Moderated by Tom Sabulis
AJC reporter Craig Schneider recently wrote that Georgia health officials have refused to name six hospitals that will join Emory University Hospital as the state’s primary Ebola treatment centers. They fear negative reactions from the public and vendors could slow the hospitals’ preparation. “We don’t want to slow down the process,” a Department of Public Health spokesman said. Today, a patients’ advocate responds to that decision. A law professor also examines how the Ebola scare has led to practices that illegally discriminate against local citizens thought to be exposed to the virus.
Reveal Georgia’s Ebola hospitals
By Dorothy Leone-Glasser
Over the year, our nation has faced multiple crises due to a lack of transparency; Ferguson, Mo., and Edward Snowden come to mind. Whether we agree or disagree with the circumstances, it can certainly be suggested that in both situations, the perceived problem spun out of control when too much control over vital information was being exercised.
“You can’t handle the truth!” seems to be the sentiment of many leaders today. We all know where that got Col. Nathan Jessup, Jack Nicholson’s character, in the movie, “A Few Good Men.”
Georgia is facing a similar decision-making crossroads today. Our leadership has an opportunity to prevent unnecessary crises by striking a more effective balance between withholding and disseminating important health care information.
Currently, our local leaders are refusing to reveal the names of the six hospitals in addition to Emory University Hospital that are being prepared to treat Ebola patients. This only maintains the cloak of secrecy that prevails in our state. To date, we have already experienced negative consequences of denying citizens critical information related to their health.
By example, medical insurance coverage for state employees was originally cut so dramatically that a group of volunteer advocates intervened in an effort to prevent grave health consequences due to neglect. Backroom deals left 1.8 million Georgians without health care due to the denial of Medicaid expansion. More recently, the viability of Grady Memorial Hospital, our safety-net hospital, is being jeopardized by threats from discreet and discriminatory practices of insurance providers.
Another blatant disregard for transparency was the recent gag order on state and local officials, preventing them from promoting the Health Insurance Marketplace. This rash decision left thousands of Georgians without vital coverage that could have been assessed by the site. How can citizens entrust themselves to other crucial state decisions when their need to be part of the conversation is ignored?
It appears Georgia officials are afraid to have any conversation with citizens to address the needs of their communities and provide an honest response to their well-being and productivity. The lack of transparency is eroding Georgia’s public trust.
Unfortunately, this is not new to advocates who stand up for the rights of millions of low-income and underserved individuals, families and hard-working citizens who struggle to access affordable, quality health care. We have been trying to get a seat at the table with our local decision-makers for many years to discuss issues that directly affect the lives of Georgians and Georgia taxpayers.
Our leaders have an opportunity to develop trust by more effectively managing the Ebola message. It is understandable that announcing the names of the hospitals in preparation could cause public hysteria in the communities where these hospitals are located. Without directly communicating accurate information to the public, people could fear they are at greater risk in their neighborhoods for becoming infected through hospital workers, staff and relatives visiting contagious patients.
Health officials in New York City urged citizens to remain calm as they announced the hospitals ready to treat Ebola patients. This straightforward announcement helped to bolster their level of preparedness as well as expand the list of designated treatment centers to ensure geographic diversity. This was a simple example of uniformly coordinated efforts to ensure the public that officials were doing everything necessary to safeguard against the risks of Ebola.
According to New York Magazine, the city’s “press conference (at Bellevue) was thorough and engendered public calm by reiterating how difficult and rare it is to contract Ebola.”
The Ebola crisis is another significant watershed where Georgia seems to have lost our strongest ethical principle to oversee the protection of the public’s trust by maintaining open communication and access to the decision-making process. This neglect by our local decision-makers will lead to an emboldened culture of concealment, backroom deals for profit, and disregard for executing the best public health policies.
The nation deserves a surgeon general to provide advice and support on all public health issues. Georgians deserve to be treated with respect by keeping us informed about critical decisions that directly impact our health and well-being.
Dorothy Leone-Glasser is executive director of Advocates for Responsible Care, an Atlanta-based nonprofit.
Virus tests civil rights laws
By Wendy Hensel
The Ebola crisis has captured the American public’s attention over the last several months as the first infected individuals appeared on our soil. Since August, there have been increasingly strident calls for quarantines and isolation of those even suspected of coming into casual contact with anyone with a remote chance of developing the disease.
Children are being excluded from schools, employees are told not to report to work, and health care workers returning from Africa are placed in isolated confinement without court orders. In some cases, such action is consistent with medical science and the guidelines and recommendations developed by the U.S. Centers for Disease Control and Prevention. In other cases, the only justification seems to be that it is better to be safe than sorry in the early days of this outbreak. This approach, even if understandable, violates federal civil rights laws and is illegal.
The Americans with Disabilities Act prevents discrimination against qualified individuals with disabilities who are in the workplace, state programs and in public accommodations such as schools, stores and restaurants. There is little doubt that individuals infected with Ebola, or those who are treated as if they might be, qualify as having a disability protected by law. The ADA also protects those associated with infected or potentially infected people, such as friends, family members and volunteers who care for such individuals. Federal law makes clear these protections are not waived during a public health crisis.
That said, the ADA does not require employers, the state or the public to ignore threats posed by an infectious disease. The law specifically acknowledges that if an individual poses a direct threat to himself or others, he may be denied services or treated in ways that would otherwise constitute discrimination. The critical point, however, is that this assessment must be individualized and based on the actual risks presented by the situation. An abundance of caution will not suffice to keep a child or worker at home; instead, specific, scientifically grounded medical evidence of a significant risk that cannot be eliminated with reasonable accommodations must support the need to limit that individual’s freedom.
Take, for example, the recent litigation filed in Connecticut over a third-grader who was ordered to stay out of school for 21 days after a family trip to Nigeria. The World Health Organization has declared Nigeria to be free of Ebola, and the child was never in contact with anyone who had the disease. At no time did she exhibit any symptoms. As such, under CDC guidelines, she would pose no identifiable risk of Ebola transmission. Nevertheless, the child was readmitted to school only after her parents filed a lawsuit and 20 days had passed.
In Atlanta, the children and spouses of CDC workers are experiencing similar unlawful discrimination. Recently, two children were escorted out of school and told not to return without a doctor’s note because their father, a CDC employee they did not live with, recently returned from Sierra Leone. Their mother, his ex-wife, likewise was sent home from her teaching job.
In another case, a woman was dismissed from her student-teaching job for 21 days because she mentioned on social media that she had hugged her father, a CDC employee recently returned from Sierra Leone. The school concluded it was “an easy call” to exclude her because it would “keep everything as calm as it could be.”
What the school ignored is that such calls also easily violate the ADA. At no time did either CDC employee manifest any signs of Ebola infection, and the risk that their children would infect others with Ebola was zero. These cases represent precisely the type of behavior the ADA is designed to preclude, and a cautionary tale of the illegal discrimination that so easily can arise as a result of fear and ignorance.
As Benjamin Franklin said, those who would give up essential liberty to purchase a little temporary safety deserve neither liberty nor safety. The real test of our commitment to civil rights laws comes in times of crisis. As we work through the Ebola threat, it is critical that those in positions of power act deliberately based on scientifically sound information rather than in a reactionary fashion based on irrational fears. This not only makes good sense for good citizens in a democracy – it is required by law.
Wendy Hensel is associate dean for research and faculty development and a professor at Georgia State University College of Law.