A Plea to Presidential Candidate Christie: Please Stop Talking About Zika

During the Republican debate in New Hampshire on Feb. 6, New Jersey Gov. Chris Christie was asked about his decision to place nurse Kaci Hickox in mandatory quarantine outside Newark Liberty International Airport in the fall of 2014. Hickox was in the airport making a flight connection to her home in Maine on her way back from Sierra Leone, where she had served in an Ebola treatment center run by Médecins Sans Frontières (MSF). In Saturday night’s debate, Christie was asked whether he would still quarantine individuals like Hickox today and if he would consider using such measures to control Zika virus spread.

Christie responded that yes, he would readily employ tough quarantine measures again to stop Zika: “You bet I would!”

Candidate and surgeon Ben Carson rebuked Christie in the debate, responding: “Just willy-nilly going out and quarantining a bunch of people because they’ve been to Brazil, I don’t believe that that’s going to work.” The New Jersey governor then insisted that the steps he took in the Hickox case were not only warranted but also wise. He continued:

“The fact is that because I took strong action to make sure that anyone who was showing symptoms — remember what happened with that nurse. She was showing symptoms and coming back from a place that had the Ebola virus active, and she had been treating patients. This was not just some — like, we picked her up just for the heck of it, alright? We did it because she was showing symptoms. And the fact is, that’s the way you should make these decisions.”

In saying this, Christie reiterated a claim he has repeatedly made that Hickox “had Ebola symptoms” when she landed at Newark, meriting her forced isolation in late-autumn chill inside a tent resting atop concrete.

According to the Washington Post, Hickox, assisted by the American Civil Liberties Union, is suing “Christie and other New Jersey state officials” for, “$250,000, alleging false imprisonment, invasion of privacy and violation of due process, among other claims.” Hickox, who has since returned to her job, still maintains that her temperature was normal and the only “symptoms” she displayed at the Newark Airport were a result of exhaustion and jetlag. Christie’s office has repeatedly insisted Hickox showed “elevated temperature” when she passed through a temporal body scan, though her blood tested negative for Ebola. After Hickox had been in mandatory isolation for a day, and tested negative, Christie Tweet-confirmed her health but insisted on continued quarantine.

According to Hickox, the only reason she was sequestered by immigration authorities at the Newark Airport was because she answered their questions honestly, telling them that she had been in contact with Ebola patients in Sierra Leone.

Following Hickox’s involuntary detention, MSF and other humanitarian organizations advised their staff and volunteers to avoid New Jersey airports, exclusively returning to the United States via New York’s John F. Kennedy International Airport. (I followed that advice in late 2014, upon my return to New York via Kennedy Airport after spending a few weeks in Liberia and Sierra Leone during the Ebola epidemic, and found the federal and New York City procedures for re-entry quite reasonable, including my daily monitoring by city health authorities for 21 days and their request that I not leave the city during that time and avoid social contact.)

Almost a year ago, an Obama administration-appointed bioethics panel denounced quarantines imposed on global health volunteers as “morally wrong,” finding that such measures had no scientific merit and were “ineffective and overly restrictive.” New York physician Craig Spencer, who contracted Ebola while volunteering with MSF in Guinea and was treated in a Manhattan hospital in 2014, has strongly denounced quarantine measures like the ones taken in New York against his fiancé and fellow MSF workers.

“What the quarantine of [my fiancé] as well as my other two friends … did is send a message that this isn’t because we’re afraid of you guys getting sick. It’s that we’re afraid of the fear and we need to do something to quell that. Because it doesn’t make sense,” Spencer told NPR-affiliate WNYC. “What happened in the aftermath of the quarantine is that a lot of people who had committed to going to the response in West Africa pulled out. Again, not because they were fearful of what they would do there, but how they would be treated on their return back home.”

NJ Advance Media, an independent group, conducted a survey after the Hickox detention that revealed a 17 percent decline in health volunteers willing to serve in the Ebola epidemic — due, they said, to their fears of confinement upon return.

Christie’s actions in 2014 were mirrored by Republican political leaders across the country throughout fall of that year. Days after Hickox’s quarantine ended, then-Louisiana Gov. Bobby Jindal attempted to bar scientists from attending a tropical diseases meeting in his state if they had previously been in West Africa. A lawsuit similar to Hickox’s has been filed by a group of Yale students and other Connecticut residents that were placed in a 2014 Ebola-related quarantine: The lawsuit targets Gov. Dannel Malloy and Connecticut state health authorities. And when Hickox was finally released from New Jersey quarantine after 80 hours, Paul LePage, Republican governor of her home state of Maine, threatened to impose further restrictions on the uninfected nurse when she was filmed bicycling outside her home.

