From day 1 of the Ebola episode in Dallas, the administration has been adamantly opposed to travel bans and quarantines, especially of health care workers who have been to West Africa. When New York and New Jersey implemented quarantines, the administration leaned on governors Cuomo and Christie very hard: Cuomo relented considerably. The administration argues that imposing restrictions on returnees from the Ebola-stricken region will impede efforts to control the outbreak there.
I’ve expressed skepticism about those arguments, but if you don’t give me any credence, what about the US Army?:
The U.S. general appointed to oversee America’s fight against Ebola in West Africa has been quarantined in Italy with at least 10 other Americans upon returning from the disease-stricken continent.
Major General Darryl A. Williams, who was appointed head of the U.S. command center in Liberia that coordinates the response to Ebola, was isolated along with several other Americans over the weekend, CNN reports.
The General’s “plane was met on the ground by Italian authorities ‘in full CDC gear,’” a U.S. official was quoted as telling CNN.
Williams and the others will now be monitored for 21 days at a U.S. military compound in Italy, according to the report.
To steal a phrase, the US military is pretty much the ultimate reality-based community–except when political pressure gets too hard to bear. But in most matters of life and death involving its areas of competence, the military doesn’t bend to political fashions, especially progressive ones. It balances risk and reward, based on its best understanding of the facts (which is often imperfect, admittedly) and decides accordingly.
So for the Army to decide, in the face of the obvious potential for fierce disagreement with the administration, that quarantine is the right thing to do, you can be pretty sure that decision is the result of a sober appraisal of the situation. Indeed, the willingness to buck administration preferences gives you an indication of the strength of the Army’s convictions.
The US military has always been more serious and squared away and apolitical with regards to biological and chemical threats. It should be assigned primary responsibility in dealing with the situation in the US too, but turf wars have ruled that out. (Hot Zone describes the turf fights between CDC and the Army during the Clinton administration during an episode involving infected monkeys in Virginia.)
The Army action is basically calling bull on the administration’s frantic anti-quarantine position. Between Dr. Barry and the US Army, I know whom I trust more.
That said, there are smart ways of doing a quarantine, and dumb ways. The measures initially adopted by New York and New Jersey seem to be ham-fisted. The quarantined nurse in NJ has something of a legitimate beef (mixing meat metaphors!), although her claims that quarantines are totally unnecessary for returning health care workers comes off as entitled and clueless, especially given the infections of health care workers here in the US and Europe, and the large numbers of deaths among such workers in Africa. One would think that someone who is selfless enough to risk contracting the disease in Africa would be willing to take prudent precautions to prevent it from spreading at home.
The Army way seems to be the right way. A special facility, outside the US, where those working in the afflicted region are quarantined in a comfortable, secure facility before returning to the US.
@libertylynx pointed out to me that quarantine can be a financial burden and family hardship on aid workers, many of whom are missionaries without substantial financial resources. That problem is easily solved, as it involves only money, and not a lot at that. There is a way of balancing the need to attract people to West Africa to fight the disease, and limiting the possibility that they can spread the virus back to the states on their return.
Put differently, the cost of compensating the workers for the burdens of a quarantine pales in comparison with the cost of dealing with an outbreak in the US. Even if the probability that returnee would spread the virus is small, given the huge cost of a US outbreak and the huge benefit of attracting workers to fight the disease the affected region, it is cheap at twice the price (or much more) to compensate them for the time and hardship a quarantine imposes. Pace Adam Smith: compensating differentials in action.
That said, the Army’s action speaks many volumes. It is saying that from a medical perspective, quarantine is a prudent measure. If the administration is concerned about deterring the travel of needed workers to Africa, the costs of that prudence can be easily paid. Rather than stubbornly fighting quarantines and travel bans, the administration should focus its efforts on designing and getting passed financial compensation measures that balance risk and reward.