A group of a dozen Maine health professionals spoke out Thursday against the state’s quarantine policies for individuals returning from West Africa, writing in a letter that the “epidemic of fear can be as dangerous as an epidemic with a virus.”
Gov. Paul LePage and officials with the Maine Department of Health and Human Services have threatened legal action against a nurse living in Fort Kent who cared for Ebola patients in Sierra Leone and refuses to remain quarantined in her home. Kaci Hickox shows no symptoms of illness and preliminary tests showed she was not infected with the virus.
The letter, submitted to the Bangor Daily News Thursday as an opinion column, was signed by four former high-ranking state public health officials and the president of the Maine Medical Association, among other health experts. The authors warned that imposing unnecessary restrictions on health care workers returning from Sierra Leone, Guinea and Liberia could devastate efforts to halt the outbreak at its source.
“Quarantining of all health care workers without symptoms upon their return from caring for Ebola patients in the affected countries may be well intended but is not supported by the science or experience,” the letter states.
Among the signatories were former state epidemiologists Dr. Kathleen Gensheimer, who served for nearly three decades from 1981 to 2009, and Dr. Stephen Sears, who resigned in May and temporarily served as acting director of the Maine Center for Disease Control and Prevention before the current director, Dr. Sheila Pinette, was hired in May 2011. The position of state epidemiologist — tasked with preventing the spread of infectious diseases, tracking their causes and effect on the population, and responding to outbreaks — remains vacant.
Also listed as signatories were former state health officers Dr. Lani Graham and Dr. Dora Anne Mills.
Mills is the sister of Maine Attorney General Janet Mills, who is advising the Maine CDC on the agency’s enforcement of restrictions on health care workers returning from West Africa.
Dr. Lisa Ryan, president of the Maine Medical Association, also signed the letter.
Even if health care workers are exposed to the Ebola virus, “40 years of experience and biological evidence show they are not contagious before symptoms present,” the letter states. Research also shows that fever often heralds the contagious stages of the illness, allowing individuals to identify themselves and seek isolation before infecting others, according to the letter.
Ebola is only contagious once symptoms arise.
“Body fluids such as blood and vomit are most infectious in the very end stages of the disease. That is why the only two people to have contracted Ebola in the United States are two nurses who cared for a patient in Texas at the very end of his life, and we understand the nurses were not fully protected,” the letter states.
Pinette said at a Wednesday news conference that Hickox “may have been tested too early,” indicating the prior negative results might not prove reliable. Tests may not detect the virus in an infected individual before the person develops symptoms, she said.
The authors said they sought to address the “epidemic of fear” spreading about Ebola, writing that the outbreak in West Africa is similar to past outbreaks, spreading because of poor conditions, inadequate public health systems and lack of health care workers.
“Centuries of experience with epidemics show that Ebola must be stopped at its source in order to prevent its spread elsewhere,” the letter states. “In order to accomplish this, we need thousands of health care workers to volunteer in these three affected countries in West Africa, and at this time, we are far short of that. Unnecessary quarantines impede these efforts.”