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Wednesday, 29 October 2014

Ebolaphobia - when prudent caution becomes an irrational fear

Events of the last week demonstrate the level of irrationality that public fervor can escalate to amid the fear of the unseen. The irrationality verging on a new phobia aptly called Ebolaphobia and suffered by those yielding unreasonable power.  The pinnacle of inappropriate behaviour was achieved in the high level quarantine of a nurse returning from West Africa.

Canada is no less implicated in this irrationality.  Current policies essentially preclude health care workers from participating in care efforts as Canada has rescinded permission for participation pending a review of its policies.  The number of Canadian workers in West Africa has eroded to merely sixteen workers with plans only to send a small number of relief deployments once the processes with the Canadian policies are met.

These health care worker heroes are returning from months using high level protective equipment when the highest risk time for infection is early in their sojourn and disease development overseas most  likely. 

Currently upon their return, they are stripped of their autonomy, essentially placed under house arrest, and deprived of the professionalism for which they have demonstrated a level of valour that many of us admire and should be aspiring to. 

It does not make sense.

For some who are employed, provinces and employers may provide salary support to remain off work.  For physicians, having giving up to two months income to volunteer, they are further deprived of an additional three weeks income while segregated from society.

Canada has actually been relatively logical in some of its approaches, with screening occurring at the points of entry, and travelers with any risk reported to their local Medical Officers of Health who can provide support and monitor wellbeing while balancing the needs of the individual and risk to the population.  It is this balance of protecting the public and respecting the person that these professionals have been trained.

That has not precluded organizations issuing the paychecks of the MOHs from expecting disclosure of names, imposing unreasonable additional limitations, and certainly such organizations have diverted limited public funds to alley the phobias demonstrated by health care workers who would never possibly be exposed to anyone remotely linked to West Africa countries.  It behooves those in the public health community to apply a level of professionalism and skill that is exemplary.  Collectively we need the ongoing avenues to reflect on our ethics in meeting this challenge.

Political led responses have historically led to tragic consequences for individuals.  Leper colonies, Canada’s quarantine islands, tuberculosis sanatoriums, are further examples of where the political reaction has exceeded the bounds of rationality and undermined any ethical sense of autonomy.  

On November 1st Canada announced a preclusion on visas for any person from countries with widespread and persistent intense transmission. A move that violates an international convention that Canada was instrumental in negotiating in the wake of the impact travel restrictions during SARS had on the Canadian economy without adding to disease control. Such actions verge on idiocy.  http://news.nationalpost.com/2014/11/01/canada-wont-issue-visas-to-residents-of-countries-with-widespread-ebola/    

November 10, is the absence of any rational reason, Canada has announced that all travellers from countries with persistent intense transmission would be placed in a 21 day quarantine, unless they were health care workers returning who had used appropriate protective gear.  The number to be affected is likely very low, but such action is unwarranted.  Who is making these perverse decisions? 

Were we welcoming back military heroes from risking their lives to protect our country, we would do so with open arms and with social and economic supports.

Let us consider treating our health care warrior heroes similarly.  They are protecting our country by fighting an unseen enemy on foreign soil so that our borders may be safe. 

Thanks to those who have made the effort, and a voice of encouragement for those with skills to consider using them to protect not just our country, but our global community while truly saving lives.  

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