January 18, 2020
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Nurse on her way to Fort Kent quarantined over Ebola, calls treatment ‘frenzy of disorganization’

NEW YORK — Illinois joined New York and New Jersey in imposing mandatory quarantines for people arriving in the United States with a risk of having contracted Ebola in West Africa, but the first person isolated under the new rules, Kaci Hickox, a nurse returning from Sierra Leone, strongly criticized her treatment and said she would contest her quarantine in court.

Hickox was placed in quarantine at Newark after returning on Friday from working with medical charity Doctors Without Borders in Sierra Leone.

According to her boyfriend, Ted Wilbur, a nursing student at the University of Maine at Fort Kent, all Hickox wanted to do was come to Fort Kent, where she had arranged to stay at his off-campus home for a 21-day, self-imposed quarantine.

“She was going to land in Presque Isle on Monday and then self-quarantine in Fort Kent,” Wilbur said Sunday afternoon. “That is what the CDC wanted her to do and what is ethically, morally, medically and scientifically the right thing to do.”

Instead, upon arriving in Newark, Hickox was transferred from the airport to a hospital, where she was placed in isolation. She described a confusing and upsetting experience at the airport and worried the same treatment was in store for other American health care workers trying to help combat the epidemic.

“I … thought of many colleagues who will return home to America and face the same ordeal,” Hickox wrote in The Dallas Morning News. “Will they be made to feel like criminals and prisoners?

“I am scared that, like me, they will arrive and see a frenzy of disorganization, fear and, most frightening, quarantine,” she said in the article.

Under a policy introduced Friday, anyone arriving at John F. Kennedy International Airport or Newark Liberty International Airport after having contact with Ebola patients in Liberia, Sierra Leone or Guinea must submit to a mandatory quarantine for 21 days. Three weeks is the longest documented period for an Ebola infection to emerge.

Hickox spent nearly six hours at the Newark airport after landing before she was told what would happen to her.

“She called me from the airport after landing and said she hoped the screening would go quickly and with no problems,” Wilbur said Sunday. “At that point, she had not heard about [the New York City Ebola case]. Then she told me she was being detained and was told she was being quarantined.”

Hickox wrote in the The Dallas Morning News article, “Eight police cars escorted me to the University Hospital in Newark. Sirens blared, lights flashed. Again, I wondered what I had done wrong.

“I had spent a month watching children die, alone. I had witnessed human tragedy unfold before my eyes. I had tried to help when much of the world has looked on and done nothing.”

According to Wilbur, who on Sunday said Hickox had indicated she did not wish to speak further to the media, his girlfriend had been in Sierra Leone running a 35-bed clinic since September. While there, she supervised close to 40 medical staff members.

“Coming back last week was not like welcome home from a Bermuda vacation,” Wilbur said. “It was more like, welcome home from hell.”

Wilbur said Hickox described her quarantine living conditions as a 15-yard-long tent with a plastic sheeted floor in the parking lot in front of University Hospital in Newark.

“She is peeing and defecating into a box and in two days has had one sort of a rinse bath that was in a bucket,” Wilbur said. “She is upset and she is distraught and she got maybe three hours of sleep last night.”

Hickox’s confinement at the Newark hospital raises constitutional and civil liberties issues, given that she remains asymptomatic and has not tested positive for Ebola, according to her attorney Norman Siegel, a prominent civil liberties lawyer.

“The policy is overly broad when applied to her,” he said.

Hickox will contest her quarantine in court, Siegel said Sunday, arguing the order violates her constitutional rights.

Wilbur likened Hickox’s experience to being falsely imprisoned and accused New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo of grandstanding and politicizing the Ebola reaction during an election year.

“It was not like she was going to get anybody sick,” Wilbur said. “Being that my house is miles outside of [Fort Kent] and Northern Maine Medical Center had already been OK’d as a place she could go so there would have been no problems.”

Earlier this month, NMMC began reviewing its infection prevention and control policies and procedures as they applied to the management of Ebola, according to a news release issued by the hospital last week.

The hospital activated its emergency response team on Oct. 17 to ensure that all the necessary safety measures are in place to detect a possible Ebola case, protect health care personnel and the public, and respond appropriately should it become necessary, according to the release.

