tv Inside Story Al Jazeera October 28, 2014 11:30am-12:01pm EDT
>> hello, i'm ray suarez. after a doctor coming home to new york after treating ebola treatments in west africa submitted himself to treatment, and a nurse landed in new jersey's newark international airport, worry about the disease spread in the country's most densely populated region. governor chris christie puts the nurse in involuntary quarantine even though she's show nothing symptoms of the disease. he backed off the absolute form of mandated quarantine for people who showed no symptoms over the weekend. the obama administration was critical of both' approaches,
noting mandatory quarantine for volunteers made it less likely for volunteers to head to west africa where their help is badly needed. the u.s. is trying to figure out how to treat the trickle of potential cases landing here. over the weekend a child checked into new york city's belle vue hospital center with a fever. >> he had a low-grade fever this morning. he has as was noted a travel to one of the three affected countries and has a fever. that's what triggers an assessment. he has no clear exposure to ebola, but our exposure history is unclear. he will be tested. >> belle vue is where craig spencer being treated in quarantine. he returned earlier this month of a working in guinea. >> dr. spencer going through a
phase of the disease as we expect. we have been in consultation of the most advanced clinical expertise around the country. people who treat ed this disease as well as the cdc, and he's receiving the most advance therapy. >> taking the unusual step of demanding mandatory quarantine for any u.s. workers returning to the u.s. after treating ebola patients whether they showed symptoms or not. >> we will consider the geographic area of origin and the level of exposure to the virus. depending on the risk level a person could require mandatory 21-day quarantine or at a government-regulated facility. >> these actions taken jointly today i believe are necessary to protect the public health of the people of new jersey and new york and it builds on what
we're doing at the state level of both states. >> the first nurse to experience the governor's plan is tracy hiccocks. she was forcefully quarantined. she was released and she is heading to maine where she'll, if any, her quarantine for 21 days. she had been threatening a la lawsuit, but her attorney said is unlikely. for people who are put in quarantine but not showing symptoms of the disease. >> are they going too far? >> i don't want to be directly criticizing the decision made but we have to be careful that there are unintended consequences. the best way to stop this epidemic is to help people fro in west africa. we need to treat them return in respect.
>> president obama agreed with dr. anthony fouchi. the president underscored the steps we take must be guided by the best medical science as informed from our best medical health experts, and measures should be crafted so as not to discourage health workers from serving in west africa . governor cuomo's administration said that healthcare workers can be monitored at home. >> during that 21 days healthcare workers would check in on them twice a day. >> and u.s. ambassador to the united nations touched down in guinea in a five-day fact-finding mission on the ebola crisis. >> we need to be part of the solution and not runaway with something. it will come to us. >> the "world health organization" said it estimates there have been more than 10,000
cases since the outbreaks' beginning earlier this year. >> thousands are already dead of ebola in west africa. many thousands more will likely be dead before it's over. how to respond in the united states this time on the program. the center of disease control outlined a new set of guidelines for health workers returning from west africa. these workers will be contacted twice a day. once in person and once on the phone to make sure that they're not showing symptoms. that's a long way from quarantine. joining us now to talk about the best way to respond here in the united states. we have dean the public health of a sunni down state medical centers wills former new york commissioner of health. here in washington, executive director of the american public health organization, former
secretary of health for the state of maryland. and in new york, professor of socio-medical sciences at columbia medical university melman's school of health. it's great to have such firepower to get great answers to my hopefully great questions. isolation, monitoring, quarantined. they're not all the same thing. what is quarantine. >> let me start by saying that the term identificationalation isolation is for those pose a threat to those close at hand and communities. quarantine is typically used when someone has been exposed, asymptomatic and needs supervision.
