POLITICS

One angry nurse forces U.S. policy-makers to review Ebola guidelines

10/27/2014 06:08 EDT | Updated 12/27/2014 05:59 EST
WASHINGTON - American politicians have received a dose of tough treatment from an angry nurse, peeved at what she has described as an uninformed, publicity-driven response to the Ebola crisis.

On Monday, it appeared that the harsh medicine was working.

Nurse Kaci Hickox was allowed to leave quarantine after she castigated policy-makers in several states that planned a mandatory lockup for health workers returning from the Ebola-affected areas of West Africa.

And the dispute over her case led the Centers for Disease Control to issue a new set of recommended guidelines Monday for returning health-care workers, which fell far short of automatic quarantine.

Canada hasn't yet had such an intense debate, partly because it hasn't experienced its first Ebola case. But the issue is relevant to the numerous Canadians in West Africa, including about 30 medical professionals who have already volunteered there with Medecins Sans Frontieres.

Hickox attempted to sway her country's discussion from her temporary home: a plastic tent outside a New Jersey hospital where she was forced to stay upon her return from Sierra Leone.

From inside those makeshift digs, she wrote a newspaper column and granted media interviews where she warned that forcing people into quarantine would be detrimental to public health.

To stop the global spread of Ebola, she said, health workers had to be encouraged to go fight it in Africa, not discouraged. But she said she was treated like a criminal when she landed last week at Newark airport.

She wrote that she spent a month watching children die, alone, and had witnessed human tragedy unfold before her eyes, while much of the world did nothing: "(Now I sit) alone in the isolation tent and (think) of many colleagues who will return home to America and face the same ordeal. Will they be made to feel like criminals and prisoners?"

She heaped particular scorn on New Jersey Gov. Chris Christie, who suggested she'd appeared ill upon her arrival from Ebola-ravaged Sierra Leone and that's why she was put away.

"First of all, I don't think he's a doctor; secondly, he's never laid eyes on me; and thirdly, I've been asymptomatic since I've been here," Hickox told CNN.

"I think we have to be very careful about letting politicians make public health decisions."

But for a few reasons the debate in the U.S. has been highly political:

— Polls show huge American support for more drastic measures. One survey last week for National Public Radio suggested 77 per cent of Americans would approve of a travel ban — a de-facto quarantine of the affected African countries.

— Midterm elections are next week. A key issue — perhaps the No. 1 national issue — is the general accusation from Republicans that the Obama administration has been slow and incompetent in dealing with foreign crises. As a result, Ebola is just the latest issue where seemingly every campaigning politician in America proposes tougher, faster action.

— Some governors are also auditioning for the 2016 presidential election. As it so happens, some of the states touched by the first U.S. Ebola cases — Texas, Ohio, and the New York-New Jersey area — have governors touted as potential presidential candidates.

The Ebola issue has become political enough that some right-wing websites Monday reported Hickox's partisan affiliation — they described the returning nurse as a registered Democrat.

New Jersey's governor defended his own handling of the case. He did this from Florida, where he was campaigning Monday on behalf of the incumbent Republican governor in that key presidential swing state.

"I’m not going to step away for a minute from protecting the people of my state and our region," Christie said.

"So I understand that she didn’t want to be there. She made that very clear from the beginning but my obligation is to all the people of New Jersey and we’re just going to continue to do that."

Even within the U.S. government itself, there were mixed signals Monday. The White House, on the one hand, had offered Hickox its vocal support. But at the same time that the administration bemoaned mandatory quarantines, several American soldiers were being held in isolation on the orders of their commanding officer in Italy, after they returned from Africa.

The national Centers for Disease Control sought to end the confusion.

It introduced a new set of recommended guidelines for state officials to consider following. It suggested that the highest-risk travellers — people who, for instance, accidentally touched the bodily fluids of an Ebola patient — should voluntarily avoid crowds and work for 21 days, and stay mostly at home.

Medium-risk travellers, like health workers who remained protected around the virus, should undergo twice-a-day temperature testing, the CDC said. In making that announcement, the CDC released scientific research that underscored how unlikely it is to get Ebola from someone — even as they're suffering in the early stages of the disease.

In Canada, the current protocols also fall short of mandatory quarantine.

The Public Health Agency of Canada says all travellers identified as having arrived from an affected West African country are referred to a quarantine officer for a mandatory assessment, including temperature check. Quarantine officers have the authority to implement public health measures under the Quarantine Act.

A Canadian whose organization works in Sierra Leone says health policies need to encourage transparency.

If countries start imposing restrictions, then travellers will start lying about where they've been, he said, and monitoring the disease will become more difficult.

"If someone takes the courageous step to go to Liberia and work for three months with Doctors Without Borders, or with any health agency... and then understands that he's going to come back to North America and be put into a condition of quarantine for 21 days... maybe that would work (for some people)," said Bart Witteveen, World Vision Canada's director of humanitarian and emergency affairs.

"But maybe someone would say, 'No, I'm not sick. And if I get sick I'll report myself. So I'll just lie — I didn't go to Liberia. I flew through Paris, and I'll make sure to show that I came from Paris.'"