UT Nurses: Mandatory Quarantine for Health Professionals is Bad Policy

By UT Nursing in Guest Columns, Letters, Special on November 5, 2014 at 2:52 pm | No Comments

Karen Johnson and Terry Jones are assistant professors of nursing, and Alexandra Garcia is an associate professor of nursing at the University of Texas at Austin.

Friday’s decision by a Maine judge to reject requests by state health officials to restrict the movement of nurse Kaci Hickox was the right call for at least two reasons: It is science-based, and mandatory quarantine would unnecessarily pull scarce public health resources from other serious threats to the health of Americans.

But we also must acknowledge that when it comes to the health and safety of the public, policies are rarely made solely on the basis of science. When it comes to Ebola and other public health issues, experts must find a way to reconcile conflicts between science and emotions in order to make the safest and most cost-effective decisions for Americans.

To be fair, the actual risk of Ebola transmission associated with Hickox’s return to the U.S. is low—but it is not zero. The public’s fear of Ebola transmission is disproportionate to the actual risk. But given the dire consequences of Ebola transmission, it can be argued that a low risk-tolerance in decision-making is not unreasonable. The response of officials who wish to implement mandatory quarantine, therefore, might not be a decision made in fear but rather one made with the intention to alleviate fear.

However, without evidence to support the medical necessity of mandatory quarantine, we cannot justify the unnecessary consumption of health care professionals’ time and resources to soothe the public’s peace of mind. Many experts argue that mandatory quarantine will discourage providers from traveling to West Africa to care for the ill. Without adequate providers on the front lines to care for the sick and establish effective public health systems, we can be sure the death toll in Africa will continue to rise well past 5,000, and cases will only continue to spread and surface across the globe. 

As nurse scientists and educators with expertise in public health nursing and nursing administration, we join the American Nurses Association in supporting the Centers for Disease Control and Prevention’s (CDC) recommendations for monitoring — but not quarantining — health care providers returning from West Africa who show no signs of Ebola.

Additionally, we have too many other pressing public health problems in the U.S. that are ravaging our economy and urgently need our attention and resources, such as the flu and other vaccine-preventable illnesses, antibiotic-resistant infections, obesity, mental illness and teen pregnancy, just to name a few.

Texas, in particular, has low vaccination rates for the flu, pertussis and the measles—all of which are more contagious than Ebola. Two-thirds of Texans are overweight or suffer from obesity, which is the leading cause of premature heart attacks and cost Texas businesses $9.5 billion in 2009. Texas also has one of the highest teen pregnancy rates in the country, costing taxpayers over $1 billion each year. More than ever, we need to invest in public health interventions such as policymaking and collaborating with stakeholders, both locally and abroad, that are evidence-based so that we have effective systems in place before a crisis happens.

To gain the public’s trust that the CDC’s recommendations are sufficient for Ebola and other public health concerns (and that our systems can and will evolve as needed to respond to changing circumstances), we must balance science with human emotions and adequately fund our public health systems. As members of the most trusted profession in America, nurses are ideally positioned to act as liaisons among policymakers, health care providers, and the public. We care for others during their most vulnerable moments, so we understand that emotions must first be addressed before individuals can be receptive to scientific facts.

In particular, nurses with advanced degrees in systems-level specialties, such as public health nursing and nursing administration, should bring together stakeholders with different viewpoints to solve the complex threats to the health of Americans. We urge all nurses to help patients, families and community members reconcile feelings with the quickly evolving evidence-based health information.

Although it may be easier said than done, the public must continue to place their trust in nurses to provide them with accurate and timely information for the protection of the health of all Americans.

Photo by Ian Aberle

Tags: Ebola, nursing