When Is A Quarantine Not A Quarantine?

I think I’m raising questions more than offering perspective with this post, but there are some things about the latest developments in the Ebola cases diagnosed in the United States.

(That’s right, it’s not an outbreak.  The situation is West Africa certainly is.  Four cases in a country that sees a few thousand times that many deaths from the flu does not qualify as an outbreak.)

Based on the latest declared case, a doctor in New York City that had been working in West Africa, the governors of New York and New Jersey declared quarantines above and beyond the recommended Centers for Disease Control monitoring (though the CDC is considering changing those guidelines).  As the politicians have more than public health on their mind, I can understand why they might go above and beyond what is medically necessary.  After all, Americans are scaredy cats, happy to act on fear before thinking things through.  Why not placate their fear, and worry about the possible negative consequences (people simply traveling around the quarantine zone, fewer military and aid workers going to West Africa, reduced disclosures of exposure, etc.)

But the terms of the quarantine, or at least the pronouncements of New York Governor Andrew Cuomo about said quarantine, make me think that at least one of the politicians involved is either unclear on public health or simply doesn’t care.

“One day after he announced the strict policy, which would impose a mandatory 21-day quarantine on returning aid workers who had been exposed to Ebola, Cuomo described it as a “flexible” system, to be implemented on a case-by-case basis, depending on the individual circumstances of the returning workers, and their exposure to the virus.

“On Saturday, Cuomo said aid workers were likely to embrace such a precaution, a change in tone from Friday, when he and New Jersey governor Chris Christie spoke of the need to compel such a quarantine.

“Cuomo said he does not expect to have to enforce the order, which applies only to J.F.K. and Newark airports.”

My reaction to this is that Cuomo appears to think the order was just for show – to make the citizens of New York think that now that the order – which may or may not be enforced – was given, that the problem goes away.  It brings out the barely concealed cynic in me.  That the mayor and health commissioner of New York City were not consulted, and might oppose the position if pressed, reinforces my inclination to dismiss Cuomo’s actions as politically motivated.  The possibly beneficial outcome from his flexibility about the quarantine is that it could minimize any negative outcomes.

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