Saturday, October 18, 2014

Isolate and Quarantine to halt the Ebola Epidemic

Why don't we use the only proven measures that have been shown to stop Ebola?  Any person who gives the Ebola epidemic any thought realizes that isolation and quarantine are the only tools we have that are 100% effective in halting the Ebola epidemic.  So why do our public health officials and our elected officials refuse to block all travel from West Africa until a 21-day quarantine has occurred?  Here are some of the more common reasons against isolation and quarantine:

Reason 1:  As stated by the President last night (October 16, 2014)--- People could do “broken travel” that is fly to another country—say France then fly to the U.S. and the 21 day quarantine would have the opposite effect.  Furthermore, the President added that this is the advice he is getting from the head of the CDC, NIH and others in his administration.
Answer 1: Do the quarantine smartly—that is require ALL persons wanting to travel to the U.S. obtain a visa and make the waiting period for the visa to become valid 21 days. All such persons must come to the U.S. embassy in their country to obtain the visa application in person and have their temperature taken.  After the 21-day period they must return to the embassy (or airport station) and receive the valid travel visa.

Reason 2:  This would hinder the world’s efforts to halt the epidemic by making travel more difficult.
Answer 2:  This is disingenuous.  No one advocates blocking travel to West Africa we just need to take the precautions that will prevent Ebola from coming out of West Africa.

Reason 3: This would hurt the economies of West Africa.
Answer 3: This is very short sighted.  Compare the cost of loosing the revenue of 150 passengers a day from West Africa to the U.S.,  with the cost of dealing with Ebola here; a few thousands of dollars versus tens of millions of dollars.  How much has the one case of Ebola cost us already—millions of dollars and still counting Furthermore, these 150 people can fly to the U.S. after a 21-day quarantine making the financial loss minimal.

Reason 4:  This would be an anti-African action.
Answer 4: No, this is simply using our best science to stop the epidemic, isolate the epidemic where it is and allow the richer countries to concentrate their Ebola efforts in West Africa rather than at home. 

Reason 5:  Scare our public so that our Congress will increase the budgets of the CDC and the NIH and possibly the military.
Answer 5: This will work but we are grabbing the tiger by the tail—if the Ebola epidemic spreads to the U.S. then this policy will have backfired.

I can’t think of one good reason that we don't do the obvious—isolate and quarantine—can you?  If you are like me and can’t think of a good reason not to isolate and quarantine you must try to reach out to all of your contacts, our elected and public health officials and world health officials now.

Steven Keller, Ph.D.

Professor, New Jersey Medical School—Rutgers University

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