Edge of Apocalypse

Longevity has a way of highlighting the abundance of cyclical events. When I was a schoolboy, a health and hygiene teacher told us the true story of a woman called Typhoid Mary. I was impressed. Typhoid Mary was a cook. She also was a carrier of Typhoid Fever. When it became evident that she was inadvertently serving death along with her delicious dinners, she was tested, found to be a carrier of Typhoid, and was taken (kicking and screaming) to a small island located in New York City’s East River. During her quarantine, she appealed against what was in effect a lifetime sentence. After two years, she was finally released from the quarantine provided that she would never cook for anyone again. She must have been a good cook because many fatalities were credited to her before she closed her kitchen.

If you’re not confused about how to prevent the spread of ebola, then you’re not paying attention to conflicting health reports. Among those reports are those that claim the ebola virus is not contagious unless and until symptoms are apparent, e.g., fever; there are also reports that warn us of what I call sources of “second-hand contagion”, e.g., door knobs or clothing that have been tainted by the bodily fluids of an ebola victim.

When I first heard that ebola is not contagious in the absence of symptoms, I recalled my lifetime experience with the common cold: in my case, a cold always begins with a sore throat. However, there are times when my throat is sore because of an irritation caused by spice in food or chemicals in the air, not by a biological agent. I can’t always determine whether the source of the pain is a chemical irritation or the onset of a cold. If the pain is caused by the former it takes a little time before it disappears; if by the latter, the pain increases until I realize I have a cold. In either case, my judgment about the cause of pain is sometimes initially ambivalent, especially when I’m too busy to take note of minor pain. And then there are times when I wake up to what I immediately know can only be a cold that has taken me by surprise.

Exactly when does a carrier know that he’s been infected with the ebola virus? Don’t we usually think or say, “I think I’m coming down with a cold?” Exactly when does a victim of ebola become aware that she is seriously ill? She may initially dismiss a symptom of ebola as just the result of a common cold or a hot room or that her fatigue is only the result of vigorous exercise.

The Ebola virus is not air-borne, but there is no question that it can easily be transmitted by other means. We can take our chances on not spreading a common cold even when it’s most contagious. However, given the virility and devastating consequences of ebola, the option of chance is not open to us.

The outbreak of ebola has sparked significantly different opinions and actions regarding quarantines as essential for ebola’s containment. Some nations have banned flights coming out of affected nations in West Africa; the United States has not done so. The argument for not doing so is that the epidemic requires high technology to stem it. It follows that a ban on air traffic would be counterproductive to the containment of ebola. Those who oppose a ban, propose that limited, carefully monitored flights would eliminate the danger of contagion. In addition to the false premise that there is a substantive difference between limited and regular air traffic when dealing with a deadly virus, this suggestion specifies that air traffic should be limited to a few of our major cities. I’m not a demographic logician, but it seems to me that New York City is the last place on earth to land aircraft potentially carrying the ebola virus. It takes only one overlooked detail to put millions of people at risk.

Upon her return from Sierra Leone where she voluntarily treated ebola patients for a month, a nurse was immediately quarantined in New Jersey. Later moved to her home in Maine, she was to remain under quarantine by order of the Governor of Maine. She strongly objected to the quarantine, twice violated the state mandate that she remain under it until the ebola incubation period was to expire, and fought for and obtained her release from isolation by a judge who agreed with her contention that she was healthy and that there was no scientific justification for her isolation. When she was free, she fully adhered to the order that she maintain direct active monitoring, avoid crowds, and stay at least three feet away from individuals until the original quarantine period was satisfied.

Her outspoken anger over being unnecessarily quarantined gave the appearance that she simply didn’t want to be inconvenienced by being under quarantine. It appeared that she was not the same person who had the will, generosity, and courage to treat ebola victims in Sierra Leone where her patients’ bodily fluids were extremely contagious. Having made her statement that the ebola virus is not air-borne, she rode her bicycle into the countryside on her first day of freedom.

At the national level, our Secretary of State, in agreement with the Joint Chiefs of Staff, imposed quarantine on a dozen soldiers who had been constructing health facilities in Sierra Leone. He had the right to do so based on the fact that soldiers are not volunteers. I’m sure he made the right decision. As of this writing they are under quarantine at a base in Italy.

There are concerns that medical personnel are less likely to volunteer their services if it entails quarantine in addition to the courage and selflessness required to treat ebola victims. There are also concerns about Federalism vs. States Rights as demonstrated by the Maine event. (No problem there. In the unlikely event that an epidemic hits America, health concerns will trump the Constitution—temporarily, of course.) My concern is that major health decisions are being ‘politisized.’ For example, there are powerful politicians with a romper room mentality who posit that as a matter of fairness (!) we must not ban air traffic from the afflicted West African nations because the ancestors of West Africans suffered slavery in America. That racist nonsense is spewed at a time when containing the deadly disease is of the utmost urgency. Urgency and panic are not the same: there’s never a need for panic, but there’s always a need for reason.