Let's start at the beginning: Craig Spencer, who contracted Ebola while working with Doctors Without Borders to stop the outbreak in West Africa, is almost certainly a better person than you are. He is almost certainly a more careful person than you are. He almost certainly knows more about preventing the spread of infectious disease than you do. He is almost certainly doing far more to protect the world from Ebola than you are.
So maybe it's time to lay off him for going bowling — and remember that we need way, way more doctors like Spencer if we're ever going to have a realistic shot at stopping Ebola's spread.
Since news broke that Spencer went bowling after his return from Africa but before the onset of clear Ebola symptoms, there have been a lot of tweets like this one:
A doctor who has worked with Ebola returns home, to a huge city and doesn’t self quarantine..in fact, goes bowling. Are all doctors idiots?
— DSR (@Dsr2) October 24, 2014
Or, here's how Julia Ioffe put it in the New Republic: "Why in god’s good name was he going bowling across the East River?"
In the same vein, CNN reported Friday morning that federal officials were considering mandatory quarantines for all health workers to returning from West Africa.
This is a horrible, counterproductive impulse — not least because there's absolutely no reason to believe Spencer put anyone at risk.
There are rules. Spencer followed them.
Doctors Without Borders has a five-point procedure for doctors returning from West Africa, to monitor for signs of Ebola.
There is no evidence that Spencer failed to follow these guidelines. Nor is there evidence that requiring doctors to quarantine for three weeks, if they are non-symptomatic, would do anything to stop the disease's spread.
"It's completely unnecessary," says Harvard University's Ashish Jha, who has been studying the outbreak. "I'm a believer in an abundance of caution but I'm not a believer of an abundance of idiocy."
Spencer came back from Guinea and did not see patients at Mount Sinai Health System. He monitored his temperature. He felt sluggish on Wednesday, but had no fever. He went bowling. His symptoms were mild enough early Thursday that he went on a three-mile run.
When Spencer did record a fever on Thursday morning, running a temperature of 100.3 degrees, he contacted Doctors Without Borders. He was in quarantine at Bellevue Hospital within two hours.
"Our colleague in New York followed the protocols and guidelines since returning from West Africa," Doctors Without Borders said in a statement. "At the immediate detection of a fever on the morning of October 23, he swiftly notified the MSF office in New York."
Doctors who treat infectious diseases also need to be able to live their lives
There are hundreds of doctors in New York City who spend their days treating patients with infectious diseases. At the end of the day, they change out of their scrubs, wash their hands, and leave the office. Some go to bowling alleys. They do so because they enjoy bowling, probably — and know that, while there is a risk they could transmit the disease to other patrons, it is very low.
We do not ask that doctors who treat patients with infectious disease spend their lives in quarantine — and for good reason. If the cost of treating infectious diseases was to give up everything else you love in life, no doctors would treat infectious diseases, and we would all be at much greater risk. Imagine how much worse the HIV/AIDS epidemic could have been if any doctor seeing patients weren't allowed to interact outside of the hospital. Few, if any, physicians would take that trade off.
So we don't ask doctors to isolate themselves. Instead, we simply ask them to take appropriate precautions. Hospitals post checklists of appropriate steps, like washing hands and safely removing their protective gear. By all accounts, Spencer did that too.
From what we know, there just isn't a way that Spencer put New Yorkers at risk. One reason Doctors Without Borders doesn't ask its returning workers to quarantine is because they're incubating a disease that is difficult to spread.
We've seen that with the four other Ebola patients in the United States who spent time outside of quarantine. One, Liberian national Thomas Duncan, did so when he was extremely symptomatic. Nobody who came into contact with these patients — not the passengers who rode on a flight with Amber Joy Vinson, nor the family members who cared for Duncan — caught the disease. That's partly because Ebola patients aren't very contagious before they become intensely symptomatic and partly because the disease itself is fairly difficult to spread.
There is no reason to think that Spencer's actions were dangerous. Yes, he was carrying a disease that is very deadly. But at the first sign of his symptoms — the moment he knew he could be contagious — he quarantined.
We need more doctors like Spencer
The organization that Spencer worked with in Guinea, Doctors Without Borders, is doing a heroic service in West Africa right now. It has brought more than 700 medical workers to an area of the world with barely any medical infrastructure to contain the worst-ever Ebola outbreak.
The work Spencer and his colleagues do is physically challenging, emotionally draining, and risky. This is why you hear World Bank president Jim Yong Kim, a doctor himself, declaring Spencer "a hero."
"He went and did the one thing we need to do to stop more cases here and everywhere else," Kim said. "We need to have health workers."
While Doctors Without Borders has developed some of the best protocols for how to protect health workers treating Ebola patients — protocols the CDC used in developing guidelines for American hospitals — they are not foolproof. Twenty-two health workers with the group have become infected; 12 have died.
"Every day we have deaths," Daniel Lucey, an American doctor working with the group, told Bloomberg News of his work in Liberia. "Every morning you get up at 6 a.m., go to sleep at 11 p.m. Meetings in the morning and meetings at night, and you work, work, work until you can't work anymore. Then you get up in the morning and do it again."
Doctors Without Borders, another volunteer physician told Bloomberg, is at "a breaking point." "There's a sense that there's a major wave of infections that's about to wash everything away," the same doctor says.
Now is the exact moment we need more doctors like Spencer to treat patients in West Africa to contain the outbreak there — and stop more cases from coming to the United States. Mandatory quarantines are an unjustified and cruel punishment for doctors who put their lives at risk. Perhaps more to the point, by giving doctors one more reason to avoid treating Ebola patients and stemming the spread of disease, they would end up putting the rest of us at risk, too.