Back from West Africa, a U.S. Nurse Says Quarantining Medical Workers Threatens Ebola Response

October 27, 2014



Carissa Guild

a nurse with Doctors Without Borders. She just returned from Guinea last week where she was helping to respond to the Ebola crisis. In 2012, she worked with Doctors Without Borders in the Congo to address an Ebola outbreak there.

The governors of New York and New Jersey are facing federal pressure to reverse new quarantine rules on medical workers returning from West Africa. Under the policy, arriving passengers with a risk of Ebola exposure will be placed in a 21-day quarantine. White House officials lobbied New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo over the weekend, saying the rules would discourage workers from joining the Ebola response in West Africa. On Sunday night, Cuomo announced a slight easing of the restrictions, saying the workers can be quarantined at home. A nurse named Kaci Hickox became the first health worker isolated under the rules after returning to New Jersey from Sierra Leone. Hickox has been placed in an isolated tent inside a Newark hospital despite testing negative for Ebola. She has threatened to fight her 21-day quarantine in court, saying the order violates her constitutional rights. We are joined by Carissa Guild, a nurse with Doctors Without Borders (MSF) who has just returned from Guinea, where she took part in the Ebola response effort.


This is a rush transcript. Copy may not be in its final form.

JUAN GONZÁLEZ: The World Health Organization said Saturday nearly 5,000 people have now died from Ebola out of 10,000 known cases. But health officials say the actual death toll may be significantly higher in Guinea, Liberia and Sierra Leone, the three worst-hit countries. The virus is now threatening Ivory Coast, which shares a border with Guinea and Liberia. The World Health Organization has sent experts to Ivory Coast and Mali to help prepare for a possible outbreak. On Friday, a two-year-old toddler in Mali died after contracting the virus in Guinea.

Meanwhile here in the United States, hospital officials say the first Ebola patient in New York, Dr. Craig Spencer, is in serious but stable condition at Bellevue Hospital. Spencer recently returned from treating Ebola patients in Guinea with Doctors Without Borders. As part of his treatment, Spencer received a plasma transfusion from Nancy Writebol, an aid worker who contracted the deadly disease in Africa and survived.

AMY GOODMAN: On Friday, the states of New York and New Jersey announced they would automatically quarantine medical workers returning from Ebola-hit West African countries. A nurse named Kaci Hickox, who recently returned from Sierra Leone, became the first health worker isolated under the rules. She arrived at Newark airport. She was placed in 21-day quarantine in a tent outside University Hospital in Newark. She has threatened to fight her quarantine in court, arguing the order violates her constitutional rights. During a phone interview on CNN, Hickox disputed New Jersey Governor Chris Christie’s assertion that she’s "obviously ill."

KACI HICKOX: I heard from my mother last night, who called me, concerned, and said, "Governor Christie just said in an interview that you were, quote-unquote, 'obviously ill.'" And this is so frustrating to me. First of all, I don’t think he’s a doctor, and secondly, he’s never laid eyes on me. And thirdly, I have been asymptomatic since I’ve been here. I feel physically completely strong and emotionally completely exhausted. But for him to say I’m obviously ill, which is even a strange statement—what does that mean? Someone define that for me, because I think I don’t quite understand what "obviously ill" means. But I am here to tell you that I am completely fine physically, and being held here is just—I just don’t understand.

JUAN GONZÁLEZ: That was nurse Kaci Hickox being interviewed on CNN. Public health officials and the White House have criticized the plan by New Jersey and New York to quarantine health workers, saying it could impede the Ebola fight. On Sunday, New York Governor Andrew Cuomo appeared to soften his stance and said people quarantined in the state who do not show symptoms of the disease would be allowed to remain at home.

AMY GOODMAN: To talk more about Ebola, we’re going to be joined by a number of guests. We start with Carissa Guild, a nurse with Doctors Without Borders, also known as MSF—it’s the letters for the French, Médecins Sans Frontières. She just returned from Guinea last week, where she was helping to respond to the Ebola crisis. In 2012, she worked with Doctors Without Borders in the Congo to address an Ebola outbreak there.

Welcome to Democracy Now!, Carissa Guild. First, can you—before we talk to you about your return from Guinea, if you can talk about the treatment of your fellow nurse? Talk about what—the whole issue of how Kaci Hickox is being dealt with right now. She arrives at Newark and is taken from there, ultimately against her will, placed in 21-day quarantine. She now says she’s going to sue over her treatment.

CARISSA GUILD: I mean, I think that it was a decision that was made that was probably not well thought out. Like everyone has been saying, there’s a lot of—it’s not well thought out. There’s no evidence that she’s a risk to anybody in the whole country. So, I obviously don’t agree with putting her being in quarantine. I think that just monitoring your health, like we’re told to do every day, and taking your temperature every day—we can’t give anybody Ebola if you don’t have symptoms. She obviously doesn’t have symptoms. So, it was not a very well-thought-out or rational decision to do, and we’ll see what happens.

JUAN GONZÁLEZ: And, Carissa, could you talk to us about what happened to you when you came in the country, when you returned in your last trip from West Africa?

CARISSA GUILD: I mean, I just returned back last week. And I came in, and I was—I went to JFK. And they brought me into a room, and they monitored my temperature, and I didn’t have a temperature, so basically I just went home. And I follow the daily rules of Doctors Without Borders, where I do take my temperature every morning, and I send an email every morning to the Department of Health, and I let them know that I’m feeling fine. And so far I’m feeling fine. So I think that actually this is less of a problem, and what we’re talking about, about ex-pats returning and not treating them well in the United States and ex-pats having Ebola here in the United States, is not really the issue. I think the issue is much more talking about those 10,000 people who have contracted the virus over in West Africa.

