Why Ebola quarantine is bad policy: From the front lines
In my mind I didn’t call it self-quarantine. I called it my “period of seclusion.”
But by the time Day 21 ticked by at the end of Monday, with no rush of fever nor corresponding rush of terror since leaving Liberia, I had begun to worry that this self-quarantine thing hadn’t been such a good idea after all.
It wasn’t just the loneliness, home for three weeks with just three dogs and two cats, out of sight and it seemed out of mind as far as most of my friends and family were concerned. Why didn’t they call?
It wasn’t just missing my 15-year-old daughter, Sylvia, who stayed with friends, and not seeing her ride horseback during the national school championships. Nor was it three weeks without being able to leave the house for a dosa at the curry place or an aglio e olio spaghetti at the Italian joint or a movie or a coffee or to stroke a newborn foal’s velvet nose. (Four were born at my daughter’s stable yards while I was out of circulation.)
There was another thing that bothered me.
It was the idea that 21 days of self-quarantine when I had no temperature and no symptoms was actually bad policy.
As the final days passed I interviewed a Doctors Without Borders epidemiologist, Iza Ciglenecki, who said that quarantines for returning Western health workers who had treated Ebola patients in West Africa made no sense, and stigmatized them when they had risked their lives to try to save people in hellish conditions. Within hours of that interview, officials in New York and New Jersey announced that a 21-day quarantine would be compulsory for health workers who — from what I’d seen in Liberia — were returning heroes worthy of ticker-tape parades.
Meanwhile, a British TV network in London declined to do a studio interview with an emergency coordinator — an administrator who stayed out of the high-risk zone — because he had worked in an Ebola treatment unit in Liberia.
My “period of seclusion” was perhaps better named a “period of delusion,” because by opting out of social contact for 21 days — based on no science — I had lent legitimacy to the practice of at times needlessly isolating returning healthcare workers. It could even have the unintended consequence of discouraging desperately needed doctors and nurses from going to West Africa.
So I was a little sheepish.
But to be fair, I mainly did it for Sylvia, whom I did not see when I flew home. It was partly to protect her. But it was partly so that if I did get sick, she wouldn’t have to spend three terrible weeks alone in quarantine in a South African hospital.
And when I first came back from Liberia, a part of me almost expected to get Ebola. I lost my appetite for a day. (“That’s a symptom,” I thought, and forced myself to eat.)
Little aches in my stomach and other parts of my body suddenly loomed large. Was I trying to fight off the tiny initial eruptions of Ebola?
I had been so nervous and clumsy when I was in Liberia. In an Ebola treatment unit run by Doctors Without Borders, I picked up my pen and notebook after dropping them on the ground and kept using them, a mistake. Then without noticing, I let my backpack barely brush against a potentially infected fence, and a hygienist came racing up from 30 yards away to tell me my error.
Was it that easy to get?
Walking from the treatment unit to my car across potentially infected ground where people might have vomited or bled, I realized I needed a boot sprayer, but I didn’t have one yet. I got into the car feeling as though the mud on my feet was Ebola lava.
I took to washing my hands dozens of times a day. I slathered hand sanitizer on dozens more times. I bought a sprayer, filled with chlorinated water so concentrated that it rotted my trousers wherever it splashed.
Afterward I would think back on missteps. Had I touched something? What about the orphan center where a child had been sick? Could my suitcase have picked up the virus at the airport on arrival?
I knew that I probably stood too close, interviewing people who were sick from two feet away. I found it hard to avoid touching my face despite the risk of spreading an infection.
Had I leaned on the wall of a house taking someone’s photo after a family member came down with Ebola? I remembered that I did touch another fence at another treatment unit, close to where ambulances pulled up with dying patients. I washed my hands, but did I do so right away?
At one point, interviewing an official, my temperature rose to 99.3 degrees. I consulted a chart that said this was “normal” but felt hot and anxious until it went back down later that night.
Outside the home where Thomas Eric Duncan had helped a neighbor and got infected with the virus — he died in a Dallas hospital on Oct. 8 — I interviewed family members, one of whom seemed sweaty and sick. Just an hour earlier two people living there had left the house to check themselves in to an Ebola treatment unit. During the interview, the Liberian journalist I was working with, Al Varney Rogers, put the palm of his hand on a shiny metal pole outside the house.
His eyes widened with alarm when I told him his mistake and he hurried to the car to wash his hands with the extra-strong chlorinated water.
In all, I might have been at a greater risk of picking up the virus than healthcare workers trained thoroughly in disinfection procedures and sprayed down multiple times after treating patients.
Being a bit scared was natural. Most people working there had occasional moments of fear. But the anxiety seemed foolish, since I was interviewing people, every day, whose lives had been turned completely upside down by Ebola.
Medical personnel interviewed told stories of people who died awful deaths, in pools of their own blood and vomit, and of desperately sick children suffering alone in Ebola treatment units.
I met survivors whose beloved children or husbands or wives or parents had died. One woman, who lost her husband and all but one of her children, stood with her small son in front of her house, tears pouring down her cheeks. I phoned a woman, who had been searching for her son at one Ebola treatment unit for two weeks. He was dead, and she was crying too much to come to the phone.
A man, who had lost every child but one, fearfully scanned the list of dead outside the Ebola treatment unit where his surviving 14-year-old daughter had been for two weeks, searching for her name. He came every day, but they did not change the list, from the original 30 names. And I never found out the end of his story.