Scientists attending American Society of Tropical Medicine and Hygiene convening in New Orleans this weekend say states are taking the science out of public health policies. Attendees to the conference that starts here Sunday were warned by the state that “in an abundance of caution” anyone who has been in West Africa in the last 21 days is banned from traveling to Louisiana — even if they have no symptoms of Ebola — and will be quarantined in their hotel room if they do.
Nola.com, by Rebecca Catalanello – If there’s one phrase that is driving the scientific community nuts today, it’s this one: “In an abundance of caution.”
The Louisiana Department of Health and Hospitals earlier this week sent a letter to members of the American Society of Tropical Medicine and Hygiene convening in New Orleans this weekend warning them that “in an abundance of caution” it is banning any attendees who have been in West Africa in the last 21 days from traveling to Louisiana — even if they have no symptoms of Ebola.
Those who do will be quarantined in their hotel rooms.
“From a medical perspective,” the letter said, “asymptomatic individuals are not at risk of exposing others; however the state is committed to preventing any unnecessary exposure of Ebola to the general public … These precautions are being taken out of an abundance of caution.”
Dr. Susan McLellan, clinical associate professor of tropical medicine at Tulane University, has two words to describe the policy: “Completely unreasonable.”
“Those of us who actually study the disease are quite aware that it does not protect the public health of people in any way to quarantine people who are a-symptomatic.”
Medical scientists who expected to attend the conference are making other arrangements in wake of the advisory from Louisiana, leaving conference organizers uncertain of the final impact.
Dr. Alan Magill, president of ASTMH, said it will be Monday or Tuesday before they will know for sure how many of the more than 4,000 expected attendees will have canceled. The organization issued a statement saying it disagrees with the policy. Leadership will be working between now and the conference’s Sunday to readjust and explore integrating remote access technology into the program, where possible on short notice.
“This is not about pointing fingers,” Magill said Friday. “The reality is we’re guests and they’re the host and typically the host makes the rules.”
Others scientists were not so accommodating.
Dr. Dan Bausch, associate professor at Tulane’s Department of Tropical Medicine, said that when he hears the phrase “out of an abundance of caution” in this context, he prepares himself.
The same phrase was used by the Louisiana Attorney General’s Office earlier this month when it decided to reject the of burned remains of a deceased Ebola patient from being buried in a Lake Charles area landfill.
“It means it’s just not scientifically based,” Bausch said. “And though this disease is a serious disease, it’s not magic. It’s still science and scientific principles still apply.”
He and McLellan both believe that the measure is not only not productive, it is counterproductive to stemming spread of the disease.
Bausch guessed that the number of researchers unlikely to travel due to the ban will be in the in the tens — not hundreds or thousands – but they are people on the frontline of Ebola research. “These are the 10-20 people who we really need to hear from.”
McLellan said another serious consequence of the messages like the one coming from DHH is that is fans the flames of fear and misunderstanding. “The harm, very specifically, is that every time policies are put in place that don’t support the science, it sends the message that the science is suspect,” she said.
Dr. Peter Jay Hotez, a past-president at ASTMH and founding dean of the National School of Tropical Medicine at Baylor College of Medicine in Texas, said there is another risk: That attendees angry about the Louisiana policy will protest by boycotting the event — a move that could have financial consequences for the organization.
He said he would take the “abundance of caution” wording more seriously if it were being applied to other areas of medical risk as well — like the 99,000 U.S. deaths annually attributed to hospital acquired infections and the thousands who die every year with the flu. “I don’t see a lot of abundance of caution with that.”
Dr. Frank Welch, medical director for the Louisiana Department of Health and Hospitals — who loves to talk about flu prevention, by the way — said he understands some of the blowback from the scientific community, but the department is trying to overcompensate in areas unaddressed by evolving U.S. Centers for Disease Control and Prevention travel guidelines.
“No matter what you do in this situation, you’re going to take the heat,” he said. “Medical experts have made a few mistakes over the past few weeks.”
DHH will have a booth at the conference, which opens Sunday with a 5:30 p.m. keynote address by Bill Gates, and lasts through Nov. 6 at the Sheraton New Orleans and the New Orleans Marriott Hotel.
Welch said the agency is also working to advise attendees of another conference, the American Public Health Association, which holds its conference in New Orleans on Nov. 15-19.
Rebecca Catalanello can be reached at firstname.lastname@example.org or 504.717.7701.