Kaci Hickox became news over the weekend when the UT-Arlington graduate wrote an op-ed for the Dallas Morning News with the help of Dr. Seema Yasmin, who writes for the paper and also worked with Hickox at the Centers for Disease Control and Prevention. Hickox, a nurse who had worked with Doctors Without Borders in Sierra Leone to treat Ebola patients, found herself in a confusing situation at Newark Liberty International Airport after she returned to the U.S.
I arrived at the Newark Liberty International Airport around 1 p.m. on Friday, after a grueling two-day journey from Sierra Leone. I walked up to the immigration official at the airport and was greeted with a big smile and a “hello.”
I told him that I have traveled from Sierra Leone and he replied, a little less enthusiastically: “No problem. They are probably going to ask you a few questions.”
He put on gloves and a mask and called someone. Then he escorted me to the quarantine office a few yards away. I was told to sit down. Everyone that came out of the offices was hurrying from room to room in white protective coveralls, gloves, masks, and a disposable face shield.
One after another, people asked me questions. Some introduced themselves, some didn’t. One man who must have been an immigration officer because he was wearing a weapon belt that I could see protruding from his white coveralls barked questions at me as if I was a criminal.
Hickox was detained at the airport without a fever for four hours, unable to get answers from staff about what was happening. At hour four, after an official with a forehead scanner read a 101 degree fever—a method of reading her temperature that Hickox disputed, saying that an oral thermometer would be more accurate—she was isolated for another three hours, then sent to the University Hospital in Newark.
She was taken to the facility in an escort of eight police cars. Another health care professional took her temperature orally, where it read 98.6, and her blood was tested for Ebola, where it came back negative.
All of this happened on Friday, and she published the story with the Dallas Morning News on Saturday. On Sunday, she gave an interview to CNN where she described the conditions of the quarantine:
She’s not allowed to have her luggage and was given paper scrubs to wear. Hickox said she has no shower, no flushable toilet and the hospital gave her no television or any reading material. Mostly, she says, she stares at the walls.
After that CNN report, the hospital released a statement saying that “the patient has computer access, use of her cell phone, reading material (magazines, newspaper) and requested and has received take-out food and drink.” There was no word on whether she was given proper clothing or a fully-functional toilet. New Jersey Governor Chris Christie, meanwhile, downplayed Hickox’s concerns while essentially declaring that she seemed to have Ebola:
At a news conference Saturday, the governor said, “I’m sorry if in any way she was inconvenienced, but inconvenience that could occur from having folks that are symptomatic and ill out amongst the public is a much, much greater concern of mine. I hope she recovers quickly.”
All of this continued for less than 24 hours, once Hickox got the sort of media attention she received, and by Monday afternoon, she was cleared by the CDC to go home. She’ll return to Maine, where she lives now, via private transportation today, and make arrangements with officials in that state about how to continue monitoring her health.
Hickox’s situation reveals just how dicey this can be. No one wants an Ebola outbreak in the U.S., and the small handful of cases thus far have been frightening. The doctor in New York who took an Uber ride and went bowling before he was diagnosed is scary, and it’s reasonable to not want to stick your fingers in the same sweaty bowling-ball holes as someone who is hours from being symptomatic with Ebola. But it’s also important not to treat health care professionals who volunteer to fight what is at risk of becoming a long-term endemic in West Africa and beyond like they’re criminals.
It’s hard not to think that Hickox’s situation resolved itself, in part, because she was able to receive the media attention that she did. If, though, she hadn’t known a staff writer at the Dallas Morning News, and if that op-ed hadn’t attracted CNN’s attention, it’s impossible to know how much time she’d have spent “staring at the walls” and waiting for answers.
There’s a balance that it’s very important to strike between taking necessary precautions and how we talk about Ebola and especially how we treat the people who put themselves at risk to help others who are suffering from it. Comments from the Dallas Morning News often seem to treat Hickox as a villain in her story. “This girl is a selfish idiot,” writes someone who signs her name “SarahBethFachett.” “Her behavior upon returning to the U.S. disgusts me,” explains Catherine Chang. Alice Wright says that her service in Sierra Leone “does not excuse the absolute selfishness and irrationality the nurse is displaying upon her return,” and a fella who goes just by “Mark” claims that “she is a drama queen and obviously stupid.”
In other words, there’s a surprising amount of hostility directed toward Hickox and other health care professionals who volunteer to treat Ebola overseas. And it’s plausible that the same hostility displayed by the paper’s commenters might affect how airport officials treat medical workers coming home, and even how politicians see quarantines carried out.
If you treat people who travel to West Africa to treat Ebola like criminals upon their return (was there a reason to deny this woman her own clothing, or access to her luggage, or a television?), then you discourage others from volunteering to do the same thing. And the consequences for that could be serious.
That’s something that risk communication experts Jody Lanard and Peter Sandman wrote about in an essay they issued in response to a press request from Wired, which they titled “Ebola: Failures Of Imagination.” It explores what might happen if the Ebola threat in West Africa becomes endemic to the region—that is to say, “a situation in which Ebola will continue to spread, and then presumably wax and wane repeatedly, in West Africa.”
Those risks are very real not just to people in West Africa, but to people around the world. Perhaps compassion for the countless lives that could be lost in places like Liberia and Sierra Leone should be enough to self-evidently explain why even those who think that Hickox is “a drama queen” or “obviously stupid” are wrong, but Lanard and Sandman offer more:
We barely try to imagine what a developing-world pandemic would be like for people who live there. We try and fail to imagine what it would be like for us and our loved ones.
What would it be like:
- if there are dozens of sparks landing in the U.S. and other developed countries, not just from West Africa but from all over the world?
- if healthcare workers won’t come to work?
- if cancer patients and HIV-infected persons and children with asthma can’t get their medicines because 40 percent of generic drugs in the U.S. come from India, where production and shipping have halted?
- if refugees, under pressure from civil unrest, insurrection, famine, and economic collapse, are pouring across every border – some sick, some healthy, some incubating?
- if Ebola in the developing world launches the next Global Financial Crisis?
- if the Holy Grail, the deus-ex-machina – a successful Ebola vaccine – cannot be developed, produced, and distributed before all this happens?
If you don’t care about sick kids in Sierra Leone, in other words, sick kids in Texas who can’t get their asthma medicine should still be on your radar. And one of the ways to fight those concerns involves the intervention of organizations like Doctors Without Borders.
Nobody wants to get Ebola. Nobody wants to ride in a car where the last person in it was sweating with a fever after returning from Liberia and then checked himself into the hospital, or to eat at a restaurant where someone at the next table over is hours away from being symptomatic. But if we see people with Ebola, or people who have put themselves at risk in an attempt to stop the spread of Ebola, as somehow the enemy, we run the risk of things getting much, much worse.
As of now, New York’s policy on quarantine has been softened to what New York magazine calls “probably an overreaction, medically”—but still fundamentally reassuring, without treating anyone returning to the country with something resembling the downright punitive-seeming measures taken against Hickox:
Cuomo finally spelled out the particulars of what mandatory quarantine would mean — 21 days at home for the asymptomatic who’ve had direct contact with Ebola victims, with two daily checkups and compensation for any lost wages. It’s probably an overreaction, medically, but politically it’s a defensible approach.
That seems, at the very least, to strike a better tone when talking about people who provide necessary services while also seeking to assuage fears.
(AP Photo/Mel Evans)