Editorial: Going by medical evidence

Published in the Hindu on October 29, 2014

Ebola virus photo - Photo Credit - Frederick Murphy
Ebola virus – Photo: Frederick Murphy


The reaction of the Governors of New York and New Jersey to the Ebola threat reflects their lack of understanding of the nature of the disease, and utter disregard for the need to institute well-thought-out public health policies that are based on sound medical advice and clear evidence. In a knee-jerk reaction, both the Governors on October 24 made it mandatory to quarantine for 21 days even asymptomatic people returning from the three Ebola-stricken West African countries if they had come in direct contact with people suffering from Ebola. Illinois soon followed suit. As a result, an American nurse returning from Sierra Leone was placed under quarantine. The policy was hurriedly introduced after Craig Spencer, a New York-based doctor who had treated patients in Guinea, tested positive for Ebola. Facing a barrage of criticism and an uproar, the Governors revised the policy in less than 72 hours to allow asymptomatic people to be quarantined at home for 21 days with twice-daily monitoring; those being monitored will be allowed to interact with family and friends. Despite the revision, the policy remains more restrictive than the requirements put out by the Centers for Disease Control and Prevention (CDC). Beginning October 27, the CDC’s updated guidance requires direct and active monitoring by public health officials once a day along with follow-up monitoring over phone for a period of 21 days for all travellers returning from the three disease-hit countries. It also calls for restricted public activities and restricted long-distance travel, but there is not a word on quarantining asymptomatic persons.

Unlike airborne diseases such as flu and tuberculosis, people can get infected by the virus only when they come in direct contact with the body fluids of an Ebola patient. Infected people remain free of symptoms and do not transmit the virus during the incubation period of two to 21 days. It is obvious that the panic-stricken Governors went overboard with their policy that had no scientific basis whatsoever. The direct fallout of their irrational policy would have led to a further reduction in the number of health workers volunteering to tackle the outbreak in the three African countries. Already the number of health workers volunteering to work in these countries is disproportionately small compared with the magnitude of the problem. While monitoring must be a top priority, allaying the fears of people by creating more awareness should be given equal importance. The U.S. has much to learn from the way Nigeria handled the Ebola situation and rid itself of the disease recently. A massive awareness programme along with tracking and surveillance was the way Nigeria tackled the situation.