A Solution to Quarantine

Table of Contents
Introduction................................................................................. 3
What Exactly Is Ebola?............................................................................................... 3
Who Are We?.............................................................................................................. 4
Our Purpose................................................................................................................ 4

Background.................................................................................. 4
The Goal..................................................................................................................... 5

The Proposal: Mobile Vital Monitors...............................................6

Patient Buy In...........................................................................7
Benefits....................................................................................... 7
Trial Period................................................................................... 8
Staffing........................................................................................ 8
What Can Happen If We Dont Do This?.....................................................................9

Economic Impact..........................................................................9
Budget....................................................................................... 10
Return On Investment (ROI).........................................................11
Authorization.............................................................................12
Frequently Asked Questions........................................................13
How would the public react?.................................................................................... 13
Why is the alternative to quarantine important?......................................................13
How does the Dallas metroplex benefit from this project?.......................................13
What if Dallas is declared Ebola-free?......................................................................14

Works Cited................................................................................ 14

Introduction
The 2014 Ebola outbreak is one of the biggest outbreaks for infectious diseases in the
21st century. In fact, the Centers for Disease Controls response to Ebola is the largest
international outbreak response in CDCs history.
As you may know, the Ebola virus has recently been contracted in Dallas. In the minds
of many Americans, Dallas is ground zero for Ebola in the United States.

What Exactly Is Ebola?

We have all heard of Ebola, but what exactly is it and where does it come from? The
virus first surfaced in 1976 in Sudan, but the most recent epidemic has been primarily
located in the West African countries of Sierra Leone, Liberia, and Guinea. It is a
disease that attacks the liver and kidneys, which is why it is so fatal. Eventually, victims
of the virus start to hemorrhage internally and die from low blood pressure due to fluid
loss.

Symptoms usually occur anywhere from 2-21 days after contact with the virus.
Symptoms include fever, sore throat, severe headaches, and muscle pain. It is critical to
identify the virus in its early stages in order to improve a patient's chances of survival.

Who is Methodist Health Systems?

Methodist Health Systems is one of the leading hospitals in the Dallas Fort Worth area.
Our hospital has been appointed to help set up and operate the North Texas Ebola Biocontainment Facility, recently announced by Governor Rick Perry. Our mission is to
save lives through compassionate quality health care. Our vision for the future is to be a
trusted provider of integrated quality health care in North Texas.

Our Purpose
Here at Methodist Health Systems, our sole purpose is to repair the damaged image
that Ebola has brought to the city of Dallas and to introduce a cost effective alternative
quarantine solution that isnt such a burden to the people involved.

Background
The origins of the Ebola Virus could have began anywhere in the United States, and
most places would have been just as unprepared as Dallas. Only a handful of hospitals
across the country would have been prepared to deal with such a lethal virus. It is
unfortunate that it happened to land in our own community. The Dallas community cant
do anything to change the past, but we can keep the past from repeating itself.
When Thomas Eric Duncan walked into Texas Health Presbyterian Hospital on
September 25, 2014, the medical staff was unprepared. Doctors and nurses had no
clue how to proceed and didnt understand how much caution they needed to take,
especially given the fact that they knew he had just gotten back from West Africa. It
wasnt until the lab results came back that they decided to quarantine him, and it wasnt
long after that that they incubated 48 of his recent contacts and confined them to their
apartments for 21 days.

During this 21-day period, some families were without work and income. After the 21day period, it was discovered that none of his contacts showed any symptoms of the
Ebola virus.
This begs the question, are such extreme quarantine measures really necessary
if the people involved arent showing any symptoms?
Quite simply, the answer is no.

The Goal
Through this project Methodist Health Systems hope to accomplish three things:
1. To monitor and provide care for people that has come into direct contact with the Ebola
virus without it disrupting their livelihood and limiting their freedoms.
2. To minimize the massive amount of out-of-pocket costs that an Ebola outbreak would
cause for the people directly involved and for those who were not, like taxpayers.
3. To show the country that Dallas is now capable of handling this virus with the care and
attention that is required.
Currently, it is up to state and local officials to determine their quarantine process for
individuals who have come into direct contact with someone that has been infected with
the Ebola virus. Most officials are telling people to lock themselves in their homes and
avoid physical contact with the outside world while they station officers outside of their
homes. For someone that is experiencing no symptoms this can be incredibly frustrating
and hinder them from making a
living.
As it turns out, it isnt illegal to break
quarantine. On October 30, 2014,
Doctors Without Borders nurse, Kaci
Hickox, went on a bike ride after
being ordered to a 21-day quarantine
period by Maine officials. She was
put on this restrictive quarantine

even though she had tested negative twice for the Ebola virus. According to recent
news, local officials would need a court order in order to arrest and detain her.
On October 31, 2014, that request was denied. Judge Charles C. LaVerdiere said,
Maine has not met its burden at this time to prove by clear and convincing evidence
that limiting Hickoxs movements to the degree requested is necessary to protect other
individuals from the dangers of infection.
This raises an even bigger question. If someone in the 21-day incubation period
is able to break quarantine without being arrested or penalized, what can

Methodist Health Systems do?

