(CNN) -- A nurse who was quarantined against her will in New Jersey after treating Ebola patients in West Africa will not obey officials' instructions to seclude herself at home in Maine, she and her lawyers said on the "Today" show and to the Bangor Daily News on Wednesday.
One of the nurse's lawyers told CNN Wednesday that they are trying to work with Maine officials to avoid escalating the situation.
The nurse, Kaci Hickox, returned to Maine on Monday after New Jersey authorities released her from a hospital tent where state officials kept her over the weekend as part of a new quarantine policy. She hired a lawyer and spoke out about her isolation and was then transported to Maine.
She has twice tested negative for the virus.
Maine officials have said that they would ask Hickox to quarantine herself at home until the passage of 21 days from her last possible contact with an Ebola patient, adding that they would make it involuntary if she resisted.
"Today" show host Matt Lauer asked her if she planned to follow guidelines and finish that quarantine on November 10.
"I don't plan on sticking to the guidelines," she said. "I remain appalled by these home quarantine policies that have been forced upon me."
That could set up a confrontation with Maine officials.
A fight ahead?
Maine Gov. Paul LePage has said the state would work with Hickox on a plan to isolate her for the 21-day period.
One of Hickox's lawyers, Norm Siegel, told Lauer that officials had until Thursday to adjust their approach, and if they tried to physically apprehend Hickox, her legal team would take the matter to court.
On Tuesday, the state's health commissioner -- without naming Hickox -- warned that the state would force the quarantine if she didn't isolate herself willingly.
"If an individual who came in direct contact with Ebola patients has returned to Maine and is not willing to avoid public contact and stay in their home voluntarily during the period they are at some risk, we will take additional measures and pursue appropriate authority to ensure they make no public contact," Maine Department of Health and Human Services Commissioner Mary Mayhew told reporters Tuesday.
"I want to be sure everyone understands what quarantine means in this case," Mayhew said. "Stating it plainly, what we are asking for is that individuals who had direct contact with Ebola patients stay in their home and avoid public contact until the 21 days for potential incubation has passed."
On CNN, Hickox attorney Steven Hyman said he thinks the next step is up to Maine.
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"We had been attempting to work with them to try to find some kind of compromise here, but that has not been possible," he said. "And I saw from their news conference last night that they intend to try to seek an order. We have received no paper, so at this point she is not under any restriction other than her own voluntary staying in the house today."
Hyman said that knowing for certain what could happen legally is unclear because "we're treading in areas" in which "there's not a whole lot of case law."
However, he said, "Society has a right to protect itself from legitimate issues of public health, but it can't do it based on what the (U.S.) Supreme Court calls fear."
The lawyer referred to the opinion of Dr. Amesh A. Adalja who also discussed the Hickox case on CNN on Wednesday, weighing in as an independent medical expert. He specializes in infectious disease and is a member of the U.S. government's National Disaster Medical System.
Adalja said the nurse is not contagious if she is not having symptoms, and even if she were symptomatic, she would have to somehow pass along her bodily fluids to other people to infect them.
He said he worried that some had "forgotten" established science about the virus.
Siegel told the Bangor newspaper that Hickox would contest any court order. But she will abide by guidelines from the Centers for Disease Control and Prevention that say she should subject herself to monitoring, such as daily reporting of measured temperatures.
"The conditions that the state of Maine is now requiring Kaci to comply with are unconstitutional and illegal and there is no justification for the state of Maine to infringe on her liberty," Siegel told the Daily News.
The nurse told "Today" that she's in good health and does not have symptoms. A person must be symptomatic to be contagious if they have Ebola.
She said that she thinks it would be "reasonable," in circumstances like hers, to self-monitor for symptoms but not be quarantined. Those are the steps that the organization Doctors Without Borders recommends. She spent time recently in Sierra Leone treating Ebola patients with the group.
Hickox initially was put in isolation Friday, after landing in New Jersey from Sierra Leone.
New Jersey and New York had just started requiring anyone who had contact with Ebola patients in West Africa to be quarantined for 21 days. New Jersey officials additionally said that screeners determined that she had a fever at the airport.
But Hickox, speaking to CNN over the weekend from her quarantine tent at the New Jersey hospital, said she never had a fever.
"They were using a forehead scanner, and I was distressed and a little bit upset, and so my cheeks were flushed," she told CNN's Candy Crowley.
Hickox said her temperature was later determined to be normal.
Dispute about quarantine policies
New Jersey Gov. Chris Christie said the state agreed to let her go to Maine after confirming she "was no longer symptomatic," but he is unapologetic about New Jersey's quarantine policy.
Hickox told "Today" that she witnessed "complete disorganization" at the airport in Newark and that New York and New Jersey's policies are "not scientifically" or "Constitutionally just."
The policies, she says, will be a "big deterrent" for health care workers who want to go to West Africa to treat patients, because they won't want to be quarantined when they return if, like her, they are asymptomatic.
