Is Negligence and Procrastination causing the spread of Ebola in the U.S.?

If it wasnt disturbing enough that untrained lay persons have brought this virulent contagion into our country, it is even more disturbing that the Ebola virus is being spread by trained health care workers. A hospital in Texas failed to timely diagnose the virus and allowed two of their health care workers to contract the disease.Today, October 24, 2014, we learn that a New York City physician, Dr. Craig Spencer, contracted the disease while treating Ebola patients in one of the affected countries. This physician then boarded a plane to the U.S. aware that he was at risk for this deadly disease and that it could be in its dormant stage.This physician then engaged in public activities in Manhattan risking a widespread outbreak in the City. If U.S. trained health care professionals are failing to take the necessary precautions to contain this dangerous disease, and even worse, are contributing to its spread, then we should all be highly concerned.

We all watch horror movies that comically show people walking into danger and ignoring common sense. That scenario is occurring right now with Ebola. We have security dogs sniffing for bombs on airplanes, metal detectors checking for weapons before boarding, but have given little effort to address a much more sinister threat, a contagious disease with a 50 % mortality rate and no known cure, spreading like wildfire. Approximately 5,000 people have died from this killer disease already in Africa and it remains out of control, infecting even our U.S. trained health care workers.

There are many common sense solutions to help contain this virulent contagion and the answer is provided by the virus, the 21 day incubation period. Implementing a few simple measures based upon this incubation period is relatively inexpensive. Here are five (5) suggested measures.

1) A U.S. travel ban to these affected countries until the outbreak is contained. Exceptions are made for health care workers, or exceptional cause, but only after receiving a training course on the disease.

2) For persons who have been in any of the affected countries within the past 21 days that want to enter the U.S., but are coming from another country, they must wait 21 days after leaving an affected country, and have a doctor after that time verify the person is sign and symptom free, as well as a documented negative blood test.

3)Any U.S. health care workers returning to the U.S. from any of the affected countries treating affected patients must verify that they have not had contact with or treated a symptomatic person for 21 days, and have another doctor verify the person is sign and symptom free before boarding, along with a documented blood test.

4) For a non-health care person flying directly from an affected country to the U.S., all passengers before boarding must verify that they have not had contact with a symptomatic person for 21 days, and produce a doctors note subsequent to that 21 day period of no contact, verifying that they are symptom free along with a documented negative blood test.

All flights crew and cleaning personnel shall be given specific training and protective equipment for said flights including masks, gloves, and sanitizing agents for both the crew and the passengers. There will be no food service, only individual bottles of water. Upon arrival, all passengers, including health care workers, shall be quarantined for 21 days and on the last day have a blood test before permitted to leave quarantine.

5) U.S. health care workers treating an affected person in the U.S. must themselves remain quarantined while treating these patients in separate housing. When the treatment of the affected patient has ended or their tour complete, these health care professionals must be quarantined for 21 days and then given a blood test. Hazard pay must be provided to these dedicated health care workers for their sacrifice.

Right now this is a containable problem. However, if our politicians continue to procrastinate, the situation can easily escalate and our fiction movies may become reality. Write to your President and local politicians and tell them that they MUST ACT NOW, not when the situation becomes worse. Share and spread the word.

ADDENDUM. 10/27/14

After Governors Andrew Cuomo and Christie began implementing 21 day quarantines, President Obama pressured them both to relax the restrictions to home confinement. Nurse Kaci Kickox was quarantined in a New Jersey Hospital after returning from treating Ebola patients in Africa and threatens to sue, claiming the confinement is inhumane. If a nurse believes being confined to a New Jersey hospital for only 3 weeks is inhumane, maybe we should be concerned about all the other patients being treated at U.S. hospitals.

Shouldn’t a caring and ethical health care professional who just finished treating Ebola patients want to protect her family and friends by avoiding contact for a mere 3 weeks? Shouldn’t this nurse want to be confined for the public safety? Is it more humane and reasonable to risk spreading the deadly virus with no cure?

Nurse Kickox allegedly tested negative twice for Ebola. This is the important medical question, can you test negative for Ebola and still have the disease? Can you test negative on day 4 and then test positive on day 20? If the answer is yes, then the negative testing within the 21 day period of exposure is meaningless.

There is a mounting argument that the confinement policy will discourage health care workers from going to Africa to help stop the spread of this disease. But if the health care workers are bringing the virus back home with them, then they are not helping the cause they went there to do, but are doing just the opposite. Do we really want health care workers who after nobly placing themselves at risk by going to Africa to treat Ebola patients, are then willing to place U.S. citizens at risk by not taking reasonable precautions?

If payment of their wages is the issue, it is a non-issue. All health care workers should receive hazard pay during their confinement, medical insurance coverage, and disability coverage, something every taxpayer should welcome out of their tax dollars. As for the living conditions during the confinement, every State should borrow, buy, or build a building ready for these workers, with extremely comfortable amenities. And of course, have the facilities cleaned extensively by CDC implemented protocols after each occupant.

ADDENDUM 10/29/14

Nurse Kaci Hickox publicly states she has no intention of complying with a mandatory quarantine. Maine Governor Paul LePage is now taking action and having the police confine her to her home to protect the State. These are the type of health care “heroes” the world can do without. Do we really want health care workers who are willing to go to Africa and treat Ebola patients, but then unwilling to isolate themselves upon return for a mere 21 days to protect the public?

What if an American health care worker who refused confinement did infect someone else with Ebola, for example, a child, and that child died as a result. Wouldn’t there be a legitimate lawsuit for negligence and wrongful death? Shouldn’t there be criminal charges such as criminally negligent homicide or manslaughter? Negligence is the failure to use reasonable care or act like a reasonably prudent person would under the same or similar circumstances. 6 people on a civil jury would decide how reasonable a health care workers’ actions are under the circumstances.

Approximately 40,000 people in the U.S. die each year from the flu. What would be the result of an outbreak of Ebola in the U.S.?Just imagine if a person infected with Ebola rode a New York City subway during rush hour? If this infected person did not wash their hands properly and repeatedly, and then held onto the poles in the subways, can any CDC worker swear that there is no risk of spread? The fact that several health care professionals have contracted the disease despite taking precautions suggests that U.S doctors and nurses do not fully understand, or appreciate how this virus can spread.

I have not found literature stating that a person without symptoms is not contagious, but rather, they are just less contagious. There is clearly a point where a person goes from non-symptomatic to symptomatic, and if that person is in the public during that time, for example, bowling, like Dr. Spencer did, then they are unnecessarily risking spreading the virus to others.

The Obama administration wants to set different Ebola protocol standards for health care workers as opposed to military or the general population. The Ebola virus does not discriminate based upon occupation and neither should we. If a person was exposed or is at risk, there must be one universal protocol, not several based upon occupation.

If there is some belief that an infected doctor or nurse is better at taking their temperature or knowing when they are feeling sick then the rest of the public, that is highly debatable, and certainly not a compelling reason to have different standards to address and prevent a dangerous disease from spreading.

If the Obama administration is still more concerned about hurting the feelings of health care workers that may dissuade others from volunteering, . . . get over it. A truly caring and ethical health care practitioner will want to quarantine themselves after exposure and will certainly not want to risk endangering their family and friends.