunteers made of stronger stuff, those prepared to put the needs of these people's suffering over that of their own comforts.

Also in reply to Dom .....I am sorry you feel they are not being treated like lepers. I see it different. I see they are being treated as though they may be potential carriers of a highly lethal virus, which is not yet fully understood. This assumption is based on their recent close proximity to infected patients, an exposure they chose to participate in. It was stated in your post that attitudes to such health workers is something to be ashamed about. If you expect me to be ashamed of applying common sense, I am sorry but I can't.

Give this virus some respect, and let's take simple precautions until we build up a reliable profile of this virus. This can't be hurried to fit in with our ideological notions.

We have a saying posted at the entrance to our labs..it simply says REMEMBER BE CAREFUL IN THERE..enough said.


Lastly remember the enormous amount of money at present being paid to certain individuals charged with bringing the PR and public opinion about this virus epidemic under control. These people and their needs are not always strictly humanitarian. They serve to protect their hefty private investments in this area of West Africa. They need the flights opened and the commuting into and out of these areas to fully resume. ( this is a different sort of traffic from the humanitarian corridor doctors with out borders ask for.) Anyway this outbreak is costing their investors millions. Lowering the global fear of Ebola is a number one priority for many important buisness investors. I am not saying the nurse is anything to do with them, but promoting her case in media, and portraying anyone that disagrees with her as ' hysterical' certainly helps them to manipulating the opinions of the public, and desensitising the demons surrounding a virus that is financially hitting their pockets.   Watch as we see more of such opinions being promoted, think the HIV groups are being targeted next to protest about the hysteria.....twisting turning the public opinion.

To finish let me say I am not hysterically blindly following the media, I follow the science and as yet there are still huge gaps in our knowledge for us to start performing without a saftey net.

Just my opinion.

Let's back up a bit.

Every healthcare worker that has volunteered to go into a hot zone is briefed extensively on what to expect, the protocols of handling patients and given the information of what is known about the disease/virus that is known at the time.

Going by what she was probably told 3+ months ago before heading over there, this virus was only spread by direct contact with bodily fluids.

While she is there, hundreds of healthcare workers are infected with this virus. They obviously couldn't have all been careless enough to ignore the protocols, so common sense would be telling them something had changed. They just have no idea how.

So now it is time for her to return home. The US has had cases brought in of healthcare workers who had unknowingly exposed themselves to the virus. A man has come in from Liberia and not only brought the virus with him, but infected two nurses that treated him.

Within her 3+ months of time being involved with this virus the "experts" have been forced to change the rules, albeit quietly, from only direct contact with bodily fluids to the fact it can be passed through a sneeze or cough. There is still the unknown if the virus can be passed before a person is symptomatic.

This healthcare worker returns from a hot zone. She had a fever, which means if she had ebola she was currently symptomatic. Her first test comes back negative.

At this point, having her test come back negative should have been an incredible relief. However, she knows first hand how these tests are not foolproof. There is still a minimum of 21 days for incubation.

Now things get out of hand. Her over-the-top reaction of how she has been wronged by the tests come out. Either she has lied and was never in contact with patients but wanted to look the hero, or she's so wrapped up in her self importance that she doesn't care about anyone around her. This includes her own healthcare workers.

To be on the safe side, she is asked, then told, a 21 day quarantine is the best thing for everyone around her to make sure she doesn't become patient zero.

We've all seen how well that has gone.

No, she doesn't have any symptoms. Her fever is gone. As far as she is concerned her rights as an individual are far more important than anyone she might come into contact with. That is utter selfishness.

Had she just agreed to a voluntary quarantine, it would have probably cost the authorities a minimal amount of money to bring in groceries, a fancy television, a game system or whatever amenities she might request to keep herself occupied for the 21 days. However, now the cost of the extra security alone has jumped this into the thousands of dollars.

She was not going to be taken to a FEMA camp. She wasn't going to isolated in a tent somewhere in the desert with no electricity and a wire fence keeping everyone away. She was asked to stay in her own home for 3 weeks for the good of an entire nation. In this case, and any future ones, it is absolutely the truth that one person could possibly affect hundreds of others.

