Ebola politics and health practices

Ebola Executive Branch Pat Quinn Trips and Vacations Chris Christie Andrew Cuomo

With Ebola, caution doesn't mean panic

Ebola has spread ... to the campaign for Illinois governor.

Late last week, Gov. Pat Quinn ordered a 21-day home quarantine for "high-risk" individuals, including medical personnel who have been directly exposed to Ebola. Republican challenger Bruce Rauner said this week that Quinn waited too long to institute a quarantine — although Illinois hasn't had an Ebola case.

Rauner, on firmer ground, also pushed the governor to drop his opposition to a travel ban on visitors from Ebola-stricken countries. Sen. Mark Kirk and Rep. John Shimkus chipped in, ripping Quinn for not supporting a travel and visa ban.

This followed a weird weekend stare-down featuring New Jersey Gov. Chris Christie, New York Gov. Andrew Cuomo and the Obama administration. With Quinn on the periphery.

In succeeding days, more maneuvering: The Centers for Disease Control and Prevention released new guidelines for how to treat medical workers and others who've had contact with Ebola patients. New York and New Jersey issued — then eased under White House pressure — tougher-than-CDC quarantine rules. Illinois officials clarified their guidelines, but insisted they were not backing off quarantines for "high-risk" people.

And more confusion: While the Obama administration pressed the governors to ease quarantine rules, the Pentagon isolated about a dozen Army soldiers and a top general at a base in Italy who returned from West Africa. More will follow.

Health officials around the country continue to scratch their heads about how these changing guidelines will work in practice. The public is left to ... well, let's not call it panic. People are not panicking. They are, though, worried and confused because the U.S. response consistently seems to be one step behind events.

And no wonder. A New York doctor returning from West Africa fell ill and sought treatment after he had moved around the city, prompting New York and New Jersey to order their 21-day quarantines for returning medical personnel. Kaci Hickox, a nurse returning from treating patients in Sierra Leone, landed in Newark and was greeted, she wrote, by "a frenzy of disorganization, fear, and most frightening, quarantine."

Even though Hickox showed no symptoms, she was clamped into isolation in a makeshift plastic tent with a portable toilet but no shower or television. New York and New Jersey officials said they were still working out details about where people who arrived after Hickox would be quarantined and how the protocol would be enforced. Hickox was released Monday and allowed to return home to Maine. New Jersey's Christie said he'd let local health officials figure out how to ensure that she abides by federal protocols for self-monitoring.

We have to assume, though, that other possible cases will arrive in the U.S. What to do then? Here's the way to think about this going forward:

•Unfortunately, we're all still scrambling. Look around.

•But if we're going to err, let's err on the side of caution. Given the lethality of Ebola and the virus' 21-day incubation period, a quarantine rule for medical professionals and others who have had contact with the disease in those high-risk countries seems reasonable.

•Given the high incidence in certain countries, a temporary travel and visa ban on visitors from those nations makes sense too. It could be structured without impeding the movement of health professionals to and from those countries.

Public health officials warn that medical personnel might not volunteer to work in Ebola-afflicted nations if they know they face a quarantine on return. Maybe. On the other hand, many will want to help stop the most dangerous outbreak of their careers. But let's make the policy as flexible as possible. That means a certain trust factor; home confinement, for example, rather than institutional isolation.

In other words, medical volunteers shouldn't be treated as suspects. They should be offered options, as Hickox was, to make the quarantine period as easy as possible. They're professionals who risked their lives in a foreign land. We trust that they wouldn't knowingly put anyone else at risk. Let's hope the subway-riding, open-bowling doc was an outlier.

Halting Ebola at the source — in West Africa — remains the key to ending this epidemic.

Doctors, nurses and health care professionals go to Africa, knowing the dire circumstances they'll confront and the extraordinarily hygiene measures required to stay safe. When they return to the United States, they should know what to expect. It will mean some time by themselves. It shouldn't mean a showerless tent.