Dr. Craig Spencer, New York Ebola patient treated at Bellevue, is discharged

As first person in New York treated for Ebola is discharged, there's an unfinished debate about the government's ability to enforce medical quarantines

By LOUIS FLORES

The New York doctor, whose public excursions in the days before his hospitalisation for Ebola treatment created a firestorm of debate about medical quarantines, was released today from Bellevue Hospital.

New York City Mayor Bill de Blasio speaking on the occasion of the hospital discharge of Dr. Daniel Spencer, right, the first person to be treated for Ebola in New York City.  Source :  NY1 Screen Shot

New York City Mayor Bill de Blasio speaking on the occasion of the hospital discharge of Dr. Daniel Spencer, right, the first person to be treated for Ebola in New York City.  Source :  NY1 Screen Shot

Medical work by Dr. Craig Spencer for the humanitarian organization Médecins Sans Frontières, better known as Doctors Without Borders in English, exposed him to Ebola in Guinea.  Dr. Spencer developed symptoms of Ebola and was admitted on October 23 into Bellevue's isolation unit.

Dr. Spencer's hospitalisation triggered a public debate that raged for days over medical quarantines, so much so that a press conference on the day after Dr. Spencer's hospitalisation was faulted for mixed messages by top government officials, including New York Mayor Bill de Blasio (D-New York City) and Gov. Andrew Cuomo (D-NY).

In the ensuing political angling by elected officials to come out on top of the public debate over medical quarantines after Dr. Spencer had been reported to have made many public excursions during a time when he was supposedly self-quarantining himself as he monitored his health following his return to New York from Guinea, Gov. Cuomo teamed up with Gov. Chris Christie (R-NJ) to announce a short-lived mandatory quarantine policy that was criticised by HIV/AIDS advocacy groups for stigmatising people with Ebola. 

Gov. Cuomo's attempt to impose stricter medical quarantines than those required by the Centers for Disease Control and Prevention triggered, in turn, backlash from medical professionals and the White House, leading Gov. Cuomo to have to walk-back his stricter policies, creating even more ambiguity around the integrity of self-quarantines and mandatory medical quarantines. 

A nurse returning from to America after having treated people with Ebola in Sierra Leone on behalf of Doctors Without Borders was ensnared in the Cuomo-Christie Ebola mandatory quarantine policy.  After she complained about being held against her will in medical quarantine in a New Jersey hospital, the public debate over mandatory medical quarantines provoked the threat of legal action to free the medically-isolated nurse.  Under public pressure, the nurse, Kaci Hickox, was released from the New Jersey hospital, and she travelled to her home state of Maine, where she continued to fight any effort to keep her in medical quarantine.

Medical professionals claim that just because some American doctors or nurses may treat people with Ebola in West Africa, where the current outbreak is raging, the medical professionals should not be required to undergo mandatory medical quarantines upon their return to the United States.  The politics against medical quarantines of medical professionals returning to the United States from West Africa belies greater risks faced by medical professionals based in West Africa.  "The infection rates for health care workers have been particularly high in Liberia, where 171 have fallen ill, of whom 84 have died," McClatchyDC has reported, adding that the "infection rate in the three most infected countries is substantially higher for women health care-givers."  Medical professionals told McClatchyDC that the pronounced spread of Ebola to doctors and nurses may have been related to the lack of preparedness and protocol in the early part of the Ebola outbreak, noting, however, that risks remain for healthcare workers outside of hospitals settings, including for midwives, for example.

Even in Africa, the issue of preventative medical quarantines is controversial.  In Liberia, clashes erupted last August after the government imposed a strict quarantine in a neighborhood in Monrovia, The New York Times reported.  The pushback against medical quarantines creates questions as to whether governments can ever enforce medical quarantines.  In Texas, the relatives of the first American to have died from Ebola were subjected to a court-ordered quarantine guarded by law enforcement, a draconian move that suggests the lengths a government must go to confront the public's distaste for quarantines.  

Yesterday, The Guardian reported that new cases of Ebola are rising in Sierra Leone but apparently decreasing in Liberia, warning the international community against becoming complacent.  In a prior Ebola report published by Progress Queens, it was noted that, "Because there is neither a drug to treat infected patients nor a vaccine to protect potential ones, the only option medical workers have right now to prevent the spread are efforts to quarantine people who are infected," according to an October CNN report.  As people fight preventative medical quarantines, it's not known how that pushback may undermine world health officials' efforts to end the Ebola outbreak.