there are different versions of quarantine. some are more astringent than others. what we witnessed over the weekend is something quite extreme and something that was not quite appropriate. >> new york landed closer to what needed to be done in your view? >> as i just heard on jew show, the cdc has come very close to being where it should be i think new jersey went far off the mark and represented the fear-based politicalization of a terribly complex and terribly important public health issue. >> doctor, you're running the health and being the
chief of those shoulder to shoulder in very fight quarters, will people be able to self monitor without taking a break from the world and remaining at home to ensure they're disease free. >> i think that the response in new york city was fueled in part by the fact that there was no c dc policy with regard how to manage returning healthcare workers from the epidemic zone in west africa. that created a vacuum in to which two governors stepped in and created mandatory quarantine of an constitutional nature, which is quite extreme. i think here in new york stay governor qu cuomo backed off of
that by recommending a quarantine at home and was reporting to the health authorities on a daily basis and monitoring one's temperature. i think the recent recommendation of the cdc comes a bit closer to that, but it doesn't require that the person who is monitored be strictly confined to their homes. now the back round to this is important. doctors without borders does recommend to its volunteers that they do not return to work for 21 days after they leave west africa. and other groups such as samaritan's purse recommends a strict home quarantine for people who returned, and the group with which dr. brantley were associated have a facility in north carolina on their
campus where returning volunteers remain for 21 days. the issue that home quarantine will place an enormous burden and discourage people from going back to west africa or keeping others from volunteering to go does not stand up well when you face the fact that many of these organizations do require that you do not return to work for 21 days. a home quarantine is simply a relatively minored a-onto that already-existing recommendation. i think people in new york city became extremely panicked when they saw someone who they thought was incubating the ebola disease was traveling to different parts of the city, and their understanding of communicate ability and when someone is communicable
created 9 governor's order for institutional quarantine, which as you mentioned was quite extreme. >> where does the public fit in the buzz of education, messaging and prudent care for the people who are in real life effected by these things? a lot of people are afraid of ebola, who are never going to get it. >> it is all about risk communication. it's a skill to communicate to people to tell them what we know, what we don't know, what should hurt them and what should not hurt them, we know what the symptoms and signs are and that was not adequately communicated. we did a much better job around the anthrax letters and small pox.
when you educate people, tell them the facts, the public will response in a reasonable matter. that did not happen here. the first press conference was amazing, but then the next day there was a break down between new york, new jersey, and the federal government. frankly, we have in many ways undermined the trust to have this resolved. >> when we return we'll talk about how nervous local governments are treating those who worked with or been exposed to people with ebola. do you have to choose between >> on the stream >> can we teach robots morality? the us military is betting millions on the prospect the stream explores the long term implications of groundbreaking technology >> the stream on al jazeera america
>> america votes 2014 on al jazeera america focusing on what matters to you >> what are the issues that americans need to know about? >> everybody needs healthcare... >> lower taxes... >> job opportunities... >> reporting from the battle ground states... >> alaska... >> kentucky... >> iowa... >> local elections with national impact >> we're visiting with the people making the decisions... >> covering what it all means for you... >> ...the mine shut down, it hurts everything... >> i just keep puttin' one foot in front of the other... >> we're fighting for the future of our state >> for straight forward unbiassed political coverage... stay with al jazeera america >> i'm ali velshi, the news has become this thing where you talk to experts about people, and al jazeera has really tried to talk to people, about their stories. we are not meant to be your first choice for entertainment. we are ment to be your first choice for the news.
governor christie or governor cuomo, but the fact that governor cuomo had to back down suggests that he himself recognized that he went too far over the weekend. and that will produce anxiety. >> the fact that there is an election in eight stays could be tangentially related to this as the governors are up for re-election? >> i think there is a history of political pandemics in the face of disease, and this make shows how easy it is to whirlwind into place . >> are there tools that we could be using for at-home medicine that we're not fully exploiting?
