Public Health Experts: Cost of Ohio's Ebola Preparations Was Worth It
It fell to the Summit County Health Department to find most of the people who had contact with Vinson when she flew home to Northeast Ohio to plan her wedding. After she’d returned to Dallas, the nurse discovered she had contracted Ebola from a patient -- setting off a cross-country race to figure out who she had contact with and what kind of contact it was.
In the end, three people -- close friends and family of Vinson -- ended up under voluntary quarantine for three weeks. Another roughly 160 were monitored.
Assistant Health Director Donna Skoda says her department chose to step gently and humanely.
"At all costs, we are very judicious with any power we have for quarantine. We prefer volunteer quarantine. We work with individuals. We meet them every day. We talk to them about their needs. If their cell phone dies, we pay their cell phone bill. If they can’t make their rent payment, we pay their rent. We bought dog food, we bought groceries. We do whatever it takes to help people be successful and feel as though they’re not being treated badly. Because you have invaded their lives.”
Besides respecting the individual, Skoda says the state had an interest in encouraging potential contacts to come forward. Lose the individuals, she said, and you’ve lost the best chance to trace the disease, as happens with STDs
“And sometimes you’re the bearer of bad news. So we clearly have to be very cautious when we deal with individuals with sexually transmitted diseases. Because we will lose them. And if we lose those contacts, we’ll never get them back again. And therefore the disease is spread.”
Ohio’s 65-year-old public health laws would have allowed the county to go much further. But Terrance O’Sullivan said more heavy-handed quarantines don’t work – for the individual or public health system.
He’s an associate professor at the University of Akron who researches homeland security issues, especially the dynamics of infectious disease outbreaks.
“Treating people well is both a moral issue and an ethical issue. It’s an issue of legality. But it’s also an issue of practicality. You basically have to do things that work. Draconian quarantine measures tend to backfire, and we’ve seen that across the world.”
People who could lose their jobs, homes, family and freedom are more likely to duck a system that threatens it all, said O’Sullivan and Katharine Van Tassel, who directs the University of Akron law school’s public health law center.
“I believe that this was a real test for us in the United State of our morals and our convictions as Americans in sticking to the rule of law.”
But Van Tassel also maintains that the law needs to be updated in Ohio and other states, where public health laws are outdated, arbitrary and inconsistent. .
In Ohio, she noted, “if a completely innocent individual happens to be sitting right next to somebody who’s infectious on a bus, and the government comes and says that they must be quarantined, we have no process in place.”
She said the U.S. should study even its own criminal justice system for models to protect rights. And she said that study should be happening now.
That’s because Van Tassel and the others expect an outbreak within the next decade of a pandemic flu or other public health risk – far more likely than Ebola to hit the U.S. hard.
“We can’t just be thinking about Ebola and then be happy when Ebola is gone because we have a vaccine. We need to be prepared for other diseases that are looming on the horizon.”
During the height of the Ebola scare, hotlines set up by the Summit County Health Department were handling as many as 300 calls a day. And all three of the panelists maintain that a key piece of dealing with any outbreak in the future will be dealing with those kinds of calls and what they called the epidemiology of fear – recognizing that people are concerned, but not pandering to irrational fears.