Thursday, October 30, 2014

You had to expect it........





"I'm not willing to stand here and let my civil rights be violated when it's not science based," stated Kaci Hickox.





Kaci Hickox, a nurse who had been working with Ebola patients in Sierra Leone, arrived at Newark Airport NJ on Oct 24 2014.  She was detained at the airport for 7 hours and then was placed in an isolation tent after a second temperature reading on her showed that she had a fever.  Hickox immediately complained that her isolation was unfair as well as the conditions in the isolation tent, which had no running shower and a port-a-potty were sub-standard.  She spent the weekend waging a media war with Gov Christie's 21 day quarantine policy for returning health care workers.  Hickox tested negative for the virus and was allowed to leave for her home state on Maine on Oct 27 2014.


I applaud all that the health care workers are doing to treat the patients with Ebola in West Africa and I had actually been on her side for a few days but her defiant whining has left me standing on the opposing side of her argument now.  I find it difficult for someone who evidently knew about Ebola and the 70% fatality rate that it has been shown to have, to travel and work with these patients..... to not think that there would be some kind of ramification upon yourself when you did return to the United States.  I also can not believe that you had no clue as to what had been happening in the US after Mr Duncan's death from Ebola.  Common sense would dictate that there had to be some sort of check instituted for exposure and future risk after that incident.


I lost respect for you when you went home with a continued defiance and threats to sue over your "loss of civil liberties" rants.  You should be very happy to know that while the US health care system is struggling with how to deal with the possibility of further instances of Ebola in the US, they have an ironclad set of rules governing disease management and livestock.  Yes, Kaci........... the government cares a lot more about animals here than they do about you.


I will start out easy then...........  I want to travel from the east coast of the US to the west coast to stay with friends for a couple of months.  Since it is a long trip, I will be bringing my dog Mumbles with me.  The rules state that Mumbles has to go in baggage since he unfortunately will not fit under the seat in a carrier until I run him through a blender.  In order for my dog to be loaded on the plane, he has to have the required carrier etc, etc as well as health papers.  That means that I have to take Mumbles to the veterinarian, at cost and have him sign off on a complete health exam stating that he is disease free.  On his return flight, he may also be required to have an updated health check since we stayed so long in another state.

Now for the more difficult regulations......... let's say that my friend in New Mexico has invited me to trailer my horse up there to spend a week or two trail riding from my imaginary home in Texas.  I can just throw caution to the wind, hook up the trailer and head off into the sunset, hoping that I am not pulled over after I cross the state lines or I could actually follow the regulations in place.  Those regulations include..... basic CVI (certificate of veterinary inspection) which includes identification of the horse and has the horse's temperature recorded on it.  The certificate must be made no more than 30 days before the planned trip.

In addition, there must be proof of ownership, proof of a negative C-ELISA test, a negative Coggins test, state the testing lab used, dates tested and results, it has to be free of ticks and showing no symptoms of equine piroplasmosis.  Here is the kicker though and I suppose I could whine that the state would be impeding my right to travel freely and enjoy my vacation......... there are six specific counties that horses are not allowed into from Texas if there has been a, as in only one, confirmed case of equine piroplasmosis.  That means that the one confirmed case could have been miles from my horse and it had never had any contact at all with mine but I am still barred from crossing the state line with my horse.

The reason states do this is to prevent the animals in their state from possibly being exposed to an infection that may not exist within their borders.  The result of an infected animal coming in contact with other livestock can be catastrophic.  The "cure" in the US for an outbreak of hoof and mouth disease is eradication, as in all the animals that may have had any contact with the infected ones are killed.  If the farmer next door were to import an infected animal by bending the rules of importation a bit, that infected animal could potentially lead to the destruction of several surrounding herds and leave those farmer's holding the financial loss.

Hickox has now gone home to Maine and has taken the stance that she will defy any self quarantine directives and has threatened to sue the state now.  Just this morning, her and her boyfriend took a 40 minute bike ride followed by the police.  I don't agree that she should be locked away in her home since they do live in a very rural area and the exercise would be good.  I do not agree with her defiant attitude though and that makes me nervous about how far she will push the envelope of no contact.




There are those who feel that the states are imposing quarantines are denying an individual of their personal liberty is wrong and I side with those who do not find it wrong.  The treatment of Ebola is evolving almost on a daily basis but there are still many questions as to how it is transmitted or even what is "safe."  A restriction of contact with other people for 21 days is not unreasonable and actually is safer for the masses.  When the needs of the masses outweigh the needs of one individual, a state or nation has to rule in favor of the masses.

One specific example of how much the government cares for "livestock" more than it does returning citizens who may have been exposed to diseases would be the race career of a South African horse named Variety Club.  In 2013, after winning the prestigious Queen's Plate in South Africa, the owners petitioned the Dubai Racing Club for an exemption of the quarantine rules so that the horse could ship directly there to compete.  The request was denied so they could not race in several important races there.