>> we have lots of tools. every grandmother can take a temperature and take it twice a day. >> but means being exposed to the person directly and their saliva request. >> well, the individual can take it themselves. but they're not infectious until they get the fever, and then the risk is very low. i wish life could give you a zero-risk lifestyle, but when you get in your car and i can't guarantee you that you're not going to be injured in your car. but i can reduce your risk if you maintain your car and wear a seat belt. i can make sure that you don't burn up if you don't smoke in bed. in this case we're trying to dramatically reduce the risk. anyone who tells you they're making a zero- risk in society is fooling themselves.
and this did not create a zero-risk society because people in emory are not on quarantine. the people in nebraska are not on quarantine. people in belle vue taking care of the patient are not on quarantine. we're not creating a fair society as though we focus on those from west africa are more risky than those we have here in the united states. >> when will we know that he's out of the woods? will new yorkers have to avoid each other and look for empty train cars for a long time, or is there a point at which there are no new cases a rule of thumb where you say i think we've broken the back of this thing . >> i think the public will be educated to the fact that in a country of 300 million people there have been very few cases
of the ebola virus disease diagnosed here in the united states. and i think once that perception becomes widespread people will become much more comfortable. i think the policy articulated today by the cdc about active monitoring will go a long way to calming people's fears that returning healthcare workers from west africa might pose a threat to the public heat. the fact that they'll be monitored fairly closely i think will go a long way to equaling the anxiety in places like new york and other places as well. >> we'll be back with more inside story on al jazeera america after this short break. we know we return we'll talk about the places where people are really dying of ebola. in africa should more emphasis be placed on ending the outbreak there rather than catching the infected here.
insisted that the response was not quarantine but more intensive efforts to stop new infections in west africa. still with us from new york, dean of the school of public health at sunni down state medical center and almost former new york commissioner of health. here in washington, executive director of the american public health association and former secretary of health for the state of maryland. also in new york, professor of socio-medical sciences at columbia university's melman school of public health. let's talk about africa. the new cases keep on coming and coming in large numbers, and they will continue to arrive here. i'm going to bet, as long as we don't push down new infections in the region. >> you know, the some of the other african nations have shown us that it's possible. and it will require a much more
aggressive assertive effort in africa by the u.s. and all other nations in we want to get our hands around this. you need to end this epidemic at its source. that means resources, that means people, that means getting their hands around it because we missed it earlier this year. >> professor, we can't seal off the united states, can we? as long as new infections keep cropping up in the heavily infected countries like sierra leone, that virus is going to continue to find its way here, isn't it? >> it's true. we've seen a few cases in the united states to seize our attention and anxiety when the real issue involving thousands and thousands of people is the issue of why the global north has not responded sufficiently. and if we don't the epidemic in africa will continue to spread in africa.
we cannot create a wall around the united states. >> a couple of weeks ago who forecasts said that they knew there would be tens of thousands more infections. how do they know they are so far behind? >> there are mathematical models that are used by those of us in epidemiology based on the immediate past transmission patterns that can predict roughly the number of new cases that will occur. we have to basically stop this epidemic at the source, which the previous speakers have alluded to, and unfortunately, we do not have a vaccine in place as of yet. we don't have effective drugs as of yet because the ebola virus disease has been made orphan by
north america and europe over the past days. the remedy is in vaccines and treatment. we have the tools at hand and we hope to be age to bring it under control. >> how important is it that the united states doesn't have and hasn't had a surgeon general for over a year when it comes to messaging and coordination of a response? >> i think it would help if we had a surgeon general as we did did have a surgeon general in the early days of a.i.d.s. i think we should not look at the magic wand in thinking about a surgeon general, although i think it says something about
the paralysis in america that we don't have a surgeon general. it's the same paralysis fueling the kind of anxiety -driven exclusionary policies. >> ronald, gentlemen, thanks for being with us. the program may be over but the conversation continues online. we want to hear what you think about the issues raised on this or any day's program. you can log on to our facebook page and put your thoughts down there, or see us your ideas send us your ideas on twitter or facebook @ray suarez news. from washington, i'm ray suarez.
holding to the battle ground account iraqi curds are off to northern syria a to help in the fight against isil. hello and welcome to al jazerra. live from our head quarters in dough uh-huh. also coming up. a call for the international community to help. millions displaced by the war can the countries displacing them. seeking to strain then ties with china. beijing is the first official foreign trip. the