Ebola quarantine was a headache for US officials
When US federal health officials ordered 179 Dallas-area residents under “public health surveillance” for Ebola last autumn, it became a major task to meet their personal needs over the 21 days they spent in isolation.
A new federal report describes the effort undertaken to satisfy their basic needs to stop the spread of Ebola. The report was intended to help other communities prepare for such outbreaks.
Dallas’ Ebola outbreak began on September 30, when a Liberian traveller was diagnosed with the disease and two of his caretakers subsequently became infected. Immediately, the government sought to identify the people who had contact with those who were infected and put them in isolation.
“Meeting the needs of the contacts of the Ebola patients was essential to successful contact tracing, which is critical to interrupting transmission,” said the “Morbidity and mortality report” from the Centres for Disease Control and Prevention.
But forcing people to stay home for three weeks had the potential for creating problems. As events unfolded in Dallas, the government had to deal with housing, transportation, education, employment, food and other household issues.
The stay-at-home orders involved 149 health-care workers who had contact with the three Ebola patients, 20 people who had “community contact” with Thomas Duncan, the initial Ebola patient, and 10 others who were exposed to the ambulance that took Duncan to the hospital.
The complexity can best be illustrated by the 30 people who were either community or ambulance contacts. They included eight school-age children, three non-English speakers, four people with complex medical conditions and a homeless person.
Five of the community contacts and two ambulance contacts were isolated under legal-control orders and about 20 health care workers voluntarily quarantined themselves. Sixty-eight health care workers were placed under “controlled movement restrictions”, stopping them from going to grocery stores or restaurants.
Under the government’s rules, each person was monitored daily by local or state health workers. This involved a visit for a temperature reading and checking for other possible symptoms, followed by a phone call later in the day to get a second temperature reading.
Staying home for 21 days was particularly hard on the seven families that comprised the community contacts.
Six of them needed money to pay their rent. Some contacts asked for food, diapers and medical supplies, the report said. Seven people requested changes to airline reservations since they were ordered not to use public transportation. Members of two households said they felt unsafe at home after their photos, names and addresses were published by local media.
More than 75 per cent of the community and health-care workers reported feeling stress, social isolation or stigma. The health-care workers, in particular, expressed anxiety about becoming ill and possibly infecting their family members.