Volunteered or Voluntold

If the decision not to quarantine civilians returning from Ebola-stricken areas is based on science, as the president and the head of the Centers For Disease Control insist it is, why is the federal government willing to pay military members for three weeks of unnecessary confinement, keeping them from essential duties?
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Army Stf. Sgt. Samuel Hines, left, helps Cpl. Zachary Wicker tape gloves to his uniform in Fort Bliss, Texas, Tuesday, Oct. 14, 2014. About 500 Fort Bliss soldiers are preparing for deployment to West Africa where they will provide support in a military effort to contain the Ebola outbreak. (AP Photo/Juan Carlos Llorca)
Army Stf. Sgt. Samuel Hines, left, helps Cpl. Zachary Wicker tape gloves to his uniform in Fort Bliss, Texas, Tuesday, Oct. 14, 2014. About 500 Fort Bliss soldiers are preparing for deployment to West Africa where they will provide support in a military effort to contain the Ebola outbreak. (AP Photo/Juan Carlos Llorca)

President Obama was correct when he said that military members sent to West Africa to support efforts against Ebola are not volunteers. They are not, at least not in the same sense as their civilian counterparts. Service men and women volunteered to serve in the military, but they are taking the fight to Ebola because it's their job. And they are getting paid. They get a paycheck while they are working in Africa, and they get paid while they are in quarantine, as they should be.

A deeper question, which is being obscured by semantic disputes, is this: If the decision not to quarantine civilians returning from Ebola-stricken areas is based on science, as the president and the head of the Centers For Disease Control insist it is, why is the federal government willing to pay military members for three weeks of unnecessary confinement, keeping them from essential duties? Our military is stretched thin, and so is our federal budget. An unscientific quarantine is a waste of military time and money. And don't get me started on the amount of time military members already spend away from their families.

The CDC says the Ebola virus is transmitted through bodily fluids. Symptoms may appear anywhere between two and 21 days after exposure, and when symptoms appear, so does potential for infecting others. We've heard repeatedly from our leaders -- the president, legislators and doctors at the CDC -- that quarantining is not necessary for those without symptoms. They assert that any measures to prevent the spread of the disease should be based on science and not fear.

Agreed.

In spite of these assurances, military members returning from construction projects in areas affected by Ebola are being quarantined in isolation for three weeks, at government expense. Civilians who work directly with infected patients are required to answer questionnaires, are sometimes monitored, but are quarantined only if they become sick and therefore contagious. Could the reason be economic?

The president and other leaders can't seem to come up another with a way to explain it, so they keep saying things that don't make sense. A couple of states have put mandatory quarantine and monitoring regulations in place for all returnees and then were chastised for it by President Obama, who then defended quarantining service members in the same press conference.

The president told the press that measures to screen civilian health workers must be based on science. Then he said the military situation was different.

"They are, first of all, not treating patients. Second of all, they are not there voluntarily. It's part of their mission they've been assigned to them by their commanders and ultimately me, their commander in chief. We don't expect to have similar rules for our military as we do civilians."

It's impossible to fathom why military members not treating Ebola patients makes them scientifically more eligible for quarantine. Equally incomprehensible is what being a volunteer has to do with disease prevention. The virus surely doesn't know or care who is being paid and who is not.

We've been treated to a string of explanations for the quarantine disparity, none of which holds up to scrutiny.

We're told that restrictions placed on those with potential exposure to Ebola would be burdensome and discourage medical professionals from volunteering to go to affected areas. For military families -- who routinely face the risk of death and loss of loved ones in service to their country and others -- quibbling over a couple of weeks of medical monitoring is truly baffling. A period of isolation as a health precaution is scarcely more onerous than risking a painful death to treat those who are suffering and dying.

Another explanation came from White House press secretary Josh Earnest. He said the thousands of military members involved in the Ebola mission made quarantine more efficient. Here again the correlation to civilian volunteers breaks down. Health care experts have said that thousands of volunteers will be needed in countries affected by Ebola, and we hope and pray they will also return home. What then?

Several thousand health care professionals attended an educational event in New York earlier this month, where they were trained by representatives from the CDC and other experts in infection-control. Presumably, these trainees will go to West Africa in large numbers as well. The policies the United States puts into place for civilian volunteers returning from West Africa must be durable and sustainable for a long battle, not just for the few cases we've seen so far. We've already seen some of the results of policies that are not clear.

Here's where I come back to that pesky volunteer issue. The fact that unpaid volunteer health care workers would have to forgo paychecks for even longer during quarantine is an obvious factor in the decision not to quarantine, but no one is talking about it. That -- as part of a larger civil liberties question -- is at the heart of the decision not to require quarantine for civilians.

I'm not sure why this straightforward explanation is not being offered, except that it would also involve an admission that economics trumps science. And it would beg the question of why the government is willing to foot the bill for military members to be quarantined. Putting large numbers of military members in extended quarantine at government expense only feeds public suspicion that there's more to the Ebola story.

Some military advocates feel quarantined troops are being treated as second-class citizens. Perhaps civilian health care workers should be asking themselves why the government is willing to make use of their expertise for free, but is not willing to foot the bill to closely monitor their ongoing health care.

As the United States moves forward to lead the fight against the spread of Ebola, there's little doubt that military and civilians alike will serve honorably and well. We can only hope that good science and good sense will ensure they are treated in the same fashion when they all come home, whether they volunteered or were voluntold.

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