Kaci Hickox, the nurse who escaped New Jersey
Gov. Chris Christie’s clutches on Monday, now faces a of confinement by Maine Gov. Paul LePage. On Friday, as
I note in my today, Hickox became the first person to be forcibly
isolated under Christie’s new 21-day quarantine policy for health
care workers returning from Africa after treating Ebola patients.
Hickox has never shown symptoms of Ebola and repeatedly tested
negative for the disease while confined at University Hospital in
Newark over the weekend, which is why Christie, by his own account,
let her leave New Jersey for her home in Maine. LePage nevertheless
wants Hickox to remain at home until the 21-day quarantine period
ends in mid-November. Today she said she prefers not to, since she
is neither sick nor contagious. In response, LePage said he
will try to compel her compliance.
“Upon learning the healthcare worker intends to defy the
protocols,” says a from LePage’s office, “the Office of the Governor has
been working collaboratively with the State health officials within
the Department of Health and Human Services to seek legal
authority to enforce the quarantine.” Meanwhile, “The Maine State
Police will monitor the residence in Fort Kent where the healthcare
worker is staying, for both her protection and the health of the
community.” That sounds like LePage is exercising a legal authority
he does not yet have by enforcing a quarantine that has not yet
been ordered. He explains why:
We hoped that the healthcare worker would voluntarily comply
with these protocols, but this individual has stated publicly she
will not abide by the protocols. We are very concerned about her
safety and health and that of the community. We are exploring all
of our options for protecting the health and well-being of the
healthcare worker, anyone who comes in contact with her, the Fort
Kent community and all of Maine. While we certainly respect the
rights of one individual, we must be vigilant in protecting 1.3
million Mainers, as well as anyone who visits our great state.
LePage, a Republican up for re-election next Tuesday, is right
that “1.3 million Mainers” (many of them voters!) deserve
protection from imminent threats to their health. But there is no
evidence that Hickox poses such a threat, and no reason to think
that daily monitoring for symptoms cannot provide adequate
protection in the event that Hickox does become ill, without the
need to detain her at gunpoint. Ebola is not airborne; it is
through contact with the bodily fluids of people
who are infected, a risk that does not arise until fever and other
symptoms appear. As The New England Journal of
Medicine notes in an published on Monday, “an asymptomatic health care
worker returning from treating patients with Ebola, even if he or
she were infected, would not be contagious,” and “fever
precedes the contagious stage.” Contrary to what LePage seems to
imagine, someone with a normal temperature who tests negative for
the virus will not suddenly become violently ill during a trip to
the grocery store and start vomiting on fellow shoppers, setting
off an epidemic.
Maine Health and Human Services Commissioner Mary Mayhew says a
quarantine policy based on such outlandish, scientifically
unfounded scenarios is “a reasonable, common-sense approach.”
The New England Journal of Medicine calls it “unfair and
unwise,” warning that it will “impede essential efforts to stop
these awful outbreaks of Ebola disease” by deterring medical
professionals like Hickox from volunteering their efforts. “These
responsible, skilled health care workers who are risking their
lives to help others are also helping by stemming the epidemic at
its source,” the journal says. “If we add barriers making it harder
for volunteers to return to their community, we are hurting
ourselves.”
Christie, desperate to justify what looks like an embarrassing
overreaction, keeps falsely claiming that Hickox was “obviously
ill” when she arrived at Newark Liberty International Airport on
Friday. According to , which as far as I know is uncontradicted, the only
evidence of illness at the airport was an erroneous reading from a
forehead thermometer indicating a temperature of 101, which she
attributes to the fact that she was “flushed and upset.” At the
hospital, a more-accurate oral thermometer indicated a normal
temperature of 98.6, while a forehead thermometer still registered
101. Hickox says a doctor told her: “There’s no way you have a
fever. Your face is just flushed.” Hickox did not display any other
symptoms, and she tested negative for Ebola, which is why she was
released from the hospital on Monday.
Here is how Christie this sequence of events yesterday:
She hadn’t had any symptoms for 24 hours. And she tested
negative for Ebola. So there was no reason to keep her. The reason
she was put into the hospital in the first place was because she
was running a high fever and was symptomatic.If people are symptomatic they go into the hospital. If they
live in New Jersey, they get quarantined at home. If they don’t,
and they’re not symptomatic, then we set up quarantine for them out
of state. But if they are symptomatic, they’re going to the
hospital.
A temperature of 101 as “a high fever” in an adult, and even that
reading seems to have been erroneous. As Christie should know by
now, Hickox never had “a high fever” or any other symptoms. By
continuing to claim otherwise, he implies that she was sick but got
better, which suggests that she might get sick again at any
moment.
“I remain appalled by these home quarantine policies that have
been forced upon me, even though I am in perfectly good health and
feeling strong and have been this entire time completely symptom
free,” Hickox on NBC’s Today show this morning. As I argue
in my , which discusses the legal standards usually applied in
quarantine cases, the government does not have “clear and
convincing evidence” that Hickox poses a threat to the general
public, and home confinement is not the “least restrictive
alternative,” given the option of daily symptom monitoring.