Hospital CEO Peter Sirois said late Sunday the review and emergency team activation was in no way connected to Hickox’s plans to travel to Fort Kent and said they were not aware of those plans.

“We did this due to our being proactive to what was going on with Ebola,” Sirois said. “We wanted to make sure we were ready in case anyone presented at the hospital with it.”

Should anyone present at NMMC with the disease, Sirois said the facility is equipped to provide a temporary quarantine setting until the patient could safely be taken to a CDC-designated location.

State quarantines were imposed after a New York City doctor was diagnosed with the disease Thursday, days after returning to the city from working with Ebola patients for Doctors Without Borders in Guinea.

Dr. Craig Spencer, now being treated at Bellevue Hospital Center in Manhattan and described as in stable condition, was the fourth person to be diagnosed with the illness in the United States and the first in the country’s largest city.

His case, and the fact he was out and about in the city in the period before his symptoms emerged, set off renewed worries in the United States about the spread of the disease, which has killed thousands of people in West Africa. The concern over Ebola has become a political issue ahead of Nov. 4 congressional elections.

New York Mayor Bill de Blasio did not directly criticize the quarantine policy at a news conference but took issue with how Hickox had been treated.

“This hero, coming back from the front having done the right thing, was treated with disrespect,” the mayor said. “We owe her better than that.”

Illinois adopts quarantine restriction

Illinois will also require a mandatory quarantine of anyone who has had direct contact with Ebola patients in those countries, Gov. Pat Quinn said in a statement Friday. His announcement did not explicitly discuss it, but the new measure was likely aimed at people arriving at Chicago O’Hare International Airport.

The airport is one of five U.S. airports where health screening is in place for passengers whose journeys originated in the three West African countries that have borne the brunt of the worst Ebola outbreak on record. Such passengers are now obliged to route their journeys into the United States through those five airports.

Quinn’s office and local health officials did not respond to requests for further comment.

Health officials in Virginia, where Washington Dulles International Airport is located, said the state is reviewing its quarantine policies. In Georgia, where the Hartsfield-Jackson Atlanta International Airport is located, officials were not immediately available for comment.

The mandatory quarantines imposed by states exceed current federal guidelines, although the Obama administration is discussing similar measures.

President Barack Obama urged Americans on Saturday to be guided by “facts not fear” as they worry about the spread of Ebola. “We have been examining the protocols for protecting our brave health care workers, and, guided by the science, we’ll continue to work with state and local officials to take the necessary steps to ensure the safety and health of the American people,” he said in his weekly radio address.

A new battle zone

Ebola has killed almost half of more than 10,000 people diagnosed with the disease — predominantly in Liberia, Sierra Leone and Guinea — although the true toll is far higher, according to the World Health Organization.

The virus is spread through direct contact with bodily fluids from an infected person. It is not transmitted by people who are not showing symptoms, but the quarantine measures in New Jersey, New York and Illinois were prompted in part by the fact that Spencer traveled around the city between arriving home and developing symptoms Thursday, including riding the subway, taking a cab and going to a bowling alley.

New York City Mayor Bill de Blasio said he was not consulted in advance of the new screening rules.

“The state has the right to make its decision, just like the CDC does, and we’re going to work with them,” he told reporters after visiting a sandwich shop where Spencer ate earlier in the week. The shop was briefly closed Friday before health officials allowed it to reopen.

Asked if he thought Dr. Spencer had behaved irresponsibly by going out around town, de Blasio said, “I think that’s a really inappropriate characterization. … Here is a doctor who went into the medical equivalent of a war zone. This is no different than a soldier that goes into battle to protect us.”

Hickox’s account of her treatment echoed concerns of critics of the mandatory quarantines who say they could discourage Americans from going to help control the epidemic in West Africa.

New Jersey’s health department said that Hickox broke into a fever soon after being quarantined and was taken to University Hospital in Newark. She later tested negative for Ebola.

But Hickox disputed that account in her article. She said her temperature was normal when tested orally at the hospital, but showed a fever when she was tested using a noncontact forehead scanner, reflecting the fact she was flustered and anxious.

Doctors Without Borders also criticized Hickox’s treatment, saying she had been issued an order of quarantine but it was not clear how long she would be held in isolation.

“Doctors Without Borders is very concerned about the conditions and uncertainty she is facing,” the group said in a statement.

 



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