With the first – and probably not the last – documented case of Ebola in New York last week, the reaction of State and local governments was big news, and the preparations of the North Shore-LIJ Health System kicked into a higher gear.
New York City Mayor Bill DeBlasio, flanked by the President of the city’s Health and Hospital Corporation, Dr. Ram Raju, and the city Health Commissioner, Dr. Mary Travis Bassett, gave a news conference. I thought they struck just the right balance of information and reassurance, and grounded their responses in what is known about the disease. In discussing the movements of the patient, a physician who had been working in West Africa with Doctors without Borders, prior to his admission to Bellevue, they repeatedly stated that he had posed no threat to the general public. Indeed, they cited the case of the man who died of Ebola in Texas, who had spent days living with family members at a much more advanced stage of his illness, and did not transmit the disease to any of them. Of course, 2 nurses who later cared for him did, but he was far sicker by then (which means he had a much higher viral load, and was correspondingly more infectious), and we now know they likely had inadequate training and personal protective equipment.
The bottom line is that people without symptoms, or even early in their course, pose no measureable threat to those around them. Of course, you wouldn’t know that based on the grandstanding by a variety of politicians staking out more extreme positions in the name of public safety (or political toughness).
This is playing out most visibly in New Jersey, where the governor has imposed a quarantine for anyone returning from caring for Ebola patients in West Africa. I believe this is wrong-headed and counterproductive. Wrong-headed because it is not based on the known epidemiology of the disease. People, who are well, even if they harbor the Ebola virus and are destined to become sick, are not a threat to those around them. Counterproductive because it stokes fear by implying the disease is more communicable than it is, thereby interfering with fact-based public health pronouncements, and because it will make it even harder to recruit volunteers to care for patients with the disease in Africa.
It is also hard to see how this would play out for health care workers caring for Ebola patients here. If the “NJ rule” were followed, then the staff at Bellevue might be quarantined, making the provision of care more complicated and demanding than it already is.
Preparations at our Health System continue. All clinical personnel are being educated. Volunteers for an Ebola care team are stepping forward and are being trained. A dedicated communicable disease unit has been established. Protocols have been written, implemented and tested. Equipment has been stockpiled and distributed. Best of all – calm professionalism has prevailed. I think we are doing the right thing for our staff and our community.
What do you think?