FORT KENT — Kaci Hickox is free to leave her home for now.
A judge’s ruling Friday dealt a setback to Maine health officials’ efforts to restrict the nurse’s movements because she had recently treated Ebola patients in West Africa.
Chief District Court Judge Charles C. LaVerdiere rejected the state’s argument that Hickox posed a public health threat and should be prevented from leaving her house in Fort Kent or interacting with the public.
“The court is fully aware of the misconceptions, misinformation, bad science and bad information being spread from shore to shore in our country with respect to Ebola,” he said in his decision. He ruled that some restrictions are “necessary to protect other individuals from the dangers of infection” and instructed Hickox that even though her movements are largely unrestricted, she should be mindful of the public’s concern.
Gov. Paul LePage, who had been outspoken about the need to quarantine Hickox, said he was disappointed with the judge’s ruling, but would abide by it.
“We don’t know what we don’t know about Ebola,” LePage said during a campaign stop in Yarmouth, where he also took a jab at Hickox. “I don’t trust her. And I don’t trust that we know enough about this disease to be so callous.”
The case has been closely watched by health care workers and policymakers because it is the nation’s first legal challenge to restrictions some states have imposed on people coming into the United States from the Ebola-affected countries of Guinea, Liberia and Sierra Leone, where Hickox worked for Doctors Without Borders. Maine health officials had been trying to require Hickox to abide by an in-home quarantine since Tuesday, but relaxed the proposed restrictions slightly in the petition, which does not reference quarantine.
The temporary ruling is in place until a formal hearing on the state’s petition, which is scheduled for Tuesday – Election Day – at 8:30 a.m. at the Penobscot Judicial Center in Bangor.
The judge’s order Friday does impose some restrictions: direct active monitoring of her health by a state official at least once a day, coordination of travel with public officials to ensure uninterrupted monitoring, and a requirement that she alert health officials immediately if she develops symptoms. It does not prevent her from leaving her house or being in contact with other people.
A health worker has gone to the house each afternoon for the last three days, including Friday, to take Hickox’s temperature. The worker has not worn protective gear.
A Maine State Police trooper stationed outside the house where Hickox, 33, lives with her boyfriend, Ted Wilbur, left about an hour after the decision was issued. State police had been at the house since Hickox and Wilbur arrived late Tuesday or early Wednesday.
Hickox said she already has been following the guidelines outlined in the ruling and has no interest in upsetting people in her community.
“I’m a nurse and a public health worker and I don’t want to make anyone uncomfortable,” Hickox said while speaking to media outside her home Friday.
“We are humbled today by the judge’s decision and even more humbled by the support we have received from the people of Fort Kent, across the nation and even across the globe,” she said.
“I know Ebola is a scary disease. I have seen it face to face, and I know we are nowhere near winning the battle. We will only win this battle as we continue this discussion, as we gain a better understanding about Ebola and public health as we overcome the fear and most importantly as we end the outbreak ongoing in West Africa today.”
Hickox waived her right to confidentiality, allowing the decision to be made public.
In his ruling, the judge noted that Hickox and all health care workers fighting the disease deserve gratitude.
“We would not be here today unless (Hickox) generously, kindly and with compassion lent her skills to aid, comfort, and care for individuals stricken with a terrible disease,” LaVerdiere said.
Though medical experts say a person is contagious only if they have symptoms and that Ebola is spread only by contact with bodily fluids, the judge said that Hickox should bear in mind the public’s concerns about the disease.
“The court is fully aware that people are acting out of fear and that this fear is not entirely rational. Whether that fear is rational or not, it is present and it is real,” he said. “(Hickox’s) actions at this point, as a health care professional, need to demonstrate her full understanding of human nature and the real fear that exists. She should guide herself accordingly.”
‘a persuasive argument’
LaVerdiere rejected the request by Hickox’s lawyers that he not issue a temporary order with restrictions pending Tuesday’s hearing. He said the ruling has critical implications for Hickox’s freedom “as guaranteed by the U.S. and Maine Constitutions as well as the public’s right to be protected from the potential severe harm posed by transmission of this devastating disease.”
Multiple lawyers, in New York and in Maine, took Hickox’s case for no fee.
“She’s a hero,” said David Soley, a partner in the Maine law firm Bernstein Shur. “She is out there risking her life to take care of these people with this horrible disease. When she comes back, instead of giving her a ticker tape parade, we’re talking about quarantining her.”