They also were forced to abandon their hopes of bringing the horse to the US to race in the Breeders cup races as well.  Their horse would be forced to stay totally indoors, with no exercise or sunlight.... at an airport for 60 days.  They had requested that the horse be allowed a treadmill but that was denied as well and it was decided that it would not be fair to their horse to have to endure that for just one race.

The traditional trip for a horse to race in Dubai is about six months..... not 21 days.  It begins with a 3 week quarantine in Cape Town followed by three months in Mauritius, one month in England and then additional restrictions once the horse arrives in Dubai.  The European Union requires this restriction because of an African horse sickness that is similar to malaria in people.  It is vector-born, not contagious, is seasonal and only found in the south of African in the wet summer months.  They keep a disease free zone in Cape Town where any horse is quarantined and shipped from and that is surrounded by an observation zone to further protect the free zone and in this way, no case has ever shipped out of Africa.  In 2011 though, there was a breach of the observation area and the European Union instituted the restrictions now in place.

Once a horse has made it through the six month process to international status, they are free to travel with the lighter restrictions and quarantines that are imposed but that means it will be months before the horse ever returns to it's native soil, if ever.  Evidently, the hopes of an owner for a chance at millions in purses is not enough to have a quarantine reduced or modified but if you are returning from an active Ebola area and stomp your feet enough, they are bent for you.

The states have an ability to reasonably protect their citizens and in this case, from a disease that has a high mortality rate, is expensive to cure and still is not very well understood in how easily it seems to be transmitted within healthcare workers.  Her quarantine is also not false imprisonment because the state would have to be shown that they were completely erroneous in their reasons for wanting her to not have contact with other people within a specific time frame.  Mr Duncan's family cried that it was so unfair in how he was treated until two of his nurses had to battle the same disease.

We do owe a great debt to those heath care individuals who donate their time to help world-wide but we do not have to be placed at possible risk when they return from an area that is dealing with a deadly, contagious disease.



Hats off to Bayou Renaissance Man for the story idea.

Related post on this blog:

http://wreckvhavoc.blogspot.com/2014/10/they-cant-travel.html



http://www.nydailynews.com/life-style/health/kaci-hickox-shakes-reporter-hand-promises-give-ebola-article-1.1992687

http://abcnews.go.com/Health/quarantined-ebola-nurse-kaci-hickox-released-jersey/story?id=26479917

http://www.dogjaunt.com/posts/u-s-airlines-requirements-for-health-certificates/

http://www.nytimes.com/2014/03/29/sports/south-african-horse-gets-his-star-turn.html?_r=0

https://www.usrider.org/EquestrianMotorPlan.html

http://www.aphis.usda.gov/wps/portal/aphis/ourfocus/importexport?1dmy&urile=wcm%3apath%3a%2Faphis_content_library%2Fsa_our_focus%2Fsa_animal_health%2Fsa_import_into_us%2Fsa_entry_requirements%2Fct_us%2Bstate_and_territory_animal_import_regulations

http://livestocktrail.illinois.edu/dairynet/paperDisplay.cfm?ContentID=603

http://www.washingtonpost.com/news/morning-mix/wp/2014/10/30/why-kaci-hickox-may-lose-a-legal-battle-against-ebola-quarantine/

http://www.nydailynews.com/opinion/editorial-home-kaci-article-1.1993132


Update Nov 3 2014:

A judge in Maine has given into Hickox's foot stomping and has ruled in her favor.  The judgement applies only to her and her whining about being quarantined for possible Ebola exposure.  It states that she does not have to submit to the stricter rules of the quarantine but must instead submit to direct active monitoring, notify officials of any change in her health status and must coordinate her travel outside of the home with officials.  She has also stated that the fight has not ended for her and she will continue to press for the more lenient versions of monitoring for returning individuals.




http://www.cnn.com/2014/11/03/health/ebola-kaci-hickox-interview/index.html?hpt=hp_t3


Update Nov 10 2014:

Hickox and her boyfriend, Ted Wilbur, have announced that they are both leaving Fort Kent ME after her 21 day quarantine ends this week.  Wilbur has withdrawn from the college that he was enrolled at there and they have only stated that they will be traveling to southern Maine first.  Wilbur it seems was upset that the University of Maine had requested that he not attend classes for a period of time.

The university has stated that they were sorry that they were not able to accommodate Wilbur in the manner he prefered and he now characterizes their efforts as insufficient.  They added that they have gone to great lengths to educate individuals about the threats of Ebola but that they still had concerns about the health and security of individuals.  They tried to accommodate his wishes but were unable to please him.

Sadly, again......... did you not see this coming?  If you vocally state that you are going to make your own rules about how you should be treated after exposure to Ebola, do you really think others are going to trust you or want to risk their future health by being with you?  I think this all could have been avoided if you had just quietly accepted the quarantine in the first place.




http://www.cnn.com/2014/11/09/health/ebola-nurse/index.html?hpt=hp_c2



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