Note: I don’t have any links to my statements of fact. I’m on a 747 jumbo jet right now. So I’ll update the post once I’m feet dry at my destination… Or whatever you call it being there safe and sound.
Human beings are interesting creatures. Tell us that we can’t do something, or that we shouldn’t do it, and we will try our darnedest to do it. Remember when you stuck your fingers in the electrical outlet, or when you grabbed the hot pan on the stove?
We also are smart and brave enough to go through some horrible stuff to find a better life for ourselves and our children. Just look at all the undocumented/illegal immigrants that come to the United States by the thousands each year. Many of them go through some pretty harrowing stuff to get here.
Or, rather, I should say “there.” I’m not in the States at the time. More on that later.
I told you on my last Talking Tuesday that I was baffled as to why we are collectively losing our minds over a few Ebola cases in the United States while thousands of people dying from it in West Africa has now become a footnote in the news. There is some coverage of the stepped-up response from the US military — and the US Public Health Service — but that’s about it. If I want to know about the situation on the ground in West Africa, I have to look to the BBC or bloggers because US media are all about the fear over a few cases of the sniffles turning out to be not Ebola.
And what can I say about so-called “conservative” pundits? They have turned this whole situation into one big opportunity to show their racism and cover it under the veil of “hey, we’re trying to keep Ebola out.” I mean, seriously… These guys would be hysterical as a comedy troupe if the consequences of their words were not so serious.
Then there are the well-intentioned folks who, in my humble opinion, don’t quite get how quarantines work. Or, rather, they don’t get that quarantines don’t work, especially the ones imposed by force. People in general react poorly to forced quarantine and flee the quarantined area. In the case of Ebola, you’re not infectious until you’re sick. Also, you won’t know you have it until you’re sick. So, in the minds of people exposed to Ebola and ordered to quarantine, they’re being punished when they are perfectly healthy… Until they get sick, of course.
We saw this a lot during the 2009 influenza pandemic. Governments around the world tried to quarantine people who they thought would have been exposed to influenza, and they failed miserably. People got through the quarantine. Immigrants still entered the the US through the porous borders, both north and south.
More recently, the government of China, a government that doesn’t mess around in its authoritative approach to its people, tried to quarantine an entire town when plague showed up. Guess what?
Hundreds, if not thousands People, because the Chinese government won’t say how many, escaped the quarantine and ran off into Chinese big cities. Again, silly humans, they find a way, especially when they’re scared.
These experiences in our recent past, and other experiences even further in the past, should tell us that all this talk of quarantining West Africa and the people from there is going to be an exercise in futility. Africa is a huge continent, and its borders are incredibly porous. Tell the people in any of the countries there that are experiencing Ebola that they need to stay put, and no one is going to stay put. Try to enforce it by force, and even less people will stick around to see what happens.
So this is why I have been pushing the idea that quarantines are a bad idea to everyone who has brought it up to me in person, and to everyone that has brought it up online. It’s a bad idea. It’s a waste of resources. It is a thousand times better to ask people to voluntarily stay home if they’ve been exposed or have symptoms, and then provide them with appropriate medical care. It’s is even better to educate them on how Ebola can be stopped… Because it can be stopped in a matter of weeks if everyone just stops being exposed through burial practices and poor hygiene, and if we provide medical providers all the resources they need to stay safe.
It really is that easy because of the nature of Ebola. But it’s going to be hard because of the nature of us humans.
POSTSCRIPT: So where am I? Well, I has the opportunity to travel to Korea for a few days, and I took it. Expect some pictures soon, and more blogging from the Far East.
René F. Najera, DrPH
I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
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