In an epidemic, quarantining people to their homes for weeks on end will not work unless you also make sure they can meet their daily needs, such as groceries, finances, work, and school. Quarantining people who have no way to provide for themselves could make them less likely to come forward, making it harder to trace people who came into contact with an infected individual.
These are findings made by researchers at the U.S. Centers for Disease Control and Prevention who evaluated events following the first imported case of Ebola in the United States. In that situation, 179 people came into contact with the Liberian man who developed Ebola in Dallas. Seven people were isolated by legal order. Twenty healthcare workers self-quarantined, with a total of 68 eventually placed under restrictions on their movements for a 21-day monitoring period.
Some of these people told the contract tracers they felt isolated and scared, and had problems obtaining basic necessities such as food. The people closest to the Liberian man were part of seven households and included eight working adults, who were told to stay home by their employers. Six households required either financial support for rent and utilities or other assistance in procuring basics like food. Several contacts said they felt unsafe leaving their homes because they were stigmatized in the community after photos, names, and addresses had been published in the media. Children were excluded from school, which meant their lessons were interrupted.
The CDC report said that, by working with local authorities and charities, public health officials were able to link these people to sources of financial aid, and to school supplies and lesson plans for students. Physicians volunteered to present information about Ebola to school administrators, teachers, and parents to help minimize stigma.
"Meeting the needs of contacts was essential to effective contact tracing and therefore was critical to interrupting Ebola transmission in Dallas," the report concluded.
The report can be read at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6405a2.htm?s_cid=mm6405a2_w.
