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October 27, 2014

Five-Year-Old Boy In Isolation at Bellevue, Undergoing Test for Ebola

He recently travelled to West Africa and has a low-grade fever. He's described as being in "isolation" but not "quarantine," for some reason.

Meanwhile, there is much drama involving the New Jersey nurse whom Christie ordered into 21 day quarantine after returning from West Africa.

Kaci Hickox went all Wendy Davis in Pink Running Shoes about her quarantine.

Kaci Hickox, a nurse placed under mandatory quarantine in New Jersey, went on CNN on Sunday and criticized the "knee-jerk reaction by politicians" to Ebola, saying "to quarantine someone without a better plan in place, without more forethought, is just preposterous."

Hickox, an epidemiologist who was working to help treat Ebola patients in Sierra Leone, has tested negative twice for Ebola and does not have symptoms, she said. She is quarantined for 21 days at University Hospital in Newark.

"This is an extreme that is really unacceptable, and I feel like my basic human rights have been violated," Hickox told CNN's Candy Crowley on "State of the Union."


"To put me through this emotional and physical stress is completely unacceptable," she said.


Hickox told Crowley that mandatory quarantine is "not a sound public health decision" and that public health officials -- not politicians -- should be making the policies related to Ebola and public safety.

"For the first 12 hours, I was in shock. Now I'm angry," she added.

She threatened to file a lawsuit (and still might).

Chris Christie defended his decision to put her into mandatory hospital quarantine yesterday, but now he's reversed himself and has ordered her released.

Hickox's situation is a bit tough. She lives in Maine. But she was ordered quarantined in New Jersey, in a hospital's quarantine ward, behind a plastic shroud.

I think that was an overreaction. Quarantine may be necessary but the easiest sort of quarantine to bear is a home quarantine; why keep her in a hospital New Jersey? Why not ship her back safely to Maine (on a chartered plane or bus) and let her spend her quarantine at her own home?

One point I keep making is that quarantine decisions are disliked very strongly by people under quarantine and it is necessary to use coercion to achieve actual quarantines. On the other hand, there's no need to make a quarantine worse than it needs to be, as if we're punishing people for doing humanitarian, heroic work overseas.

And you don't want to make government response so punitive that people conceal their symptoms or history of ebola contact.

Other states are enacting "active monitoring" programs, which seems like a possibly good compromise between voluntary self-monitoring and the overreaction of forced isolation-ward hospitalization for people not showing any actual symptoms.

When Christie and New York Gov. Andrew Cuomo announced their new policies Friday, they called for possible hospitalization. And on Sunday night, the governors said the quarantines could be carried out at home.

Florida Gov. Rick Scott has approved an executive order mandating twice-daily 21-day health monitoring for people returning from Ebola-affected Guinea, Liberia and Sierra Leone. The order, signed Saturday, gives Florida Department of Health authorities the go-ahead to work alongside the Centers for Disease Control and Prevention to identify people who have recently returned to Florida from those areas so they can be monitored, the governor's office said in a news release.

Virginia is following suit. The state is implementing an "active monitoring program" for all returning passengers from Guinea, Liberia and Sierra Leone, "with a special emphasis on returning health care workers," Virginia governor's spokesman Brian Coy has said.

There is an easy cheap method of encouraging self-isolation: requiring people who have been exposed to ebola to keep a log noting every place they go and every person they come into contact with (say, within six feet), to the best of their ability.

Sometimes just forcing someone to remind themselves of something through a means like journal-keeping can wind up causing them to do a better job of avoiding unnecessary risks to others.

In unrelated health news, a compound found in small quantities in chocolate called "flavanol" has been found to forestall or reverse age-related cognitive decline when fed to subjects in large doses. (Doses much larger than you could possibly get from eating any medically-plausible quantity of chocolate.)

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posted by Ace at 12:38 PM

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