Kaci Hickox spent a month in Sierra Leone treating patients with Ebola through the well-known humanitarian organization Doctors Without Borders. On Kaci’s last night in the Ebola-afflicted country, she fed crushed Tylenol tablets to a ten year old girl who she then watched die in a tent, alone. Of course, that little girl was only one of the many children Kaci witnessed fall victim to the disease that is running rampant in West Africa. What Kaci was not prepared for, however, was how her home country would greet her heroic efforts upon her return.
After two days of traveling back from Sierra Leone, Kaci arrived at the Newark Liberty International Airport exhausted and emotionally drained. At immigration, Kaci found herself being harshly questioned about her travels. Within minutes, she was escorted to a small office with those nearby quickly cloaking themselves in protective gear. Alarmed and uninformed, Kaci sat in that small office for three hours as officials endlessly questioned her about her trip, her exposure to Ebola, and her current medical status. The officials insisted on taking Kaci’s temperature several times using a body scanner. When the unreliable test showed Kaci had a fever, the altruistic volunteer was transported to a local hospital. It was there that Kaci found herself where she left the ten year old little girl—in a tent, alone.
With health-care workers like Kaci returning from Ebola-affected countries, U.S. policy makers have been confronted with public safety concerns. State response efforts were initially limited to recommended and voluntary quarantining. However, public panic, fear, and politics, under the guise of science, have lead many states, including New York, New Jersey, Maine and California to adopt mandatory 21-day quarantining. The policies affect all individuals potentially exposed to Ebola, even those who are asymptomatic and test negative for the disease. In Texas, court ordered quarantining is compelled by threat of criminal sanction.
Health officials, and Kaci herself, have challenged the policies on scientific and legal grounds. While the state’s power to quarantine as a public health measure is well-established, that power is not unlimited. Courts have acknowledged that involuntary quarantining constitutes a deprivation of liberty, affording those affected due process rights. In this context, due process procedural rights include the right to written notice and a court hearing. According to Jason Sapsin, former Assistant Attorney General for Maryland, the form of notice is “dependent upon the nature of the emergency facing the public health authority.” So, what is the nature of the emergency currently facing the United States? Officials in Connecticut seem to think we have, in fact, reached a state of emergency. But with only four cases of Ebola and one death in the U.S., health officials correctly question the drastic state measures. After all, the state mandatory quarantines clearly violate citizens’ due process rights. Kaci was the first, but potentially just the first of many, whose only notice of quarantining was actually being quarantined.
Joel Kupferman, executive director at the New York Environmental Law and Justice Project, contends that the government’s right to quarantine is “very, very limited” and notes that, “[if] you want to quarantine U.S. citizens, they should be afforded the right to see an attorney and appeal their quarantine.” The right to appeal is particularly important now when officials seem to be impulsively and frantically adopting quarantine policies whose scientific underpinnings are underdeveloped and questionable.
The science behind the 21-day quarantine policy is the finding that individuals inflicted with Ebola may not show symptoms for 21 days. For those asymptomatic 21 days, individuals assert that the Ebola-bearing individuals continue their daily lives, interacting with others and potentially spreading the disease. However, according to the Mayo Clinic, Ebola is not contagious until symptoms develop. Therefore, those with Ebola cannot actually spread the disease until after the 21 day quarantine ends. Of course, officials hope that within the 21 days of monitoring affected individuals will be identified. But there is no science supporting this theory.
What is the motivation behind these quarantines? Fear. The people of the United States have called the government into action. Frantic and unorganized, officials have responded by secluding the problem through quarantining. This panic-driven, paternalistic measure comes at the expense of citizens’ civil liberties. How necessary is this draconian approach? Officials gratuitously assume that health-care workers risking their lives to save others are willing to haphazardly undermine their own efforts by returning home and infecting the public.
Government policy should reflect both the disposition of potential carriers and the science behind the spread of Ebola. Virtual imprisonment via quarantining in airports, tents, and eventually in homes is egregious and unreasonable and borderline punitive. After all, it is not a crime to be sick.