A very good Ebola debate and a shoutout to Forbes Matthew Herper

FScreen Shot 2014-10-27 at 1.58.30 PMorbes Matthew Herper, who has been regularly covering the Ebola story since it broke, recently presented an in-print debate concerning the best way to handle this potentially scary situation.

His recent piece, entitled A Defense Of The Ebola Quarantine, contains two very different opinions about the best course of action at this time.

The debate is unusual, since it does not deteriorate into name calling. Instead, it gives two very different views on the same matter, each making sense in its own way.

On one side is ACSH Trustee, Dr. Paul Offit, chief of the division of infectious diseases at Children s Hospital of Philadelphia, who firmly believes that the system in place to prevent the spread of the infection is working just fine. He says, If someone is afebrile and asymptomatic, they aren t contagious. The New York city doctor [Craig Spencer] acted in a responsible manner. The minute he noticed his first symptom (temperature of 100.3 degrees) he quarantined himself.

On the other hand, former New York City Health Commissioner Pascal J. Imperato, now the Dean at SUNY Downstate Medical Center, strongly disagrees. Dr. Imperato says, I strongly support the decision by New York and New Jersey to quarantine those entering these states who have been exposed to those with active Ebola disease infections in Africa...As demonstrated by the case of Dr. Craig Spencer, self-monitoring simply does not work.

He takes it one step further: The Centers for Disease Control and Prevention has hesitated to implement the quarantine regulations now in force in New York and New Jersey out of a concern that they will discourage medical volunteers from going to the epidemic zone in West Africa. However, such a position is based on an unproven assumption that these volunteers are vital to the treatment of Ebola patients. This assumption has not yet been supported by firm evidence.

ACSH s Dr. Josh Bloom says, I believe that in this case, both Offit and Imperato are right. Yes Dr. Spencer did everything correctly, and the chances that he infected anyone between his return to the US and when he reported for quarantine are just about zero. But DOES THIS mean that everyone returning from the three Ebola-ridden countries will act similarly? No way. So the idea of a mandatory quarantine, even just restricting such travelers to their homes, for anyone coming here from those countries makes sense, at least until we have more confidence that our current beliefs are supported by evidence.

Dr. Bloom continues, We have been very fortunate that (assuming we have been told the truth hardly certain, given the performance of the CDC thus far) no one has acquired Ebola in the US, except for those who have returned from the hot zones in Africa, or people who have treated them, especially the Thomas Duncan debacle in Dallas. The problem is that if there is one instance in which the infection has been passed from an infected individual to someone in the general public, look out. The ensuing panic will probably do much more damage than the virus. This type of idiocy has already begun to rear its ugly head, despite the lack of any infections.

So, there are really three issues here:

  • Should we assume that what Dr. Offit says will apply to similar situations that will invariably arise?
  • Should we be extra careful as Dr. Imperato suggests?
  • Are volunteers going to countries where the infection continues to rage going to be more helpful, or harmful?

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