It is in such situations, that what Methodist Health Systems proposes here would be a
perfect solution. Although another Ebola outbreak in Dallas isnt likely to happen, it isnt
impossible either, and it would be better to be safe than sorry.

The Proposal: Mobile Vital Monitors

Our company, Methodist Health System, plans on developing an alternative to
quarantine solutions to help high-risk individuals by ensuring their well being as well as
their economic livelihood with mobile Wi-Fi
vital monitoring systems.
The whole purpose of handing out the vital
monitoring systems is to avoid disruption of
peoples daily lives. These vital monitors will
alert our medical staff should there be any
abnormalities or deterioration in a patient's
vital signs. When it comes to Ebola, early
detection is critical to enhance the odds of
survival and to maximize containment.
The monitors used will be Soteras Visi
Mobile System. The Visi Mobile System was
designed to enhance a patients safety and
increase clinical efficiencies by allowing our
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physicians to check the vitals via an Ipad or Iphone application any time they want, from
virtually anywhere they want.

In light of recent news, these Visi Mobile Systems will act as a sort of compromise
between people who have recently come into contact with others that have been
infected with the Ebola virus and state and local officials.
The Visi Mobile System would be a perfect solution to containment without breaching
peoples civil rights or limiting their economic livelihood and people would actually buy
into the idea without feeling violated. We would do this by giving them an incentive to
wear it.

Patient Buy In
Unlike quarantine, people will actually want to wear the Visi Mobile devices provided by
Methodist Health Systems because it gives them peace of mind. Even though they may
think that they are fine, they would be one hundred percent assured with the Visi Mobile
Vital Monitors.
The most common reason for death of Ebola is because it isnt caught soon enough,
and we will make sure we educate them of that. With our devices, if a patient does
contract it, their odds of survival increase dramatically and they would have a team of
registered nurses just a phone call away.
We would also sell them on the fact that our hospital is one of the hospitals called on to
operate the North Texas Bio-Containment Facility recently being built and that the best
equipped hospital in Texas is ours because we have a whole floor dedicated for
infectious diseases such as Ebola. We would also emphasize the fact that this is a
compromise to quarantine, and that not only is it the best thing for them, it is also
beneficial for the community.

Benefits
Flu season is upon us, and many people may think that they have a simple cold or the
regular flu. With that said, they may be afraid to admit that they have an elevated
temperature to local officials, mistakenly thinking that it couldnt possibly be Ebola.
With our monitors it would be impossible to hide the symptoms from us. Once we detect
an abnormality we would immediately notify the patient and take them to our facilities
here at Methodist Health Systems.
With these monitors, and this program, we know exactly when symptoms exceeded the
set standards and where they were at during that time period.
We wouldnt have to wait for them to come to us, and we wouldnt have to worry about it
being too late. We would call the North Texas Ebola Bio-Containment Center and have
them pick up the patient.
If the patient still refuses to come in, we can send their vitals directly to a judge and
have them issue a court order immediately.

This is different than the Kaci Hickox situation because we would only request this court
order for patients that have possible symptoms. When patients agree to use our devices
they also agree to have GPS tracking activated on their phones.

Trial Period
The plan that we propose is on a trial period of 45 days. If the trial period is successful,
we will seek the necessary funding for an extended period. Success will be measured
on the responsiveness of our nurses and the overall containment of the Ebola virus.

Staffing
To implement this plan we have decided to hire a team of four well rounded and
experienced nurses. It will consist of three registered nurses and one nurse practitioner.
The purpose of having them on call shall be to monitor the wifi monitoring system
should a patient's vitals exceed the set standard. They will each work 12 hour shifts
and keep a watchful
eye on the patients
vitals.
We will buy 25 of the
Visi Mobile Systems
within the trial period.
These 25 monitors
will be designated to
individuals that have
come into contact
with infected persons.
Each individual will
use the Visi Mobile
System for a 21 day period and carry it with them at all times.
If someone does happen to contract Ebola during this 21 day period we will hire a
hazmat cleaning crew to thoroughly decontaminate their residents and destroy the
monitor that was used. The monitors used by the individuals that pass the 21 day
incubation period with no symptoms will be reused.

What Can Happen If We Dont Do This?

The costs of ordering a household to be quarantined can easily add up to over $1000
which accounts for lost wages, food delivery, and any overtime pay for police officers
patrolling the area. Not to mention, any extra costs to pay for health official visits to
these homes.

