With the West African Ebola epidemic still raging out of control, killing 20 people a day in Sierra Leone alone, Americans, confronted with their first few cases, are taking on the tough questions: Can Ebola be transmitted by a bowling ball? What about co-location in a hipster coffee bar near the High Line? And—OMG—what about Uber-based transmission?
Right on cue, as if in an attempt to push the discussion ever further toward irrelevancy, the twin towers of presidential posturing, Governors Chris Christie and Andrew Cuomo, agreed to hog the spotlight together in order to get presidentially tough over an issue that needed no decisiveness at all: What to do about the small trickle of health-care volunteers who return to the States from West Africa? Tired, apparently, of all the goddamned evidenced-based pussy-footing coming from people who understand science and public health, the Two Big Guys made their kick-butt pronouncement: They are throwing those weenie volunteers into the 21-day slammer, no ifs or ands or buts. Goddammit.
With this they are further tarring the poor schmuck who is fighting off a life-threatening infection: Dr. Craig Spencer. Remember him? Remember 55 percent death rates from Ebola? Yet Spencer’s current predicament has taken a distant back seat to the pressing worries of 8 million people who are at zero risk but appear to want to feel threatened. It is an odd inversion—dumping on a guy who is sick and at real risk for death and maybe a little heroic (after all, he chose to go to Guinea to help the dying, chaotic masses) and focusing instead on his “selfish disregard for the public” as he traipsed across the subway system to access the cultured and well-turned-out parallel world of Brooklyn and its contents.
I don’t know Spencer, but my only beef with him is that he opted to go bowling—meaning he either likes bowling, which is inconceivable, or he “likes” bowling, i.e., he is edging along the gentle ironies of the early-30s New York life, bowling and macaroni and too-skinny pants, passions that start out in passionate jest yet become anchored and beloved, the supercilious eyebrow shake lost in the shuffle as comfort turns out to be, well, comfortable. No matter what one thinks of him personally, though, clearly he is a victim here and not a villain.
Admittedly, the Governators are addressing a real concern: the cost of managing the seemingly inevitable panic that accompanies the mere mention of Ebola. Though not necessary, public-health workers in New York City are busy right this second making phone calls to people who might have been on a subway, in a diner, at the bowling alley, spending substantial time (and therefore tax dollars) all in the name of panic, not disease, control. So surely there is a cost-saving argument to be made in this sort of nip-’em-in-the-bud quarantine first, ask questions later approach.
But the real situation is far more complex than the simple, thuggish gubernatorial action suggests. Indeed, there is a consequence to Christie and Cuomo’s decision that endangers the safety of the rank and file of New Jersey and New York far more than it protects it. Searching for a bump in some internal poll or perhaps because it feels good to make a damn decision once in a while, the governors know but choose to ignore the obvious big fact: There is a larger crisis occurring in redoubts well beyond Trenton and Albany. Their move, though perhaps it plays well now, will have a desiccating impact on volunteerism; this in turn will make the African epidemic worse, which will make it more likely cases will appear in the United States, which will increase the risk of Ebola for John Q. Public as he wanders through Trenton and Albany, Brooklyn and Newark.
Plus it is exasperating. They are both really smart guys, yet they have decided to ignore science and evidence and decades of careful observations made by those brave enough to have gone to Africa to assist in the control of epidemics. After all, an enormous amount is known about Ebola and its transmission. Honest. Because of work done over the last 40 years of Ebola outbreaks, scientists knew what to expect. And despite political panic over a very dramatic situation, Ebola in the United States has appeared according to the established “rules” of disease spread: appearance of a few cases here and there, the transmission to two nurses exposed before the diagnosis was made, the lack of transmission to Thomas Eric Duncan’s family or to the emergency-room staff who treated him briefly, the lack of transmission to appropriately trained staff in Omaha and Atlanta and Bethesda. As predicted, there are no cases in the United States outside of health-care workers, a cameraman filming health-care workers, and poor Mr. Duncan, who died because, in a health-care worker role, he helped his dying family member.
Yet we have seen that paragon of efficiency, leanness, and clarity, Congress (Congress!), force a perp walk of those involved, poring over Friday’s decisions with the smugness (and maturity) of South Park’s Captain Hindsight. And now we have seen Big Footers further bigfoot the experts as Christie and Cuomo lay down a law that is cruel, short-sighted, and against the interest of the public’s health.
Showing unexpected if slight flexibility, Cuomo on Sunday night appeared to rework the rules of the quarantine, saying the prison will be one’s own home, not a hospital room (or makeshift tent), and detainees will receive paid leave for the time from work lost. Call it Quantanimo Lite.But the adjustment fails to undo the basic badness of the idea—the plopping of a heavy-handed, ineffective, fear-enhancing new dictate right into the middle of a public-health emergency that is being handled just fine, thank you, by the people trained to handle it.
Since the outbreak began, now 11,000 cases and 5,000 deaths ago, much has been written about this being a perfect storm of infection, fragile local governments emerging from long civil wars, and international hesitancy. Tragically, this characterization appears apt.
Here, though, we have a different but equally destructive perfect storm: the confluence of a dangerous, potentially lethal infectious disease, an upcoming congressional election, and the brutal selfishness of veteran pols in the hunt.