Editorials

State Ebola policy is smart, but we need national Rx

A state trooper is stationed across from the house of Kaci Hickox in Fort Kent, Maine, on Thursday. State officials are going to court to keep Hickox in quarantine for the remainder of the 21-day incubation period for Ebola that ends Nov. 10. Police are monitoring her but can’t detain her without a court order signed by a judge.
A state trooper is stationed across from the house of Kaci Hickox in Fort Kent, Maine, on Thursday. State officials are going to court to keep Hickox in quarantine for the remainder of the 21-day incubation period for Ebola that ends Nov. 10. Police are monitoring her but can’t detain her without a court order signed by a judge. The Associated Press

It’s unfortunate that when the Ebola outbreak first arrived in Texas, the U.S. Centers for Disease Control and Prevention didn’t respond flawlessly.

If ever a public health issue cried out for a uniform national response, it’s this one. Though hard to contract, Ebola, once spread, can be debilitating and deadly. And the fear of its grisly symptoms has been even more contagious.

The CDC’s initial missteps, though quickly corrected, created an opening both for legitimate concern and political exploitation. Unfairly or not, federal credibility was weakened.

Now that the disease has shown up in New York, the result has been a growing patchwork of state quarantines that, in some cases, far exceed CDC guidelines.

Kaci Hickox, the nurse who returned from Sierra Leone only to end up in a legal fight over her mandated confinement in Maine and New Jersey, has a point when she notes angrily that she poses no medical risk to others. She has tested negative for the virus and has had no symptoms other than a now-long-gone, low-grade fever.

Blanket quarantines in those states don’t leave room for such nuance. More sensible are the guidelines issued Wednesday in California, which mandate a 21-day quarantine for travelers who have had contact with Ebola patients, but recommend enforcement on a “case-by-case” basis.

Isolating those who are potentially exposed during the virus’ three-week incubation period while giving county medical officers the flexibility to deal with varying risk profiles seems to strike the right balance between civil rights and public safety.

Certainly the strategy makes more sense than the knee-jerk panic of, say, Louisiana, which told participants in an upcoming New Orleans conference on infectious tropical diseases to just keep out if they’ve recently been in Liberia, Sierra Leone or Guinea.

And surely it’s fairer than the strategy of U.S. Defense Secretary Chuck Hagel, who is rewarding servicemen and women building West African clinics with quarantines when they return, whether or not they’ve been anywhere near anyone with Ebola symptoms.

Dr. Ron Chapman, director of California’s Department of Public Health, noted that this state has yet to see its first case of Ebola. But, he added, California has legions of brave health care workers who have been back and forth from West Africa, manning the trenches in this record outbreak.

“These people are providing humanitarian aid, and we know what dedication it takes,” Chapman said. “We hold them in very high esteem.”

He’s right. But if we really want to esteem health workers, we’ll trust them enough to let them mount a coordinated, apolitical, national response.

The CDC may not be staffed with superheroes, but it does have health workers who are trained to deal with public health scares. Right now, it’s asking anyone returning from Ebola-affected regions to check in with local health authorities, let them know where they’ll be and voluntarily isolate themselves for three weeks.

Practically speaking, that’s only a little less strict than the new policy in California, which, with a little trust, could be the basis for a national consensus. This state-by-state patchwork is a prescription for trouble. Let the CDC do its job.

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