This Friday’s shoot-the-shit topic centers around the West African Ebola epidemic and the quarantine debate taking place in this country. The question being decided is this…

Should an individual who has had direct contact with infected person(s) be quarantined for a 21 day period be they symptomatic or not?

In my view, the answer is an unqualified yes, and this is why.

People in the infectious disease business; researchers, clinicians and healthcare workers tend to disagree presenting an argument based on a limited sample, and as statisticians and actuaries will tell you, all samples by default have errors or what we call outliers. An outlier is an event or observation that falls outside the norm. However,  real risk is not from what is known but rather from what we don’t know and the associated probability that an outlier will manifest itself. In fact, outliers is what drives premium prices of insurance policies; this is how insurance companies establish premiums.

Although It is accurate that in the “majority” of cases observed the Ebola virus is transmitted by contact with bodily fluids and that an infected individual is infections when symptoms are present, because data is imperfect, one has to consider outliers. It’s therefore very reasonable to weigh any number of questions. Are there individuals that can transmit the disease without showing symptoms, or are there instances where incubation takes longer than 21 days? Is there a risk that an infected individual, at early stages of incubation, vomit while out and about and a rodent or stray animal comes in contact with that fluid? What then? What happens when that outlier manifests itself in a population center. What happens when an HIV positive individual is exposed to the Ebola virus, does it trigger full AIDS?

From current data, which by the way relies on self reporting,  the later may be remote, but still possible nevertheless. I recall a recent CNN interview in which Wolf Blitzer asked a researcher a similar question to which she responded “ Wolf, yes it is possible, but those our outliers.” I contend that it is those outliers, when considered with the fact that Ebola is 50% – 70% fatal, that constitute the risk. So I applaud Governors Scott, Christi and Cuomo for making responsible management decision in the interest of their constituents.

I’m flabbergasted by individuals like nurse Kaci Hickox, who in my view lacks the maturity and discipline that someone working in the medical field, and more specifically with infectious diseases, should have. She and others like her should clearly understand the risks, and not just with typical cases but with the “outliers,” and the corresponding need for an abundance of caution.

Should we impose a mandatory quarantine for individuals that have had direct contact with an Ebola infected person? Absolutely, twenty-one days is not much to ask. But, on the flipside of this imposition a quarantined individual has every reason to expect they will be treated with dignity and not suffer economic or job loss resulting from their mandatory isolation.

Let us know what you think.

Have A Great Weekend Everybody!