White House

Why We’re Holding an Ebola Nurse Hostage

Lack of faith in leadership class leads to extreme, outrageous outcomes.

National Journal
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Ron Fournier
Oct. 27, 2014, 5:55 a.m.

The gov­ernors don’t trust the sci­ent­ists who op­pose a man­dat­ory quar­ant­ine for health care pro­fes­sion­als ex­posed to Ebola.

The White House doesn’t trust the gov­ernors. The gov­ernors don’t trust the White House. Doc­tors don’t trust nurses. Nurses don’t trust hos­pit­al ad­min­is­trat­ors. Hos­pit­al ad­min­is­trat­ors don’t trust fed­er­al of­fi­cials, and the Feds don’t trust them. Nobody trusts the me­dia. The pub­lic trusts noth­ing.

This rampant lack of faith in each oth­er and in our in­sti­tu­tions is how we got to a place where the state of New Jer­sey is hold­ing a cour­ageous 33-year-old nurse host­age. After treat­ing Ebola pa­tients in West Africa and twice test­ing neg­at­ive for the vir­us, Kaci Hick­ox was ordered quar­ant­ined in a cold, spartan tent out­side Ne­wark’s Uni­versity Hos­pit­al.

“We can have a con­ver­sa­tion about what fur­ther meas­ures would look like, but this is an ex­treme that is not ac­cept­able,” Hick­ox told CNN. She’s right. While the Obama ad­min­is­tra­tion hasn’t done enough to con­tain Ebola and re­as­sure anxious Amer­ic­ans, Gov. Chris Christie has gone too far.

NBC News’ ex­traordin­ary health care re­port­er, Mag­gie Fox, says, “The people most at risk of Ebola are care­givers and health care work­ers, who are phys­ic­ally touch­ing Ebola pa­tients at their sick­est. In 40 years of study­ing Ebola out­breaks, no one has seen a mys­tery case. People are in­fec­ted by dir­ect con­tact with oth­ers—not cas­u­al con­tact on buses, trains, or in the street.”  

I worked with Mag­gie be­fore she joined MS­N­BC. She’s a friend. I know her to be a know­ledge­able and ob­ject­ive health care journ­al­ist, a per­son whose opin­ion I trust when she de­clares there’s no danger of an Ebola out­break.

But, see, there’s the prob­lem: Most people don’t have a Mag­gie Fox in their lives, a trus­ted ex­pert. Not that long ago, the lead­ers of Amer­ic­an so­cial and polit­ic­al in­sti­tu­tions were the hon­est brokers, but no more.

The gov­ernors of New Jer­sey, New York, Illinois, and Flor­ida backed man­dat­ory quar­ant­ines last week, of­fer­ing few de­tails. New York Gov. An­drew Cuomo back­tracked Sunday. Christie bowed Monday, an­noun­cing that Hick­ox will be trans­por­ted to Maine. I can think of a num­ber of reas­ons gov­ernors might be so cava­lier with civil liber­ties, start­ing with ig­nor­ance, fear, and pres­id­en­tial polit­ics. But there’s more to it than cyn­icism.

There’s a lack of faith in the Cen­ters of Dis­ease Con­trol and Pre­ven­tion and oth­er health care in­sti­tu­tions that over­stated the cer­ti­tude of the sci­ence be­hind Ebola, the pre­pared­ness of the U.S. health care sys­tem, and the ef­fi­ciency of their own pro­to­cols.

Whom do you trust?

The con­sensus of the sci­entif­ic com­munity is that man­dat­ory quar­ant­ines will dis­cour­age health care work­ers from fight­ing the roots of the dis­ease in West Africa, a long-term threat to the United States.

But at least one health care pro­fes­sion­al, Dr. Nancy Sny­derman, an NBC cor­res­pond­ent who had traveled to Liber­ia and whose cam­era­man had con­trac­ted Ebola, vi­ol­ated a vol­un­tary-based pro­tocol by pick­ing up food at a res­taur­ant near her home. When a doc­tor, Craig Spen­cer, tested pos­it­ive in New York City on Thursday, forensic sci­ent­ists had to re­trace his every step.

Do you trust doc­tors and nurses to mon­it­or them­selves?

In­sist­ing upon an­onym­ity, White House of­fi­cials told re­port­ers they had pres­sured Cuomo and Christie to re­con­sider man­dat­ory con­fine­ment. Christie said he had “got­ten ab­so­lutely no con­tact” from the White House. Cuomo said he has not been pres­sured.

Do you trust any of these politi­cians?

When the ini­tial case of Ebola rattled a Dal­las hos­pit­al, doc­tors and ad­min­is­trat­ors blamed nurses for over­look­ing the pa­tient’s trip to Liber­ia. Turns out, doc­tors over­looked nurses’ warn­ings. When a nurse who treated the first pat­ent be­came in­fec­ted, of­fi­cials ac­cused her of vi­ol­at­ing their pro­to­cols. Turns out, the pro­to­cols wer­en’t in place.

Whom do you trust in the med­ic­al pro­fes­sion?

In the me­dia, cul­tur­al and busi­ness pres­sures have cre­ated news­rooms with far few­er people like Mag­gie, ex­per­i­enced and im­par­tial re­port­ers who dig for the truth. Facts mat­ter less than years ago, a prob­lem of­ten hid­den by the rise of writ­ing that em­phas­izes “point of view” and “voice.”

On Ebola, con­ser­vat­ive me­dia or­gan­iz­a­tions tend to ex­ag­ger­ate the threat of vir­us, and they stretch to link Demo­crats to it. Lib­er­al news or­gan­iz­a­tions tend to min­im­ize the threat, de­ploy­ing con­des­cen­sion and mock­ery where a dose of em­pathy might be more per­suas­ive.

Do you trust the me­dia?

Count­less polls sug­gest that the pub­lic has lost faith in all in­sti­tu­tions, par­tic­u­larly the me­dia and polit­ics, which is how a health care heroine such as Hick­ox finds her­self con­fined to a tent, when a parade is in or­der. When we don’t know whom to trust, when there’s no sane cen­ter of Amer­ic­an dis­course, ex­treme and out­rageous things oc­cur.

“I think this is a policy that will be­come a na­tion­al policy soon­er rather than later,” Christie said of the man­dat­ory quar­ant­ine. Un­for­tu­nately, giv­en the lack of hon­est lead­er­ship around us, I trust he’s right.

COR­REC­TION: A pre­vi­ous ver­sion of this story misid­en­ti­fied Mag­gie Fox’s em­ploy­er.

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