Workers Vanguard No. 1058
12 December 2014
On Ebola and Quarantine
15 November 2014
The Workers Vanguard article titled “Ebola in America: Capitalist Criminality and Racist Indifference” was quite good in what it said about the inequity and racism inherent to healthcare in the United States and the gross disregard with which the imperialists treat the third world. However I am deeply disturbed by what was not said in the article. The article leaves the reader with the mistaken impression that WV opposes the quarantining of non-symptomatic Ebola healthcare workers. WV has in fact taken no position on the home quarantining of such workers. If this position had been honestly expressed it would have given a tacit endorsement of those quarantines which are currently in effect in at least six states. A non-position is not appropriate in this case. Despite the fact that Ebola research has not been adequately funded there is a basic scientific understanding of what Ebola is and how it is transmitted. Under socialism, society would still have to face questions about how to deal with the emergence of new infectious diseases that have not been researched as extensively as we would like.
The medical establishment speaks with one voice on the question of the quarantines of non-symptomatic healthcare workers including the New England Journal of Medicine, Doctors Without Borders, the WHO and the CDC. Many have expressed distrust of these pronouncements due to the bad record of these institutions when it comes to issues of social policy; this is especially true of the CDC. I am willing to ascribe to the CDC all kinds of prejudices and bad practices, which are inherent to the capitalist system of healthcare. The bad treatment and lack of training given to healthcare workers by the CDC is evidence enough to illustrate the bad faith of the CDC. However the only reason that the CDC would lie about the risk posed by Ebola healthcare workers would be to not discourage workers who would volunteer to go to West Africa to treat those infected. It makes no sense for the CDC to place the medical needs of Africans ahead of the safety of U.S. public health generally. Furthermore it is the healthcare workers returning from Ebola-decimated regions of Africa that are fighting these quarantine orders, and these are precisely the people who would know best about what medical precautions are needed to prevent the spread of Ebola. We as communists should be standing with the healthcare workers who are courageously placing their lives at risk to help impoverished Africans decimated by Ebola.
Science and medicine are moving targets. Medical understanding is always incomplete. This is true of all medicine, not just a disease like Ebola which has been deliberately under-resourced. This however does not indict medicine as a whole. We must rely on the best science we have available at any given moment no matter how insufficient it is. Today all indications are that there is no need to quarantine non-symptomatic healthcare workers returning from Africa. The official position of the SL was obfuscated by the WV article, however if it had been properly described it would be clear that by refusing to side with the healthcare workers and the overwhelming opinion of the medical community that these quarantines are unnecessary, WV would have given the states political cover for their unscientific hysteria.
Some comrades have pointed out that Cuba has a policy of quarantining those healthcare workers who volunteer to treat Ebola, but also pays the workers for the extra risk and the time in quarantine. The way the Cubans treat their healthcare workers and have conducted these quarantines is in sharp contrast to the treatment dished out in the U.S. and illustrates the more egalitarian nature of the deformed workers state. The policy is still scientifically wrong, and I would warn any comrade against relying on Cuba as a model for good public health policy that as late as 1994 Cuba was quarantining AIDS patients.
WV replies: Our article in WV No. 1055 (31 October) purposely did not take a position on the mandatory quarantining of asymptomatic health care workers exposed to the Ebola virus. We do not rule out the possibility that quarantine might be warranted as a necessary public health measure, even if it comes at the expense of personal rights and liberties. This stance does not preclude us from condemning the manner in which the capitalist government implements quarantine. So when New Jersey governor Chris Christie incarcerated nurse Kaci Hickox in a tent in Newark for three days, we stated the obvious in our article: Hickox “was treated like a criminal.”
In making his case, Ken R. missteps by reducing the issue to one simply of medical science. The control of disease is as much a social question as a scientific one. For various reasons, even medical personnel can sometimes cut corners on voluntary monitoring. By all accounts, community contacts of a newly symptomatic Ebola victim are very unlikely to be at risk of infection, but the risk is not zero. And although much is known about the development and transmission of Ebola, still more remains to be learned.
While many medical authorities have come out against mandatory quarantines of asymptomatic individuals, the same authorities advocate strict monitoring for the length of time that the virus takes to incubate in its host—an estimated 21 days. That course of action is itself a form of social control and closely related to quarantine. The returning health care workers themselves do not speak with one voice. Dr. Craig Spencer, whose fiancée voluntarily submitted to quarantine after he tested positive in New York City, called himself a living example of how protocols for early detection and isolation work. Kaci Hickox favorably cited the European Union guidelines, which include quarantine under certain circumstances.
In this case, we have taken a cautious approach. As a Marxist fighting propaganda group—not a medical organization—it is not incumbent upon us to pronounce on specific policy in all cases, especially in the absence of an epidemic or other overriding public health concern. In this sick capitalist society where there is effectively no public health system, government officials and hospital management lied through their teeth about their ability to adequately deal with the problems posed by Ebola, giving fuel to the hysteria that Christie and other politicians seized on.
Notably, health care unions like the National Nurses United and SEIU have not opposed the quarantine measures as such. Rather, they have made demands that no worker exposed to Ebola forfeit pay, rights, benefits or seniority while being monitored or treated. In contract negotiations with the University of Michigan hospital system, nurses won an Ebola clause protecting their jobs and guaranteeing that they “will not lose their salary or have to use paid time off or extended sick leave if quarantined.”
Ken raises the argument that Cuba should not be looked to for a good public health policy because “as late as 1994 Cuba was quarantining AIDS patients.” Our article “Cuba: Socialized Medicine and the Fight Against AIDS” (WV No. 1010, 12 October 2012) detailed Cuba’s treatment programs. Noting that Cuba relaxed its mandatory quarantining in 1989 and gave the option of outpatient treatment in 1993, we explained: “Given that HIV cannot be transmitted by casual contact, quarantining proved to be unnecessary as a public health measure.” But we did not criticize the bureaucracy of the Cuban deformed workers state for adopting an extremely cautious policy intended to restrict exposure to a disease that was little understood at the time.
Today, Cuba has by far the lowest prevalence of HIV in the Western Hemisphere, if not the world. The superior quality of health care in Cuba compared to the rest of the Caribbean (not to mention parts of the U.S.) is a result of the overthrow of capitalist rule in the period following the 1959 revolution. Absent the aid Cuba once received from the Soviet Union, there has been an exacerbation of material scarcity on the island amid U.S. imperialism’s ongoing blockade. It is reasonable that a workers state in such hostile waters would exercise a zero-risk policy to keep a devastating disease like Ebola from reaching its shores.
The mobilization of the necessary resources to combat deadly epidemics and other threats to the well-being of mankind will not be forthcoming in a world order dominated by the imperialists, in which the value of the mass of the population lies in its capacity to generate profits for the capitalist masters. An international socialist society will strive to implement the highest levels of technique and culture to the benefit of all.