Three days after Hickox’s release from quarantine, on Oct. 30, 2014, New York Gov. Andrew Cuomo and Mayor Bill de Blasio released a statement that contradicted the sentiment of over-precaution proffered by their neighbor, Christie, announcing a program that would incentivize medical professionals to travel to Ebola-afflicted countries: “The depth of the challenge we face in containing Ebola requires us to meet this test in a comprehensive manner on multiple fronts, and part of that is encouraging and incentivizing medical personnel to go to West Africa.”

Furthermore, many public health authorities and veterans of the HIV-related tensions of the 1980s decried Christie’s quarantine measures, saying the actions were reminiscent of anti-AIDS punishing efforts during the early days of that epidemic. AIDS did not disappear when blood transfusion recipient Ryan White was barred from public school because of his HIV status. Like many of the discriminatory measures advocated for or imposed in the United States during the 1980s, it didn’t slow the spread of the virus or save any lives.

Campaigning in New Hampshire last September with LePage at his side, Christie cracked a joke: “What gift did Paul give to me? A nurse from Maine who happened to travel back from Africa through New Jersey to ultimately get to Maine and what we said very clearly in New Jersey when she came in … is that we are not going to expose you to the people of New Jersey.” On a more sober note, he continued, “After we were assured that she didn’t have Ebola, then I called Paul, and I said, ‘Tag, you’re it. You have her back.’ Then she realized the governor of Maine felt exactly the way the governor of New Jersey [did].”

“Thank you, Chris,” LePage quipped.

The merits of Christie’s actions in the Hickox case will no doubt be decided when her case against the state goes to court, probably long after he has withdrawn from the presidential race. (Which is likely to happen given that he is falling behind the current GOP front-runners: Donald Trump, Ted Cruz, and Marco Rubio.) But his Zika comments can — and should — be addressed immediately.

Nothing is gained by mixing electoral politics with public health: Worse, lives may be lost. When Michele Bachmann insisted during her 2012 run for president that she knew of “mentally retarded” babies whose developmental state was the result of their mother’s HPV vaccination, she was not only wildly incorrect, but may have also deterred some women from seeking an immunization that could prevent their dying of cervical cancer. When Rand Paul reacted to the Disneyland measles outbreak in 2015 by saying, “I’ve heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines,” he not only gave inaccurate information, but may have imperiled children’s lives by bolstering parental refusal.

When candidates assert that infectious diseases come from “illegal immigrants,” conflating the hot-button issues of disease and immigration, they mislead the public. Mexico and much of Central America have higher child immunization rates than the United States, yet Carson stated, “It’s not to prejudice anybody, but we have to deal with reality, and if you have people coming into your country who have not been properly screened, who have not had the same kind of care as people in this country, I don’t think you have to be a genius to figure out that that could introduce some communicable problems.”

Gov. Christie, the Zika virus is spread by mosquitoes, which you should “quarantine” or obliterate to protect the good people of New Jersey. But Zika is rarely, if ever, spread from person-to-person, so quarantining infected people will do nothing to stem a Zika outbreak. Yes, there is evidence that pregnant women can pass the virus through the placenta to their fetus, and, in three cases, infected men may have passed the virus to a sexual partner. But a tough guy like you knows the enemy when you see it, right? And the enemy is Aedes aegypti mosquitoes, which are found in the Garden State every summer, competing ecologically against indigenous mosquito species since the early 1990s.

Moreover, Mr. Governor, you have already had a person infected with Zika in your state — a traveler from Colombia, visiting Bergen County in mid-January. You did not order that traveler placed in quarantine or housed á la Hickox in a parking lot-nested tent.

A year ago, the health controversy du jour was the Disneyland measles outbreak and parental refusal to immunize their children. When asked whether New Jersey should compel routine vaccination of children, you responded, “You know it’s much more important what you think as a parent than what you think as a public official. And that’s what we do. But I also understand that parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide.”

In the case of measles, which actually is extremely contagious from person-to-person, you saw no need for quarantine and suggested parents ought to vaccinate — yet allowed that it was a matter of personal choice. In contrast, an uninfected nurse who had worked in Sierra Leone and a hypothetical Zika-infected individual, you have argued, should be quarantined.

Governor, your responses illustrate no coherent or consistent public health policy. They do, however, reflect the political attitudes of your would-be constituency amid your presidential aspirations. But to what constituency are you playing? Last year, a Research!America poll revealed that 87 percent of American voters believe a would-be president should understand basic public health and science-informing policy issues. This was true for both Democrats and Republicans, more than 80 percent of whom from both parties say, “It is important for scientists to inform elected officials and the public about their research and its impact on society.”

Photo credit: Kayana Szymczak/Getty Images