Ebola in the Big Apple and Common Sense in Short Supply

So much for Ebola being under control, limited to Western Africa, and not a threat to the American homeland. There is now a new confirmed case in New York City, with three others in quarantine. Doctor Craig Spencer, recently confirmed with Ebola, works for Doctors Without Borders, and was providing medical and humanitarian relief to Ebola victims in Western Africa.

He returned to the US from Guinea almost a week before exhibiting first symptoms of infection. Arriving at JFK airport on October 17, he cleared the CDC’s protocol for “enhanced screening of all returning travelers from W. Africa.” No quarantine, either voluntary or mandatory. He is just one of many going through similar “enhanced screenings” at US airports on a daily basis.

Testifying before Congress last week, Obama administration officials, “admitted that 100 to 150 West Africans from Ebola infected areas are entering the US every day.” How many others might be in the early stages of Ebola infection, similar to Dr. Spencer?

Missing is the common sense role of quarantine. Not a novel idea. Quarantines were used in the 1700’s in New York for new immigrants, “To prevent the bringing in and spreading of infectious distempers in the colony.” Within three weeks, this infection plays itself out and those quarantined can be released with a high probability of non-infection. Why wasn’t Dr. Spencer in a quarantine, especially after having returned from the “hot zone” in West Africa, himself working with Ebola patients? As a physician, shouldn’t he have known that he could be infectious? Why not self-exile for a few weeks fulfilling his duty to “first do no harm”?

What about the hundred plus entering the US every day who are not physicians and cannot be expected to know better? Aside from the folly of these potential infectious persons being allowed entry into the US in the first place, why not quarantine rather than simply asking a few questions and checking a temperature at the airport? If a physician slipped through the cracks, how many more potential Ebola carriers are also getting through?

The NYC Mayor reassures us, "There is no reason for New Yorkers to be alarmed." Sure, the city government has its citizens’ health as its highest priority, busily banning large sodas, salt, and trans fats, but not Ebola. Dr. Spencer took multiple subway and taxi rides, went bowling, walked along the High Line, and presumably ate at a number of city restaurants. How many people did he come in contact with? Most if not all will not even know they had potential contact with an Ebola patient. Good luck tracing and finding all his contacts in a city of eight million people. Three contacts of Dr. Spencer are in quarantine, but how many more are not but perhaps should be? Who sat next to him on the subway? Who served his meals and removed and cleaned his dishes?

Even the CDC director admits, “An infected person shouldn’t take public transportation because they could transmit the disease.” Yet Dr. Spencer did just that. The A-train, L-train, and 1-train, packed with commuters and visitors. Where are they commuting to and from? Where are the visitors returning home to after their trip to NYC? Where else can Dr. Spencer’s virus spread?

One NYC resident declared, “Now that Ebola is here, I ain’t takin the subway no more.” How many more of the city’s eight million feel the same way? Despite assurances from the Mayor, Governor, and other officials, NYC residents are understandably afraid. And this could have likely been prevented through travel restrictions and quarantines, both common sense and time tested measures to control an infectious disease outbreak.

Add to that the fears that if Ebola doesn’t get you, a hatchet in your head might. The double threat of a deadly virus and random terror attacks might be enough to shut down “the city that never sleeps.” What if they are combined into a “bioterrorist threat”? Yet the government, from the White House on down, dithers over these serious threats with empty promises and reassurances. Much of this predictable and preventable.

 

Dr. Joondeph is a retina surgeon at Colorado Retina Associates and serves on the faculty of Rocky Vista University School of Medicine. Twitter @retinaldoctor.

 

So much for Ebola being under control, limited to Western Africa, and not a threat to the American homeland. There is now a new confirmed case in New York City, with three others in quarantine. Doctor Craig Spencer, recently confirmed with Ebola, works for Doctors Without Borders, and was providing medical and humanitarian relief to Ebola victims in Western Africa.

He returned to the US from Guinea almost a week before exhibiting first symptoms of infection. Arriving at JFK airport on October 17, he cleared the CDC’s protocol for “enhanced screening of all returning travelers from W. Africa.” No quarantine, either voluntary or mandatory. He is just one of many going through similar “enhanced screenings” at US airports on a daily basis.

Testifying before Congress last week, Obama administration officials, “admitted that 100 to 150 West Africans from Ebola infected areas are entering the US every day.” How many others might be in the early stages of Ebola infection, similar to Dr. Spencer?

Missing is the common sense role of quarantine. Not a novel idea. Quarantines were used in the 1700’s in New York for new immigrants, “To prevent the bringing in and spreading of infectious distempers in the colony.” Within three weeks, this infection plays itself out and those quarantined can be released with a high probability of non-infection. Why wasn’t Dr. Spencer in a quarantine, especially after having returned from the “hot zone” in West Africa, himself working with Ebola patients? As a physician, shouldn’t he have known that he could be infectious? Why not self-exile for a few weeks fulfilling his duty to “first do no harm”?

What about the hundred plus entering the US every day who are not physicians and cannot be expected to know better? Aside from the folly of these potential infectious persons being allowed entry into the US in the first place, why not quarantine rather than simply asking a few questions and checking a temperature at the airport? If a physician slipped through the cracks, how many more potential Ebola carriers are also getting through?

The NYC Mayor reassures us, "There is no reason for New Yorkers to be alarmed." Sure, the city government has its citizens’ health as its highest priority, busily banning large sodas, salt, and trans fats, but not Ebola. Dr. Spencer took multiple subway and taxi rides, went bowling, walked along the High Line, and presumably ate at a number of city restaurants. How many people did he come in contact with? Most if not all will not even know they had potential contact with an Ebola patient. Good luck tracing and finding all his contacts in a city of eight million people. Three contacts of Dr. Spencer are in quarantine, but how many more are not but perhaps should be? Who sat next to him on the subway? Who served his meals and removed and cleaned his dishes?

Even the CDC director admits, “An infected person shouldn’t take public transportation because they could transmit the disease.” Yet Dr. Spencer did just that. The A-train, L-train, and 1-train, packed with commuters and visitors. Where are they commuting to and from? Where are the visitors returning home to after their trip to NYC? Where else can Dr. Spencer’s virus spread?

One NYC resident declared, “Now that Ebola is here, I ain’t takin the subway no more.” How many more of the city’s eight million feel the same way? Despite assurances from the Mayor, Governor, and other officials, NYC residents are understandably afraid. And this could have likely been prevented through travel restrictions and quarantines, both common sense and time tested measures to control an infectious disease outbreak.

Add to that the fears that if Ebola doesn’t get you, a hatchet in your head might. The double threat of a deadly virus and random terror attacks might be enough to shut down “the city that never sleeps.” What if they are combined into a “bioterrorist threat”? Yet the government, from the White House on down, dithers over these serious threats with empty promises and reassurances. Much of this predictable and preventable.

 

Dr. Joondeph is a retina surgeon at Colorado Retina Associates and serves on the faculty of Rocky Vista University School of Medicine. Twitter @retinaldoctor.