Clinical Topics   /   HIV

We fear things in proportion to our ignorance of them.

USM By U.S. Medicine
December 7, 2014

Editor-In-Chief, Chester "Trip" Buckenmaier III, MD,  COL, MC, USA

Editor-In-Chief,
Chester “Trip” Buckenmaier III, MD, COL, MC, USA

We fear things in proportion to our ignorance of them.
Christian Nestell Bovee (1820-1904)

I had the honor of being invited recently to speak at the 39th annual Garland Lecture series at the Boston Medical Library. As I tend to do in order to combat the chaos of modern air travel, I arrived hours early for my flight to Boston. With time on my hands and no breakfast in my stomach, I decided to stop in for a coffee and bagel at an airport bar to wait for my flight. I was, as they say, minding my own business, watching CNN on the television above the bar.

The story concerning the Maine nurse Kaci Hickox, who had recently returned from Sierra Leone, West Africa, where she had volunteered to help with the Ebola epidemic, was one of the new items that day. She has received national attention because of her crude handling and involuntary three-day isolated quarantine when she returned to the U.S. through New Jersey, and her refusal to remain in isolation as she had been asymptomatic. Her desire not to be quarantined is consistent with current Centers for Disease Control and Prevention (CDC) guidelines, which reject state-mandated quarantine for health officials returning from Ebola-stricken areas of Africa. Since her return, Ms. Hickox has maintained that her quarantine was unnecessary based on the current scientific understanding of the virus and its transmission (by direct contact with contaminated body fluids, not through airborne transmission like the flu). Furthermore, the CDC has expressed concern that unwarranted quarantine of health professionals returning from fighting the disease and its spread will become a significant deterrent for other altruistic health professionals from volunteering to travel to West Africa to help in the future. Despite these facts, Ms. Hickox has received significant public ridicule from a fearful and ill-informed public that has been fueled by the news media focused more on the entertainment value of Ebola fear than the medical facts surrounding this public health issue.

From my perspective, based on the best science available, we should be celebrating Ms. Hickox’s efforts and those health professionals like her, not sequestering her behind plastic and subjecting her to public loathing born of uneducated fear.

These were my thoughts as I watched the CNN report that was spiced up with frightening graphics better suited for a violent video game than a supposedly informative national news broadcast. My waitress was watching the same newscast with a look of concern on her face and commented that she was not sure she was comfortable with a nurse who might be harboring Ebola walking around in Maine. Perhaps I should have focused on my bagel and let the comment pass, but the physician in me cannot resist the opportunity to educate the public on health related issues. In my best “doctor voice,” I briefly described why Ms. Hickox’ handling was excessive, how unlikely it would be for her to spread the Ebola virus while asymptomatic and how we should appreciate healthcare workers willing to confront this epidemic in Africa as opposed to waiting for it to appear on our own shores. 


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