With the Ebola outbreak in Africa making headlines and some cases being reported in the U.S., we're seeing that quarantines for fighting the disease aren't very effective, especially with U.S. citizens who feel that quarantines violate their personal freedoms.
Even those U.S. citizens put on voluntary quarantine by the Centers for Disease Control (CDC) are not staying at home, Just recently, NBC medical correspondent Dr. Nancy Snyderman returned from West Africa to the U.S. There, she was put on a voluntary quarantine after one of her cameramen tested positive for the disease.
However, Snyderman chose to leave her home, while on quarantine, and have dinner at a local mall, sparking panic and outrage.
Of course, Snyderman was acting under the knowledge that those without symptoms of the disease are not infectious carriers, but she still violated a promise she made to the CDC and the public.
However, Snyderman is not alone in violating a voluntary quarantine. Nurse Amber Vinson reported a slight fever to the CDC, after having cared for an Ebola patient in Texas. However, even after put on voluntary quarantine, she visited schools in both Texas and Ohio. She was recently diagnosed with Ebola and is now being treated for it.
Perhaps the only option is making quarantines mandatory until the Ebola danger passes.
"We need to start using quarantine orders, at least for the near term, so people are under the legal obligation to obey," says Mark Rothstein, director of the University of Louisville's Institute for Bioethics, Health Policy and Law. "Quarantine is a scary word and the authorities are saying these people need to be monitored. If these people felt it was OK to travel or to go out and get dinner, something is missing."
Although the U.S. has locked up disease carriers in the past, it doesn't happen often. Federal officials can call mandatory quarantines for carriers of a variety of infectious diseases, including Ebola. As of 2000, the director of the CDC has authority to impose travel bans, even between states, but has not yet done so. The CDC has imposed a "do not board" list for air travel, but even that recently allowed several flyers on the list through because that sort of travel ban is usually handled by states.
There is also a recent study by Drexel University that suggests that the mandatory quarantines of 21 days aren't long enough. The 21 days refers to what the CDC believes is the time it takes for a patient exposed to the virus to get symptoms. And although that is mostly the case for this particular outbreak, previous outbreaks of Ebola told a different story: in 1995, there was a 12 percent chance that someone could show symptoms after the 21-day quarantine period was up.
"Clearly for pathogens that have a high degree of transmissibility and/or a high degree of severity, the quarantine time should be greater than for agents with lower transmissibility and/or severity," says Charles Haas, PhD, of Drexel University. "The purpose of this paper is not to estimate where the balancing point should be, but to suggest a method for determining the balancing point."
Although science tells us that Ebola is difficult to contract, most Americans might feel safer if federal agencies were more transparent about their precautionary measures.
