As a physician with 15 years' experience in West Africa, and a recent Ebola survivor myself, I have both professional and personal insights into the likely consequences of such quarantine orders. Difficulties range from the order's impact on the global fight against Ebola, to a series of inconsistencies and logical loose ends in the rationale presented to justify it.
It is important that we avoid an isolationist approach to the Ebola epidemic in West Africa. On Oct. 21, Mali reported their first case of Ebola in a child who had crossed the border from Guinea. The borders in West Africa are porous and unregulated, as local people walk across the border to sell their wares or to seek medical attention. Other nations in West Africa also have vulnerable health systems which could be overwhelmed if enough Ebola cases occurred. In addition, there are thousands of travelers a day from Sub-Saharan Africa to countries in Asia like China, India and Pakistan. If the Ebola virus were to emerge in a major Asian population center, one can only imagine the impact.
Either one of these scenarios — widespread Ebola transmission across Africa or into a major population center in Asia — would lead to a tremendous increase in risk for cases in the United States, as well as overwhelming the world's resources to contain such an epidemic.
The only way to reduce the risk of continued spread of Ebola is to bring it under control in those three countries where it has already taken root.
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One unintended consequence of burdensome quarantine policies is that returning individuals may falsely report their activities or re-enter the jurisdiction by another route. Health care workers flying under the radar would indeed pose a risk to the public. A system of monitoring that encourages transparency and frequent contact between returnees and their local health departments would be the safest approach for all of us.
Dr. Sacra: Quarantine has negative consequences
