Sunday, November 2, 2014

Ebola, Science and Civil Rights

Should all people who enter the USA from Ebola-stricken countries be quarantined?

Maine resident Kaci Hickox returned to the US after caring for Ebola patients as a nurse in West Africa.  She arrived in New Jersey, and she was detained in a tent under strict quarantine, even though she had no symptoms.  New Jersey allows its own healthy residents to self-monitor for symptoms of Ebola, but the state's officials didn't know what to do with Kaci.  All this despite scientific evidence that Ebola spreads only when the infected person experiences symptoms, such as a fever and body aches.

Now Kaci is back home in Maine and remains healthy.  As a nurse who fought to contain the deadly virus, can she not be trusted to self-monitor and report for medical treatment at the appropriate time?  Some people don't think so.

There are some US politicians who would impose a travel ban on West African countries.  Those who disagree say that such a ban could be circumvented.  They say that infected individuals could arrive here indirectly, so it would be better to permit them to travel normally and simply monitor them.

It almost seems reasonable to me to give the Ebola medical volunteers complete freedom to travel, provided they monitor themselves for symptoms and maintain a record of their contacts and activities.  What do I mean by “almost”?

“Almost” means that I'm not 100% certain that these volunteers are unable to transmit Ebola when they are asymptomatic.  Basically, I don't trust science.  Science lives by its data.  If it lacks data, or if the data shows poor correlation between Thing A and Thing B, it will announce that there's no evidence that Thing A causes Thing B.

Correlation is wishy-washy.  A study could show poor correlation between Thing A and Thing B even if one instance of Thing A was “well associated” with Thing B when 99 others weren't.  That one data point might be considered an outlier and discarded.

Thus when a so-called medical expert recently claimed that there's no evidence that someone with no symptoms can spread Ebola, and that Ebola is spread only through contact with an infected person's bodily fluids, I became suspicious.  To believe in this claim, I'd need to read the study, look at the data, understand the limitations of the measurement system, etc.

I'd want to know why science was unable to find evidence.  And yet science seems to be unable to explain how other seemingly well-equipped medical volunteers became infected.

Bodily fluids can be coughed into the air and sneezed onto a surface, and then you and I could come into contact with it.  Science might claim that it's unlikely that we'd catch Ebola this way.  But not impossible.

What do you think?

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