Sunday, October 19, 2014

Life in Quarantine for Ebola Exposure: 21 Days of Fear and Loathing

By on 6:03 AM

DALLAS — The refrigerator in Youngor Jallah’s small apartment broke down last week, and it did not take long for the stench of rotting food to grow unbearable. But when she reported the problem to the front office, the complex’s manager said that a repairman would not be sent until Monday.

That is the expiration date for the 21-day, self-imposed quarantine that Ms. Jallah, her partner and her four children have endured since the day her mother’s boyfriend, Thomas Eric Duncan, was hospitalized here with Ebola. Because her mother was at work, it was Ms. Jallah, 35, who last cared for Mr. Duncan, making him tea and handing him a thermometer — but, she said, never touching him — before summoning an ambulance.

Life in Quarantine for Ebola Exposure: 21 Days of Fear and Loathing
The complex’s manager urged Ms. Jallah to move her food to the apartment across the stairwell, which has been empty since a new renter decided against moving in after hearing about the neighbors. When the landlord sent a maintenance man to deliver the key, he arrived wearing two pairs of rubber gloves.

So it has been in Quarantine Nation. As the Ebola scare spreads from Texas to Ohio and beyond, the number of people who have locked themselves away — some under government orders, others voluntarily — has grown well beyond those who lived with and cared for Mr. Duncan before his death on Oct. 8. The discovery last week that two nurses at Texas Health Presbyterian Hospital here had caught the virus while treating Mr. Duncan extended concentric circles of fear to new sets of hospital workers and other contacts.

Officials in Texas announced on Thursday that nearly 100 health care workers would be asked to sign pledges not to use public transportation, go to public places or patronize shops and restaurants for 21 days, the maximum incubation period for Ebola. While this is not a mandate, the notices warn that violators “may be subject” to a state-ordered quarantine.

When officials revealed that one of the infected nurses had flown from Dallas to Cleveland and back before being hospitalized, nearly 300 fellow passengers and crew members faced decisions about whether to quarantine themselves. The next day, a lab technician who had begun a Caribbean cruise despite possible exposure was confined to a stateroom. Medical workers, missionaries and journalists returning from West Africa — especially from Guinea, Liberia and Sierra Leone, where Ebola is rampant — are also staying home.

Dr. Howard Markel, who teaches the history of medicine at the University of Michigan, said the quarantines recalled the country’s distant epidemics of cholera, typhus and bubonic plague.

“Ebola is jerking us back to the 19th century,” he said. “It’s terrible. It’s isolating. It’s scary. You’re not connecting with other human beings, and you are fearful of a microbiologic time bomb ticking inside you.”

While a quarantine is designed to protect those on the outside, it also fuels the community’s fear, and sometimes its cruelty.

In Payson, Ariz., paranoia ignited after word spread that a missionary who had traveled to Liberia on a church trip was spending three weeks under a self-imposed quarantine with his wife and four children. The missionary, Allen Mann, strung yellow caution tape and a “No Trespassing” sign around his front door and left a bucket in the yard for neighbors to drop off food and treats for his children.

While most neighbors understood there was scant risk that Mr. Mann, 41, had carried the disease home, rumors nevertheless coursed around town that he had tested positive for Ebola and would soon be medically evacuated. Mr. Mann said an anonymous commentator on a local news website had suggested burning down his house.

“People had this lynch-mob mentality,” he said.

As with other aspects of the Ebola response, the criteria for recommending or requiring quarantine have often seemed ad hoc, random and evolving.

In Dallas, the four people who shared an apartment with Mr. Duncan during his brief visit from Liberia have been the only subjects of a state-mandated quarantine. With their apartment contaminated, they were moved to a residence provided by a local benefactor.

It has been particularly wrenching for Louise Troh, 54, Mr. Duncan’s girlfriend, who has had to mourn his passing in isolation. When her pastor, the Rev. George Mason, arrived to break the news of Mr. Duncan’s death and she collapsed to the floor in tears, he could not console her with a hug. On his regular visits to the house, he stands three feet away and signals his affection by crossing his arms in an X over his chest.

Mr. Mason said it was not yet clear where Ms. Troh and her 13-year-old son, Timothy, would live once their quarantine ends on Monday. Judge Clay Jenkins, Dallas County’s top official, said it had been hard to find a willing landlord.

Ms. Troh has taken comfort in cooking Liberian food and talking to relatives by phone, Mr. Mason said. She listens to gospel music on a CD player, while Timothy and the two young men in the house, Oliver Smallwood and Jeffrey Cole, kill time watching action movies.

“They all want to get out,” Mr. Mason said. “They want their liberty and to be able to touch and be human beings. But they fear they’re not going to be normal human beings again. When I asked them if they heard about the second nurse, Oliver looked at me and said, ‘Are they going to blame us for that?' ”

The day after Mr. Duncan’s illness was diagnosed, Ms. Jallah and her family received verbal instructions to stay inside. Her partner, Aaron Yah, who had not been exposed to Mr. Duncan, was cleared by county and federal health officials to leave the apartment after four days, the couple said.
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