To all of us sitting at home, we are thinking of our families and loved ones. What if my child is in the same class as the child of the nextdoor neighbor? What if my sister is the one who is in line behind this woman in the grocery store? What if my spouse is the one who pumps gas right after her and she just happened to cough into her hand just before she grabbed the handle?

This healthcare worker KNOWS this virus is surrounded by changing variables and complete unknowns. So yes, she absolutely has no compassion for anyone but herself and she is acting completely self-centered.

Albert wrote: Hickox is probably going to have a left over Halloween candy.  Wonder if the police will let kids go to the door.   scariest house in town.

Johnray1 wrote: CRS,Dr.PH, This nurse in Maine is doing a great disservice to her profession.I do not think that most nurses agree with what she is doing and what she is doing is illegal and irresponsible.She is getting a lot of mileage out of this for her EGO and damageing her own profession. As more Ebola infected healthcare people return to this country and other countries,she will be more and more dumped by her profession. I also really wonder if she actually treated any infected Ebola patience while she was in Africa, She may been what we referred to in Vietnam as REMFs. Since this country and many other countries face Ebola as it continues to spread,this lady will be looked at more and more as an arrogant duma** .In your list above,you list Viral hemorrhagic fevers,if Ebola does not qualify as a Viral Hemorrhagic fever,nothing does. Johnray1

You guys missed my point.  

Don.  I accept this looks knee-jerk but it is carefully thought out.

1.  Ebola is assumed to be contagious only when symptoms are present.  This is a very unsafe assumption.  The vast majority of contagious diseases have different latent and incubation periods.  As ebola is contagious from as little as one viron, statistically speaking, it is more likely to have a shorter latent period than incubation period.  Ebola is a stealth virus.  The reason it is so deadly is that patients immune systems do not recognise it until it is too late.  Symptoms of a disease appear when the immune system reacts.  This also suggests the latent period should be shorter than the incubation period.

2,  Ebola has a very high CFR and no effective treatment.  If a tummy bug escaped it would be an inconvenience and an economic drain.  When a disease this deadly escapes the panic alone can crash an economy.  When the panic spreads people run away.  This increases the spread and here in the countries where the vast majority have cars and can use public transport (not the case in W Africa) that is an inconcievably nasty senario.

3,  Every point Hazlepad made is valid.  I have only listed what we know.  What we do not, is far greater. 

4,  The ebola test is new and not highly accurate.

5,  Quarrantine for less than a month is no hardship............................... even for such a Diva!

D

Luckily a judge issued the temp restraining order against her today so she has to stay home.  No doubt the judge did that with Halloween here.   Will cost her 3k to get out of it. Unfortunately the courts are closed on the weekend so her attorney will have to file motion on Monday.   They will file a motion, and the D.A. will try to drag it out until around November 10.  Hickox attorney will file for an ex parte motion on Monday for an emergency hearing.   This is probably when her bf says, hey babe, let this thing go, too much money.  This is costing Hickox thousands. 

When it's over after the 10th, and if she has no symptoms, guaranteed she will file civil law suit.  That is 100% her plan and she will go for money.  Because of this court order, she won't win.

Ya I edited and added to last post.  She will file civil law suit the day after 21 days is up if she's Ebola free.    She won't win.

Albert wrote: Luckily a judge issued the temp restraining order against her today so she has to stay home.  No doubt the judge did that with Halloween here.   Will cost her 3k to get out of it. Unfortunately the courts are closed on the weekend so her attorney will have to file motion on Monday.   They will file a motion, and the D.A. will try to drag it out until around November 10.  Hickox attorney will file for an ex parte motion on Monday for an emergency hearing.   This is probably when her bf says, hey babe, let this thing go, too much money.  This is costing Hickox thousands.  When it's over after the 10th, and if she has no symptoms, guaranteed she will file civil law suit.  That is 100% her plan and she will go for money.  Because of this court order, she won't win.

Hickox and MSF are really clueless.  This entire thread is hitting the search engines (Google) soon and MSF is about to have a tainted image for years to come.   If you google "MSF discussion forum", you will see that our Ebolainfo.org has 4 listings on page 1 of google already, lol.

Here is a doctor who unlike the nurse has got no affiliation with CDC, and who is not linked to senior lawyers or activist from political parties etc etc..... so there is no murky waters of possible vested interest in using the media to promote certain policies, while shouting and challenging others. Murky waters which the nurse stands in. He is also a consultant, and a clinical assistant professor of surgery at Stanford. He has last week returned after working in Liberia with the International Medical Corps.

