Catapang breached Ebola quarantine protocol, says doc

By Ira Pedrasa,

Posted at Nov 17 2014 12:58 PM | Updated as of Nov 17 2014 08:58 PM

MANILA - Armed Forces of the Philippines (AFP) Chief of Staff Gregorio Pio Catapang breached Ebola quarantine protocols when he visited the Filipino peacekeepers who arrived from Liberia last week, a health expert said.

Philippine College of Physicians President Anthony Leachon, who has been pushing for stricter quarantine processes for Filipinos and foreigners entering the country from Ebola-infested countries, told "The AFP and the Department of Health did not issue guidelines on quarantine applicable to the situation. But quarantine in its strictest definition is a state enforced isolation to prevent spread of a highly contagious communicable disease like Ebola to the general population."

Catapang and Acting Health Secretary Janette Garin visited yesterday the troops undergoing quarantine in Caballo Island in a bid to allay public fears on Ebola infection.

Last week, one peacekeeper was reported to have fever and chills, two of many symptoms of Ebola. The peacekeeper was later diagnosed with malaria and is now undergoing treatment at the Research Institute for Tropical Medicine.

The DOH insists the country remains Ebola-free.

Leachon said it is still the call of the government officials to visit quarantine areas. But what happened was still a breach of protocol.

He explained a "quarantine" is a "state of enforced isolation" to separate and restrict the movement of persons especially those exposed to communicable diseases.

He noted Ebola has a long incubation period, thus a person who might have been afflicted can still be asymptomatic – or experiencing no symptoms – during the first few days.

Leachon said the visit was seen by many as a way to dispel fears that Ebola has entered the country.

"We understand the situation. But the risk-benefit ratio should be analyzed… In this case , a person developed fever and it's not sure who among the peacekeepers would have developed ebola symptoms given the long incubation period of the disease," he said.

He took note of Thomas Eric Duncan, one of the victims of the virus.
He said Duncan did not show symptoms when he traveled to the US from Liberia.

Duncan acquired the virus when he helped transport a victim, Marthalene Williams, to a hospital in Liberia on September 15. Four days later, he left for the US via a Brussels Airlines flight to Belgium and then a United Airlines flight to Washington.

Duncan supposedly did not reveal his contact with the disease in a questionnaire he filled out at the Monrovia airport. From Washington, he took another flight to Dallas early in the evening of September 20. There, he stayed with his girlfriend and her five children.

After complaining of high fever and abdominal pain, Duncan was brought to the Texas Health Presbyterian Hospital on September 24. He was initially diagnosed with mild viral infection and was sent home with an antibiotics prescription.

Four days later, he went back to the same hospital. The Ebola diagnosis was confirmed on September 30.

On October 8, Duncan became the first person to die from the Ebola virus in the US.

Leachon said quarantine processes that prevent the spread of communicable diseases are the best for third world countries with less efficient healthcare systems.

"Exit screening is a preventative measure and can be focused on three major international airports in affected countries in West Africa whereas entry screening would require far greater resources to implement. Thus, the need for imposed quarantine," he said.

He said the country fails in health systems on many fronts.

"We fail in health through the following: One, ignorance - thus education is key. Two, ineptitude - knowledge and protocols exist but we fail to apply correctly. Three, failure to establish a healthy and safe environment," he said.

He said the country provided for the knowledge and protocols, but "we have defied [it]. We have breached the protocol."

Leachon said Catapang’s action, therefore, means the families should subsequently be allowed to visit the soldiers.

“This move opens doors to questions regarding the approval of family members to visit the quarantine area,” he said.