"It's already difficult for people to take time out of their lives to go and respond," she said, though she definitely plans to go back because it's a "privilege to help."
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Christie said he doesn't plan to move "an inch" on New Jersey's Ebola quarantine policy.
Campaigning Tuesday in Rhode Island for GOP gubernatorial nominee Allan Fung, the straight-talking Republican also hit back at criticism that the nurse wasn't treated well enough, arguing that she even had Internet access and takeout food.
"Whatever," he said, when pressed by reporters about a potential legal challenge. "Get in line. I've been sued lots of times before. Get in line. I'm happy to take it on."
The debate about how to treat returning health care workers comes amid what officials say is the worst Ebola outbreak in history.
According to the World Health Organization, there are more than 10,000 confirmed or suspected cases of Ebola -- almost all in Guinea, Liberia and Sierra Leone -- and there have been nearly 5,000 deaths.
And those are only the ones that authorities have been able to count, in a region where health care access and record-keeping are limited. And the WHO, the United Nations' health authority, says the death toll may be especially under-counted: Some ill people who are seen by physicians and counted as Ebola cases may not stay for treatment and die of the disease, and the record keepers won't know to record their deaths.
The WHO has said that the mortality rate from the current outbreak, starting with the first death in December, is roughly 60% to 70%
Post by gretchenindisguise on Oct 29, 2014 11:19:06 GMT -5
I don't think I'd have the balls to do it - but I'd want to do the same thing.
How many doctors and nurses have worked with ebola over the past how many months/years? How many of them have subsequently infected anyone in their home country?
We shouldn't be making policy based on fear - and that's what the 21 day quarantine is.
Post by ChillyMcFreeze on Oct 29, 2014 11:22:29 GMT -5
What does testing negative really mean? She can still develop symptoms within the 21 days, right? It doesn't mean there's no virus, just that it hasn't presented yet?
Even though we (and I mean the scientific community and those of us who are even a little bit informed) understand that you are not contagious without symptoms, it's important at this stage that people follow reasonable quarantine and monitoring recommendations. Moreso than containment, it's about quelling public panic right now. Just like Nancy Snyderman was irresponsible for going for takeout even though she had no symptoms, this nurse is being petulant at this point. Just stay at home, ride it out, and be a good example.
We shouldn't be making policy based on fear - and that's what the 21 day quarantine is.
It's fear if we're quarantining everyone traveling through the hardest hit countries. Quarantining medical workers who had direct contact with patients is not fear.
We shouldn't be making policy based on fear - and that's what the 21 day quarantine is.
It's fear if we're quarantining everyone traveling through the hardest hit countries. Quarantining medical workers who had direct contact with patients is not fear.
Then what is it based on? It's not based on science, current best practices, or past history/risk.
I like how she declared that the conditions of her own home are displeasing to her. Uhm, really?
Also, I didn't hear her worrying about paying her bills or about repercussions from her place of employment. She just doesn't want to because, well I don't know why. Because she's pissed at Christie?
I mean I'm pissed at Christie but I have no problem with the 21 day quarantine. Health workers have become infected. And it would be 21 days from last exposure so some of those days have already been eaten up. Doesn't she have some netflix shows to catch up on?
Are there other returning medical workers that have been quarantined also? Is she the only one who's speaking up? What about medical workers that treated patients in the US? Where does it stop?
The tent was ridiculous and I get that 21 days is a long time, but it's not a death sentence. I was at a wedding in Dallas earlier this month and if I'd been quarantined I'd still have 4 days to go. That's a LONG TIME. You miss a lot. You can't go to work.
I understand not wanting to be in your house for 3 weeks. I really do. But I can't feel good about her right now. I would think someone who has seen the disease work first hand would be more willing to comply with a quarantine.
White privilege. If she was black and African and pulling this shit....?
I get the distinct impression she's totally expect someone who was African to be quarantined. I can't put my finger on why but there's something very white savior about miss ma'am. But I admit that it might be that article on white privilege I read last night.
I like how she declared that the conditions of her own home are displeasing to her. Uhm, really?
Also, I didn't hear her worrying about paying her bills or about repercussions from her place of employment. She just doesn't want to because, well I don't know why. Because she's pissed at Christie?
I mean I'm pissed at Christie but I have no problem with the 21 day quarantine. Health workers have become infected. And it would be 21 days from last exposure so some of those days have already been eaten up. Doesn't she have some netflix shows to catch up on?
Post by miniroller on Oct 29, 2014 11:43:19 GMT -5
Does anyone else feel like she's so pissed about the deplorable tent treatment that she's now, 'F whatever you say- I do what I want!!'? (Questionable punctuation- sorry)
I just think its impractical. Does it mean don't leave your building no matter what? Sure, she's just by herself (and her BF) But what about someone with a family that needs them? No talking the dog out? No picking up your kid? No getting something from the store? Are we really prepared to enforce this for every single worker?
Plus the CDC says you are gonna present with symptoms by 8-10 days most probably.