If the hearing goes forward Tuesday it will be open to the public because Hickox has waived confidentiality, Soley said, adding that Hickox would appear via a video link.
Steven Hyman, one of Hickox’s lawyers in New York, believes the judge’s order bodes well for his client’s chances in court if the state continues to press its case.
“I think the state of Maine will find this (decision) a persuasive argument,” he said.
Attorney General Janet Mills issued a statement Friday praising the judge’s decision as balancing public health and civil rights, and basing that decision on science.
“I believe we must do everything in our power not to fan the flames of fear but to encourage public health professionals such as Kaci Hickox to continue their brave humanitarian work to control this deadly disease and to welcome them home when they return,” she wrote.
Hickox’s resistance to the state’s quarantine effort provoked a passionate debate across the country, with many people calling her unwillingness to quarantine herself selfish.
“Believe it or not, we’re getting calls from Florida, California, Texas, Michigan,” said Fort Kent Police Chief Thomas Pelletier. “They’re finding our number on the website and calling, telling us they’re very concerned and giving us their own spin about what we should be doing to restrict her movements and arresting her.”
Unless the court says otherwise, Pelletier said his department has no intention of interfering with Hickox and Wilbur, and told them to inform police if they received any threats.
Petition outlined state’s case
LaVerdiere’s decision denying the quarantine was his second in less than 24 hours.
He had issued a temporary order Thursday in response to the state’s petition, directing Hickox to follow a series of restrictions that mirrored guidelines from the U.S. Centers for Disease Control and Prevention for patients with “some risk” of Ebola.
In the decision issued Friday morning, LaVerdiere said the earlier order was to give himself time to review the arguments of both sides.
The temporary order issued Thursday afternoon prevented Hickox from coming within 3 feet of the public and required her to avoid places where people gather and to stay in Fort Kent. It was based on an affidavit by Dr. Sheila Pinette, director of the state Center for Disease Control and Prevention and the acting state epidemiologist, that laid out the state’s case.
Pinette did not return a call for comment Friday.
Pinette argued in the petition that Hickox’s conduct and circumstances meet the legal definition of a public health threat.
“The law defines a public health threat to mean any condition or behavior that can reasonably be expected to place others at significant risk of exposure to infection,” she wrote.
Hickox worked for several weeks with Doctors Without Borders in Sierra Leone, according to the affidavit, finishing that work on Oct. 20.
The Ebola virus has a 21-day incubation period and while Hickox has shown no symptoms, Pinette said they usually develop in the second week after exposure – which for Hickox began Tuesday – and that 90 percent of the cases develop in the first two weeks.
Hickox was detained in New Jersey when she returned to the United States. She tested negative for the virus, but such tests can be negative in the early days after exposure, with symptoms showing up later, Pinette said.
After her release by New Jersey health officials Monday, Hickox told Maine health officials she planned to spend one or two nights in Freeport on her way back to Fort Kent. However, Hickox went straight to Fort Kent, Pinette said.
Health care workers treating Ebola patients are at increased risk even if they wear personal protective equipment because protective equipment can be breached, Pinette said. The affidavit said that Hickox’s roommate in Africa had contracted Ebola – something Hickox refuted – although it also noted that the period for potential risk to Hickox had already passed.
An email Friday night from Doctors Without Borders spokesman Tim Shenk said that Hickox had her own room during the assignment in Sierra Leone.
Returning to normal life
Wilbur briefly addressed the media Friday afternoon, saying it would be “really nice” to return to school at the University of Maine at Fort Kent, where he is studying nursing, but he’s not sure the school will allow it.
Wilbur said he would like to volunteer in Africa at some point but is just starting his nursing education, which has been put on hold for the past week. He has asked the university when he can return and is waiting to hear.
Wilbur said he will follow Hickox’s lead when it comes to their interactions with the community in Fort Kent, which has a population of 4,200.
“I personally feel we’re in a different sort of circumstance,” he said, “because we kind of brought, as you might notice, a national media frenzy onto a very small community and I don’t want to put the people of Fort Kent out any more than we already have, although they probably appreciate the business.”
Staff Writer Whit Richardson contributed to this story.
David Hench can be contacted at 791-6327 or at: