Why Take Chances?

I took my mom to the hospital yesterday. Two or three times during the admitting process, she was asked if she had been in West Africa within the  past month or so. Knowing my mom as I do, I had to chuckle inwardly at the absurdity of the question. This was a subjective absurdity, however; it seemed absurd only because I know her so well as no world traveler. For the hospital staff, who don't know the absurd particulars of the situation, it remains a practical necessity to ask the question. To many health-care professionals, meanwhile, it seems similarly absurd for politicians, not to mention the general public, to demand that they submit to quarantine after returning from the West African hot zones. We've just seen the state of New Jersey buckle under the threat of litigation from a nurse who resented her admittedly crude quarantining, despite having tested negative for the Ebola virus. The medical establishment has rallied around the nurse and against the aggressive policies recently adopted in both New Jersey and New York, by a Republican and a Democratic governor respectively, while the White House backs the medical establishment. I'm no distruster of institutions or resenter of elites, but there is a whiff of arrogance in the medical establishment's campaign against more sweeping quarantines. Certainly the doctors know better than the hysterical yahoos in local governments or the national media, after all! Their case boils down to this: if Ebola isn't contagious until a patient exhibits symptoms, than anyone who has treated Ebola should have full freedom of movement until he or she exhibits symptoms. But if the doctors and nurses want to persuade the general public of this, they need to make absolutely clear how quickly infected people can begin to exhibit symptoms, and how quickly those with symptoms can become contagious. If they prove unpersuasive, the public remains justified in asking: why take chances?

The federal government prefers to amplify a secondary argument about incentives. The problem with stricter quarantines, it's argued, is that American medical personnel won't want to go to Africa to treat Ebola if it means submitting to quarantine and becoming "pariahs" at home. This is a curious argument. The claim is that people willing to risk contracting the Ebola virus can't stand the thought of a 21-day quarantine. At one moment, they're pretty brave; in the next, they're throwing hissy fits because of some people's possibly excessive concern for public safety. If they're willing to risk their lives, however, they ought to have the fortitude to stand a quarantine of some sort. But what looks like inconsistency is really a kind of professional arrogance. What probably irks these people as much as the prospect of enforced isolation is the idea that someone other than them, outside the medical establishment, wants to declare a quarantine and has the power to do so -- that someone other than them can ask: why take chances? I suspect that this will cease to be an issue before long, as Ebola seems to prove difficult to catch and relatively easy to survive in the U.S.  By sometime next year many people may feel that their fears of Ebola were silly. But until then a little more respect for the concerns of the general public would be a good idea. In return, a little more faith in the objective findings of doctors would be a good idea as well.