Post by Velar Fricative on Oct 29, 2014 11:46:23 GMT -5
I'm seriously going back and forth on this and no one here is helping me decide what side of the fence I'm on. Do your jobs, people!
On the one hand, I feel squicky telling a health worker who's willing and able to monitor his/her conditions and will contact the right people asap to stay inside her house for 21 days. Not saying she will definitely do all the right things, just that this does seem like overkill to me. The doctor who took the subway to go bowling hasn't appeared to infect anyone (so far)!
On the other hand, I would ASSume that if there was someone with some other highly contagious disease, the government would be within its rights to compel that person to stay in one place for the sake of public health (or maybe not - remember, I'm ASSuming). But if they are, then I'm not sure home quarantines for anyone with direct contact with patients confirmed to have Ebola is either unconstitutional and/or ridiculous.
But serious question - what happens with home quarantines? I assume everyone else living there has to live somewhere else temporarily. But the person needs to eat, especially if they've been gone a long time and there are few groceries in the house. Do they call the local pizzeria and send out a guy to deliver pizza in this?
And for me, it's not even about spreading Ebola. That shit has a high ass mortality rate. How about you come home and take care of yourself to keep yourself from getting it AND to give you the best possible chances of beating it if you did contract it?
I'm looking at the American patients and so far, the ones who are doing the best and recovering with the quickest speed are the ones who weren't traipsing all over behaving as if exposure ain't no thang.
I'm confused. I thought Ebola isn't easily communicable, and that unless an infected person is vomiting/drooling/bleeding/shitting on people, there's no risk. So why are we mad that a medical professional who is not symptomatic doesn't feel compelled to quarantine herself?
Besides the doctors and nurses treating Dr Spencer in NYC are under no quarantine order whatsoever so I highly doubt that it's actually disease transmission that is driving this policy.
The early stories I heard about Ebola, before it showed up in Dallas were rife with stories of underfunded, understaffed clinics without the proper equipment. Healthcare workers in those countries were contracting Ebola at much higher rates than previous outbreaks because of inadequate supplies. Many of them died.
My understanding is that aside from Texas Presbyterian, the facilities that are treating Ebola patients have all the supplies and precautions needed to protect them. They are hospitals that are equipped to handle these kinds of infections, particularly Ebola. I'm not at all certain the same thing can be said for the places where Kaci Hickox was working.
I'm confused. I thought Ebola isn't easily communicable, and that unless an infected person is vomiting/drooling/bleeding/shitting on people, there's no risk. So why are we mad that a medical professional who is not symptomatic doesn't feel compelled to quarantine herself?
Because this country loves security theater? I see enough support for travel bans to make me bang my head on my desk repeatedly.
The fact that the NYC health workers directly treating Dr. Spencer just tipped me into Team Hickox.
And for me, it's not even about spreading Ebola. That shit has a high ass mortality rate. How about you come home and take care of yourself to keep yourself from getting it AND to give you the best possible chances of beating it if you did contract it?
I'm looking at the American patients and so far, the ones who are doing the best and recovering with the quickest speed are the ones who weren't traipsing all over behaving as if exposure ain't no thang.
I don't think we can use the mortality rate in Liberia as an accurate indicator of much. The mortality rate for people treated in the US and Europe is about ~20% and those who died had underlying conditions (Duncan who had kidney problems and a lifetime of third world healthcare) or were elderly (the Spanish priests).
Except that the article I read said they weren't really sure why our victims have overcome the illness as well as they have. There are a variety of factors they think are contributing, better quality of health of the patients, the age of the victims, being treated with the blood of survivors, or more interesting to me, that they were in contact with a lower viral load than those who were exposed in the nations currently affected. This seems interesting to me given that Dr Spencer is stable but still struggling while those who were exposed to the virus by one man in Texas are already headed home.
White privilege. If she was black and African and pulling this shit....?
OMG.
OMG what?
It's true. If she was a black nurse returning from West Africa who treated Ebola patients and acted this way can you IMAGINE the racist shit that would be hurled at her?
Post by redheadbaker on Oct 29, 2014 12:05:46 GMT -5
Maybe I don't understand Ebola transmission (or virus transmission in general).
She's tested positive twice now. Is it possible for the virus to be in her system, but not "infecting" her (thus, tests for the virus show up negative)?
If she's testing negative now, back home in the US with no further contact with Ebola patients, how could she possibly test positive later on in the 21-day quarantine period?
Maybe I don't understand Ebola transmission (or virus transmission in general).
She's tested positive twice now. Is it possible for the virus to be in her system, but not "infecting" her (thus, tests for the virus show up negative)?
If she's testing negative now, back home in the US with no further contact with Ebola patients, how could she possibly test positive later on in the 21-day quarantine period?
She's hasn't tested positive and doesn't have symptoms.
My guess is that she could test positive at a later date if the virus wasn't abundant enough in her system in the earlier tests to show a positive, but I dunno what sort of test it is.