Here he describes how he has absolutely no quams about a 21 day quarantine. He does reinforce that he isn't contagious but is doing what he thinks is right. He makes no comment on the nurse. Link at bottom.

Dr. Colin Bucks sits in his Redwood City home every day -- completely alone. He sent his wife and dog to a hotel. The only time he goes out the front door is to retrieve food delivered into a cooler on his porch.

He won't even walk down the driveway to pick up the tossed fliers that are piling up.

Bucks, 43, a Stanford emergency physician, is one week into a 21-day quarantine since his return from a jungle camp in Liberia, where he served for a month on the front lines of the Ebola epidemic that killed about half his patients whose stories "hit you right in the gut."

Bucks remained healthy in what he called an "enormously austere" environment. The medical teams covered themselves head to toe in sweltering, yellow Hazmat suits while treating patients, then hosed the suits down with a bleach solution as they undressed. He has no symptoms and believes he poses no health risk to his community.

But unlike Maine nurse Kaci Hickox who has been making headlines by defying her quarantine order after returning from treating Ebola patients in Sierra Leone, Bucks has no quarrel with his required isolation. He knows that while unlikely, it's possible he could develop symptoms within 21 days of his last exposure to the virus that has killed nearly 5,000 people. And even though San Mateo County health officials have given him the go-ahead for bike rides or jogs through the neighborhood by himself, he chooses to exercise in the confines of his house.

( Contrast this with the nurse response Qu ote: Hickox is locked in a battle with Maine's governor and health officials who insist she avoid the public. On Thursday, before a throng of journalists, she went on a bike ride with her boyfriend followed by state troopers. )

"If I had to go outside the house, it would be completely safe. But for community reassurance, I'm staying completely inside my house and on the property," Bucks, a clinical assistant professor of surgery at the Stanford School of Medicine, said in a phone interview Thursday ( note the phone interview not a meet and greet and shake hands like the nurse).. "I wouldn't want anything to happen that would heighten anxiety in my community."


So far, he said, he's received nothing but support from his friends, colleagues and neighbors, people who appreciate his work that is helping to stem the deadly virus from spreading

Bucks lost 9 pounds during his intense monthlong experience in Liberia and is ravenous now that he's home. He is required to take his temperature twice a day and communicate with San Mateo County health officials at least once a day. As much as he thought he'd be bored watching TV during his quarantine, instead "the phone hasn't left my right ear since I got back." Doctors and hospitals and health organizations from throughout the country and around the world are calling him for advice on equipment and procedure to keep the virus contained. He's also interviewing potential recruits to volunteer in Ebola zones.

On his character one of his work colleagues says.

"His first question is never what can we do for him, but what he can do for others," said Auerbach, who earlier this week dropped off in Bucks' cooler a duck for dinner and chocolate for dessert.

What Bucks hopes isn't being lost in the national quarantine debate is the important work being done in West Africa. Bucks is an emergency medicine physician with special training in humanitarian disaster response. Volunteering in Liberia with the International Medical Corps is just one more way to be ready for any kind of epidemic or natural disaster on home soil, he said.

The article then goes on to describe conditions in West Africa, the need for public support and aid. ( I.e. he is using his media platform to help the people affected, raise awareness for them,).

Full article link below

http://www.mercurynews.com/health/ci_26831840/ebola-stanford-doctor-back-from-liberia-has-no


In another article he simply states ,” Bucks, 43, said Thursday from his Redwood City home. “Of course I miss my family but we recognized in advance that it would be essential to be separated on the return. It’s an extension of the deployment to me.

Albert I agree it does not actually say the nurse had direct contact with Ebola patients in the last 21 days, think she is secure in knowledge she wasn't directly working with them. She has side skipped this when asked, always turning the debate to her home situation, not what the nature of the work she was doing. Unlike other health workers who would have seized the media circus opportunity to help promote the need for donations and aid, she only promotes her self and her human rights, and getting her online profiles professional changing to create a whole new personna, really weird. She seems too reactionary, volatile at the moment to work under such pressure conditions. Hope after this she has a break before returning.