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October 30, 2014

Acting Up Against Ebola

by John S. James

As AIDS activists begin to engage with the ebola outbreak, we need to get our message right. I think we should target dumb quarantines, not all quarantines. Especially, we should target dumb quarantines motivated by politics.

For example, Kaci Hickox, the MSF nurse who was quarantined at Newark Airport and then in Maine, seems to have been selected for quarantine attention because she had a temperature measured once as 101. But later, her temperature measurement became normal and stayed normal. Unless ebola has a quiescent phase -- most unlikely -- that meant that the original measurement was not due to ebola. It should then have been irrelevant to her status. But Maine's governor has a difficult re-election race next week.

If there are more U.S. cases, the cost of a policy of quarantining everybody who cares for an ebola patient also needs to be considered. It would mean that doctors and nurses would be in permanent quarantine until they stopped caring for those patients. All sorts of problems would result.

So far, the most horrible example of dumb quarantine is Louisiana telling medical people who have recently been fighting ebola in West Africa not to attend the meeting of the American Society of Tropical Medicine and Hygiene, November 2-6 in New Orleans. This meeting is supposed to be a forum for sharing experiences and improving strategies for fighting the disease. See

I can't imagine any situation where it would make sense to quarantine people who have no symptoms, no fever, no detectable virus, and no other sign of ebola infection, and who are willing to follow CDC and other medical recommendations. But conceivably, that might change.

Ebola activism is not a direct continuation of AIDS activism. The situations are very different. For example, stigma is a major problem in both cases, but the stigma is different.

Keeping an open mind even on quarantine will help reassure the public that we are always putting their interests first.