Will nurse Kaci Hickox's stand help quell US hysteria around Ebola?

Kaci Hickox's battle to reduce the strictures of her home confinement could have an impact on the hysteria that seems to be gripping the nation – but it may not be the one the Maine nurse was hoping for.

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    Nurse Kaci Hickox, shown in an undated photo, has vowed to take the state of Maine to court if it does not lift the quarantine against her by Thursday.
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Kaci Hickox's battle to reduce the strictures of her home confinement could have an impact on the hysteria that seems to be gripping the nation – but it may not be the one the Maine nurse was hoping for. 

Amid calls for the US to close its borders to travelers from Ebola hotspots, Ms. Hickox is making herself a vocal example, claiming her case shows people can safely travel to and from West Africa to help fight the disease without spreading it across borders.

"I do think [quarantine measures in the US] will have a negative effect on the overall response for this outbreak," Hickox, who spent four weeks in West Africa helping treat patients, said on the "Today" show Wednesday. "To put these extra measures in place, that again are not scientifically just, I think it will be a big deterrent." 

Hickox, who has not been diagnosed with Ebola or exhibited any symptoms thus far, has vowed to sue the state of Maine if a quarantine imposed on her is not lifted by Thursday. The state, meanwhile, says it is seeking legal authority to compel her to obey.

“I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public,” Hickox told “Today” on Wednesday. “I do understand that it has created a lot of fear, but we still have to make policies based on evidence.”

However, some observers believe Hickox's stance could have the opposite effect than she intends, increasing public hysteria surrounding the disease. (To date, only one person, Liberian Thomas Eric Duncan, has died in the US after being diagnosed with Ebola. In West Africa, the death toll is much higher, having surpassed 4,000 people, according to the World Health Organization.)

"If anything, her actions are going to increase the hysteria by letting the public know there are people coming back from the area that are going to do whatever they see fit," says Eugene Kontorovich, a professor of law at Northwestern University in Evanston, Ill. "If it turns out that one person who pulls this is actually sick, we will never ever see flights to West Africa again."

However, Hickox is "raising an important issue" about the domestic US response to Ebola patients by criticizing her treatment, says George Loewenstein, a professor of economics and psychology at Carnegie Mellon University in Pittsburgh.

Still, Professor Loewenstein says that Hickox is "making a mistake to not abide by the regulations that prevail."

"In my view it's not really her position to engage in civil disobedience," he says, but adds that he does think she has raised valid concerns.

"She's highlighting the fact that there's a patchwork of regulations across the country and that a lot of the regulations don't really make any sense," Loewenstein says.

The checkerboard of quarantine guidelines that different states have introduced over the past week appears to be confusing matters.

On Wednesday, California became the latest state to announce it would impose mandatory 21-day quarantines on people who had direct contact with patients diagnosed with Ebola. Earlier this month, New York, New Jersey, and Illinois announced similar policies. Illinois has since clarified its guidance, saying mandatory quarantine only applies to "high-risk individuals" who fit into five specific scenarios. 

Minnesota, meanwhile, has no mandatory quarantine. Travelers are subject to twice-daily checks from health staff, have to keep a log of all their activities and contacts during the 21-day incubation period, and are only allowed to take trips on public transportation for less than three hours.

A blanket federal guidance from the Centers for Disease Control and Prevention would standardize all these differing state responses, but such guidance has not yet been issued. 

"The CDC could issue regulations on states, but it hasn’t," says Professor Kontorovich, "which suggests a lack of confidence in what the rule should be."

 
 
 

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