When the news media revealed that townspeople in Fort Kent, Maine had chosen to ostracize their neighbor and healthcare hero, nurse Kaci Hickox, because of a presumed #Ebola virus infection, I was reminded of Hawthorne’s classic novel, “The Scarlet Letter,”[i] where the character Hester Prynne was required to wear a scarlet letter ‘A’ on her dress after being found guilty of adultery with an unidentified man. In our real-life scenario, nurse Hickox was ordered to quarantine and was shunned by townspeople, some who went so far as to threaten a boycott of a local pizzeria if she were to dine there - even though Hickox hadn't a health problem.
Has fear of Ebola come to this? Has irrationality so consumed people’s minds that they believe an infection can ensue if they eat a meal in the same room as a person who has no infection?
Given what can best be described as insufficient education fueling fear, nurse Hickox may have fared better had she worn a scarlet ‘E’ on the front of her shirt when she returned to the USA. From that point forward, identified by 21st century social branding, perhaps Hickox could have walked outdoors or enjoyed riding her bicycle knowing that, in good conscience, she had given her neighbors due notice that she may carry a deadly disease for which she showed no symptoms and had twice been blood-tested as negative for infection. Absurd.
Should all persons returning from West Africa be required to wear a scarlet ‘E’ on their clothing to signify possible exposure or infection by the Ebola virus? How about a big ‘Q’ for quarantine? Or maybe a removable countdown quarantine patch that starts at 21 and is changed daily as the person goes through the timeline? Surely some legislator will support the idea that the public has a right to know if one of their neighbors may have been exposed to the virus - and require that suspects wear a mark so that they may be duly shunned for 21 days by all who fear magical transmission and infection. Ridiculous!
People, we cannot allow collective fear and ignorance to transform into paranoia and hysteria. We can’t allow a national cognitive breakdown to overwhelm evidence-based assessments and decision-making, or to otherwise rule our thought processes and actions. We need to get a grip on the mass hysteria that’s been slowly creeping into the minds of our nation’s people. Prominent media healthcare professionals like Dr. Richard Besser have done well to provide the public with truthful, palatable information and education - but Besser was also stigmatized and ostracized after returning from his trip to Liberia.
We need reliable information sources. Sadly, this isn’t the first time we’ve received wrong information from what we thought were bona fide experts. I was a clinical nurse in the early 1980’s when the public was made aware of AIDS. There was a lot of disinformation and misinformation released to both the public and the health care community. Infectious disease specialists told nurses and others that we couldn’t catch it – while we handled sharp, bloodied instruments from starting intravenous lines, giving medications, performing wound care and collecting blood specimens; and while we were regularly exposed to all manner of body fluids. This turned out to be especially bad for those who contracted the disease by occupational exposure. When the truth came out about how the AIDS virus was spread, some healthcare workers refused to take care of HIV-positive patients - even after the initiation of universal precautions, prevention programs, administrative controls and post-exposure guidelines. Many educated healthcare professionals succumbed to fear. I get it.
Much has gone wrong with the management of Ebola in Texas, New Jersey, New York and Maine, to the point that people (and states) seem to have lost faith in the Centers for Disease Control (CDC) as a trustworthy source of information and guidance. Some states are making their own rules. The court system is involved. The CDC has lost credibility and now has severe branding issues. The organization may do well to hire experienced crisis communication professionals who can help regain public trust and confidence, in addition to tightening-up its own knowledge, policies and practices - because it appears that a truck could drive through the gaps.
Is that enough? No. The World Health Organization (WHO) seems to think we’ll have a vaccine soon enough. Perhaps all this attention has brought in more research dollars. Isn’t that how it went with HIV/AIDS? Beyond that, we need to develop a plan of action for mandatory travel immunizations, screening, illness monitoring and compliance – as soon as possible. Public education, with special attention to health literacy, must be a high priority with all efforts.
We are very fortunate to have healthcare professionals and workers who consider their own lives and examine their own ethics - and make the choice to provide lifesaving services all over the world to victims of serious diseases. How these healers come to be spurned and condemned instead of being honored as heroes is beyond comprehension. If not for these dedicated individuals working on the front lines, not only will countless lives be lost, but we will fail to learn how to manage the diseases that befall our global human community. Without that knowledge, how will it be for you or your loved ones if no one is there to take care of you, or if we have no idea how to help you, because your fear reactions today caused many to decline an opportunity to be part of the solution?
Nurse Hickox and all of the healthcare professionals and workers who tirelessly and selflessly provide the best care possible to those in need, around the world, are to be honored for enduring inhumane conditions and for risking their own lives so that others may live and science may learn.
Come on, America – we’re better than this. We can solve the problem without hysteria. We’ve survived many other viral outbreaks and catastrophes, and we must press on.
#Ebola #EbolaVirus #EbolaEducation #EbolaOutbreak #EbolaPhobia #EbolaFatigue #EbolaStigma #DrRichardBesser #CDC #CDCEbola #NIHEbola #WorldHealthOrganization #KaciHickox #NinaPham #AmberJoyVinson #NancyWritebol #KentBrantly #RickSacra #CraigSpencer #EbolaSurvivors #ThomasEricDuncan
Claire Santos is a registered nurse and healthcare communicator in Honolulu, Hawaii. She can be reached at asknursesantos@gmail.com. You can follow her on Facebook at Ask Nurse Santos, and on Twitter at @nursesantos.
[i] Hawthorne, Nathaniel. 1850. The Scarlet Letter. http://www.pagebypagebooks.com/ . Accessed November 2, 2014.