AMY GOODMAN: Can you talk about what you found in Guinea? Talk about your time there.

CARISSA GUILD: I mean, there’s a lot of problems in Guinea right now. I’ve been there—I guess that the first time I went was in April. And I basically just have seen the progression get worse and worse and worse with the virus. MSF is basically reaching its capacity. Where I was was in a town called Guéckédou, which is where the whole outbreak began. And we ended up having nearly 100 beds in our facility. Right before I was leaving, we were discussing of what we’d do if we have to start turning patients away, because we were getting patients coming from very long distances away, and we were worried that we weren’t going to have enough capacity to actually treat and isolate the cases. So, there needs to be a lot more work and a lot more help going there to help get this under control.

JUAN GONZÁLEZ: And what do you think will be the impact of what’s happened to Kaci Hickox on the other caregivers thinking about going to West Africa and doing their part to be able to stem the spread of Ebola?

CARISSA GUILD: Well, I’m hoping that not every state takes this decision. And hopefully the decision gets relooked at, so hopefully it won’t have too much of an impact. And it wouldn’t probably impacted me so much going, but that’s also knowing that there’s plenty of other countries in the world which would be happy to have me for 21 days after I came back and would let me hang out at home and not be in a hospital. So, hopefully, the decision will get looked at and it won’t have an impact, because it would be really unfortunate. It’s unfortunate for her. She went over to Africa to help in West Africa for this Ebola crisis. There’s a lot of suffering over there. There’s a lot of people who are really, really scared over there. And to have her welcomed back into her home like we’re welcoming her back is not the best face of America.

AMY GOODMAN: How did you protect yourself? How did people in Guinea protect themselves, both in communities where people had Ebola and in the hospital where you worked?

CARISSA GUILD: We were using the personal protective equipment, so when we were in the center, the treatment center, we were very, very well protected. We had the jumpsuit, the yellow jumpsuit, on and masks and two pairs of gloves and hoods and aprons and everything that you see on TV. So we were very protected while we were inside the treatment center.

Outside the treatment center, though, is basically the passive part of a response to Ebola. And the part that’s very important is the training of people in the community and doing outreach and going into the villages and speaking with a lot of people and teaching health workers. In this, we were protecting ourselves basically by keeping distance with patients or keeping distance with the population, keeping a two-meter distance, washing your hands a lot. There was chlorine everywhere, everywhere, everywhere. I mean, that said, it doesn’t make the risk zero, and there are certainly—there’s plenty of health workers in Guinea who have gotten sick. But there’s many, many precautions that certainly MSF is taking, which is keeping me—I feel pretty confident that I don’t have Ebola and that I didn’t get Ebola while I was there.

JUAN GONZÁLEZ: I wanted to go back to Kaci Hickox, the Doctors Without Borders nurse who was placed in a 21-day quarantine in New Jersey after she returned from Sierra Leone. On Sunday, she called into CNN. This is part of her conversation.

KACI HICKOX: We have to be very careful about letting politicians make medical and public health decisions. And all of the evidence about Ebola shows that if you are not symptomatic, you are not infectious. It’s really inhumane. I just came back from one of the most difficult months of my life, and I am completely [inaudible]. And no one knows—no one can predict if I will develop Ebola or not in the next 21 days. And most aid workers [inaudible] come back will not [inaudible] Ebola. So, to quarantine everyone, in case, you know, when you cannot predict who may develop Ebola or not, and to make me stay for 21 days, to not be with my family, to put me through this emotional and physical stress, is completely unacceptable.

JUAN GONZÁLEZ: That was Kaci Hickox talking to CNN. What about this issue of the politicians making decisions that really should be in the hands of medical experts and scientists?

CARISSA GUILD: I mean, I guess I really don’t have too much to say about that. I definitely agree that Ebola is a medical problem. It’s an outbreak. And it should be in the hands of people who know what they’re doing and who understand how the virus works and how to protect yourself. It’s a pretty tricky virus, and there are very specific things that we already know work, and there are people who know those things. And I would trust those people over someone making a decision who is less informed.

AMY GOODMAN: Carissa, what is most needed now in Guinea, where you were? What were people most calling for to deal with the Ebola crisis?

CARISSA GUILD: I mean, in Guinea, there’s a lot of fear, and I’ve seen it spread quite far. So, it started off in one prefecture called Guéckédou. And when I was leaving, we were having cases coming from very far away, in the whole right half of the country, which means that people were waiting until the end. They were being sure that these people had Ebola. They were coming—they were putting them in ambulances for 10 hours. They were sending them to our center for treatment. They were arriving very late, so sometimes you would open up the ambulance door, and there would be three people who were still alive and one or two people who had died on the way. So I think there needs to be a lot of effort in building treatment centers and making access to care bigger and doing outreach and training staff workers and training health workers in how to detect cases of Ebola, putting labs to make sure that we know where Ebola is. And I just—there’s a lot to be done there right now.

AMY GOODMAN: Carissa Guild, I want to thank you for being with us, a nurse with Doctors Without Borders, also known as MSF. She just returned from Guinea in Africa, where she was working with Ebola patients. She has come back to this country and is in Cape Cod now. When we come back, we will go to Jeffrey Sachs, a leading economist, director of The Earth Institute at Columbia University, has a team in Guinea, as well. And we’ll speak with Johns Hopkins scientist Nancy Kass about experimental drugs dealing with Ebola. Who should get them? Who doesn’t get them? Stay with us.

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