Clinicians Back Quarantine, Travel Bans in Medscape Ebola Survey

October 31, 2014

Taking a harder line than the Obama administration, a slim majority of clinicians favors banning travel from Ebola-ravaged countries in West Africa or else quarantining visitors from there, according to a new Medscape/WebMD Ebola survey.

Stopping flights from Ebola hot-zone countries to the United States until the outbreak is under control seemed reasonable to 52% of clinicians, especially those in the Southeast (62%). In lieu of such a travel ban, 56% supported quarantining visitors until the end of the virus' 21-day incubation period.

Both positions echo public sentiment. According to the Ebola survey, 69% of consumer respondents support a travel ban, while 57% could live with just quarantining visitors from West Africa.

The Obama administration opposes a travel ban, arguing that it would undermine the effort to stop the outbreak at its source in Liberia, Guinea, and Sierra Leone by impeding the flow of healthcare workers and supplies into those countries. Reflecting the views of infectious disease experts, President Barack Obama also has warned that mandatory quarantines of asymptomatic healthcare workers returning from the Ebola front would discourage their peers from volunteering for what he calls "God's work." A number of states nevertheless have mandated such quarantines to play it safe.

More than 1000 physicians, physician assistants, nurse practitioners, and registered nurses, along with almost 1300 adult visitors of WebMD, shared their views in the online survey during the second half of October. Most clinician respondents hailed from the specialties of emergency medicine, family medicine, internal medicine, and pediatrics. Physicians represented about 60% of all clinicians.

The margin of error for the clinician sample is ± 3.06%, at a 95% confidence level.

Ebola Readiness Receives Dismal Marks

The readiness of the nation's public health for a significant Ebola outbreak received dismal marks from clinicians. Only 5% agreed that the United States was very well prepared. Another 39% thought the public health system was somewhat prepared.

"The top [US] officials are underestimating how fast and rapidly this can spread in the United States," one clinician said in the survey. "They are overestimating our ability to contain an epidemic if it occurs."

When it came to the preparedness of their own practice, department, or hospital to deal with a patient whose travel history and symptoms suggest Ebola, clinicians were a bit more positive. Sixty-three percent said they were either very well prepared or somewhat prepared for this scenario.. However, 35% of clinicians reported that their workplaces were not very prepared or not at all prepared.

One chief form of preparation has been reading recommendations on Ebola screening and care from the Centers for Disease Control and Prevention (CDC). Eighty-eight percent of clinicians described the CDC as one of their primary sources of Ebola information, and 82% of clinicians said they had reviewed the agency's guidelines for evaluating patients who present with possible Ebola symptoms. Those in emergency medicine led the pack in terms of Ebola homework, with 93% saying they had read the CDC recommendations.

Information on Ebola is one thing; Ebola training is another. Only 49% said they or their employer had initiated Ebola training or practice drills, and only 36% reported personal participation. Training rates were significantly higher for registered nurses (50%) than physicians (35%).

The survey results suggest that clinicians, although paying close attention to Ebola, don't view it to be nearly as dangerous as the general public does. Thirty-eight percent of consumer respondents classified Ebola as a high threat to public health, roughly on par with influenza (37%). In contrast, only 17% of clinicians said Ebola posed a high threat, and put influenza (69%) and enterovirus D68 (33%) ahead of it on the danger scale.

Clinicians aren't taking Ebola lightly, however. Roughly half (49%) said they were very or somewhat concerned about becoming infected in the course of patient care. Those most worried about the risk for infection were emergency medicine physicians (65%). By occupation, registered nurses (59%) were the most concerned about contracting the virus from patients.

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