Andre Aggasi was once the spokesperson for Canon cameras. The tag line was “Image is Everything”.
That applies to politics as much as it does to cameras and photography.
Two politicians who take that to heart more than most are Gov. Chris Christie of New Jersey and Gov. Andrew Cuomo of New York. Both have presidential aspirations, and both appear to be using the current medical crisis in Africa (and its spillover effect locally) to distinguish themselves from other prospective and actual candidates for president.
Both are governors of states whose main airports are international gateways and are two of the five airports through which 94% of all passengers from Liberia, Sierra Leone, and Guinea travel. And both initially sought mandatory 21 day quarantines for medical personnel who are returning from working with Ebola patients.
Since Dr. Craig Spencer self-reported that he had a fever and the NYPD/FDNY took the necessary precautions that he might have Ebola (since confirmed), the governors have engaged in a shifting policy battle about who and when someone will be quarantined.
Both governors have shifted their stances in public pronouncements. First they both indicated a blanket mandatory quarantine, which later shifted to self-reporting, though Gov. Christie denies that he modified his position. That’s blatantly false. Josh Marshall points out the pretzel spin and logic of Gov. Christie:
In Florida yesterday, Christie was asked why he’d shifted his policy in releasing Nurse Kaci Hickox and allowing her to return to Maine. His answers were simply false on two counts. First he said that she’d been symptomatic for Ebola and was running a fever. Neither appears to be true.
According to her undisputed account, she was briefly shown to have a fever using a forehead strip thermometer which showed a slight fever, apparently because she was upset and stressed. Whatever the reason, a subsequent oral thermometer reading showed no fever. That almost certainly means she never had a fever. Nor has there been any suggestion that she had any symptoms of Ebola. So Christie’s claim that she was symptomatic for Ebola, but then saw her symptoms go away, is just false.
When asked if he’d reversed his decision, Christie denied any change in policy and said she would only have been forced to remain in isolation, “if she continued to be ill. She hadn’t had any symptoms for 24 hours and she tested negative for Ebola. The reason she was put in the hospital in the first place was because she was running a high fever and she was symptomatic … The minute she was no longer symptomatic she was released.” (emphasis added)
Again, based on everything we know about Hickox’s care, this is false. She was never symptomatic for Ebola and she never had a fever with the exception of one reading which was apparently contradicted a short time later by a more accurate test.
Nor was there any need for her to be symptomatic under the policy that the two Governors announced. The explicitly and expressed goal of the policy was not to hold people who were symptomatic but to hold everyone who’d treated Ebola patients in West Africa in isolation for 21 days in case they became symptomatic. Again, these are Cuomo’s and Christie’s own words.
So Christie is not only lying about the specifics of Hickox case he’s also claiming the policy says something different from what he said it was when he announced it.
Marshall further points out that it seems that both governors are pushing health policies that appear without any consultation with actual health experts. I wonder just who exactly is behind Christie’s policy here - especially since he took great pains to announce and identify an Ebola team that included top health officials in the state. Did they have a say in the policy, and what was their basis in medical and health policy? So far, they haven’t been heard from since Christie spoke.
And yes, I’ve seen the nj.com report that a Nobel prize winner in Medicine seems to support a quarantine for medical workers, though he (or perhaps it is the report itself) that seems to ignore that there are symptoms other than fever that can indicate that the person is symptomatic with Ebola. The doctor notes that there is a percentage of people who never show a fever but are symptomatic with Ebola. Omitted from the report is the bit about how there are other symptoms that include fatigue, weakness, etc.
That’s why the fever indicator isn’t a good indicator of whether someone has Ebola - there are undercounts (persons never show fever, but are symptomatic in other ways), or overcounts (person has fever from unrelated condition).
Christie instead pushed for and got a political solution to a medical issue, and says that he’s not changed his position, even though he had called for a medical quarantine in medical facilities, but changed that tune to allow the nurse to self-quarantine at home in Maine instead.
Christie and others have pointed to the medical correspondent from NBC News as proof that a voluntary quarantine isn’t enough. People should minimize contacts where possible, but if they’re not symptomatic, then they aren’t going to spread the disease. The guidance is to check for symptoms regularly and to check in with health authorities at the slightest change in condition.
To date, there have been far more false positives - those who were taken to facilities with suspected cases that were later ruled out (such as the five-year-old in NYC that was suspected of having Ebola but was found to have a respiratory ailment instead), than false negatives - such as where someone got Ebola from unannounced cases that came into the country and spread from other as yet unidentified sources.
Moreover, is Gov. Christie imposing quarantines on any of those health workers at Bellevue who live in NJ and are working in direct contact with Dr. Spencer? After all, they’re at risk of contracting the disease and spreading - without going to the epicenter of the epidemic in West Africa. Somehow, I doubt he’d have much success with that - and spin furiously to distinguish the two.
UPDATE at 10/29/14 8:37:53 am by Vogon Poetry
Since writing this yesterday, the confusion over exactly what New Jersey is doing has only grown. Despite the governor saying that they haven’t changed their policy since announcing it over the weekend, it’s not clear what even that policy is and who’s formulating it.
That contrasts with the NY policy, which clearly spells out what people should do.
Yet four days after he and the governor of New York announced the 21-day quarantine for high-risk travelers, neither Christie nor state health officials have offered details about how this will be accomplished.
If people are quarantined at home, can their families stay with them and still go out? If they are alone at home, is someone going to bring them food? What about high-risk travelers who are passing through the airport in Newark — should they be allowed to continue to their destination?
Those and many other questions remain unanswered — Christie officials said specifics about how the mandate will be enforced are “internal documents” and are not public.
What’s more, some of the agencies that are supposed to be enforcing the plan say they are uncertain about protocols because no policies have been presented. There is growing frustration, officials said. The Port Authority, for instance, had received no guidance from New Jersey health officials about the state’s Ebola response protocol as of Tuesday afternoon, a person familiar with airport operations said.
“Clarity would be incredibly helpful,” said the person, who requested anonymity because the person was not authorized to speak about the protocols.
In contrast, New York health officials circulated guidelines for screening at JFK International Airport on Tuesday, in a document that stresses “a respectful and supportive approach” to implementing the quarantine rules. It provides steps for agencies to follow to determine who should be quarantined, where they will stay and even how they will be transported.
And that they haven’t made it public also adds to the legal woes facing the state for trying to enforce a policy that appears to be thrown together with no actual input from health officials or legal staff, despite the Governor putting together a committee that has both health and legal officials involved.
The way New Jersey is going about this quarantine isn’t going to pass legal muster, because those rules should be available and distributed to all relevant agencies and departments so that there’s uniform understanding of what they are. Rather, the governor is going to approach this ad hoc. That’s no way to run things.
UPDATE at 10/29/14 11:43:32 am by Vogon Poetry
Elsewhere, a Connecticut family has filed suit after their child was told to stay home from school over Ebola fears. The family recently returned from a trip to Africa, but had not traveled to one of the three countries struggling with the current outbreak. They had visited Nigeria, which managed to stop a cluster of cases in Lagos several weeks ago. They have been outbreak free since then.
But it points to the ludicrous lengths to which some people will deny access on account of Ebola. People, including politicians, seem to have no idea of the geography involved, or that there are separate countries involved in this outbreak. Others think that all of Africa is somehow affected, even though it’s a tiny portion of a continent with more than one billion people living there.