Budget
Equipment
Vital monitoring
systems

25 reusable vital monitors

@$2,500/unit.

$62,500

Personnel

Nurses

4 on-call registered nurses working 24/7

for
48 days @$28/hour plus $5/hour
incentive.

$35,640

Technical support

1 IT technician in charge of equipment

maintenance, repair, and operations.

$2,000

Other costs
Transportation

Cost of periodic travelling between the

hospital and patients houses for the
nurses.

$1,000

Hazmat clean-up

Cleanup service provided at patients

home.

$1,000

Wireless network
installation

Setting up wireless network

connections for patients - Installation
costs @$50/family and monthly charges
@$30/family/month.

$1,650

Total cost

Asking the Dallas Regional Chamber of

Commerce for $30,000 of the total
amount.

$103,790

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Return On Investment (ROI)

Our budget may seem unreasonable but compared to extraordinary costs that patients
may incur is incomparable. The cost of treating an infected person within the early
stages of Ebola is $100,000 a day, while the cost of treating someone in critical stages
of the virus is over $1,050,000 per day. This situation will have a trickle down effect on
the economy, especially the taxpayers if those infected are not insured.
The aforementioned costs were actual numeric figures that nurses, Nina Pham and
Amber Joy Vinson, were billed for while being treated for Ebola when they contracted it.
Luckily, most of it was covered through their medical insurance. But when thinking about
how the uninsured individuals in Texas alone account for 24% of the population, these
medical expenses will not be able to be paid by them and therefore the state will have to
pay. As in the case of the uninsured Thomas Eric Duncan, this means that it boiled
down to taxpayer money.
The task of avoiding these scenarios by detecting the symptoms of Ebola early on is at
hand. Methodist Health System not only wants to ensure the safety and health of our
residents here in Dallas, but wants to make sure that these enormous costs for medical
bills be minimized or even eliminated completely.
When patients like Nina Pham and Amber Joy Vinson each accumulated treatment
costs of over $400,000, this could have been seen as an opportunity for Methodist
Health System to take action. Meaning that the individuals who had come into direct
contact with the nurses, could have utilized our vital monitors and got into a position to
have been better prepared just in case any symptoms arose. Our main goal is to reduce

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our cost and chances of more people being infected.

By helping prevent the spread of Ebola with our monitors, this will benefit the Dallas
metroplex financially as it pertains to people from other cities and states feeling safe
enough and comfortable while visiting. The potential for businesses to continue thriving
with the assistance of these monitors will be limitless.

Economic Impact for an Alternative to Quarantine

When non-infected people are ordered to be quarantined, they have no choice but to
stay in a remote location for a specific period of time. Many of these people cannot
afford to miss significant amounts of time away from work. By law, individuals cannot be
fired from their current employers if they are ordered to be quarantined, but it does
nothing for the fact that the flow of income has been halted.
This ultimately affects their buying power which negatively affects businesses and their
need for customers. When customers are not able to shop, businesses are not able to
continue operating successfully. Fortunately, the monitors that are being provided by
Methodist Health System can have a positive impact on the fact that these same
individuals will be able to bypass the quarantine process. Aside from that, businesses
will continue to flourish.

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Authorization
Signing this form authorizes Methodist Health System to implement this proposal for the
Free Rein operation on behalf of the Dallas Regional Chamber of Commerce. The
Dallas Regional Chamber of Commerce agrees to fund the project with $30,000.

________________________________
Dallas Regional Chamber of Commerce

________________________________
Date

________________________________
Authorized Chamber Witness

________________________________
Date

Methodist Health System hereby attests that the funds in the amount of $30,000 given
by the Dallas Regional Chamber of Commerce are to be used strictly for the
implementation of the Quarantine Solution business proposal.

_____________________________________
Nghia Tran
Authorized Methodist Health System employee
_____________________________________
Juan Ramirez
Authorized Methodist Health System employee
_____________________________________
Christopher Clark
Authorized Methodist Health System employee
_____________________________________
Jane Nwalie
Authorized Methodist Health System employee

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Frequently Asked Questions

How would the public react?
Our goal is to protect the public without overreaction. We will be prepared for any
backlash we may receive, and will address the fact that the people we are monitoring is
strictly for precautionary reasons only. If vital signs begin to be detected, we will be able
to admit patients into our containment center long before he/she becomes contagious.
One of the challenges will be to beat the perception that these individuals are
dangerous to be around. The vital monitors that they use will allow getting real-time
results and observations every time they check in, which is 24 hours.

Why is the alternative to quarantine important?

According to the World Health Organization, individuals who may have Ebola do not
become contagious unless they begin developing the first symptoms like fever fatigue,
muscle pain, headache, and sore throat. These high risk individuals will be promptly
picked up and taken to the Ebola Bio-containment Center as soon as discrepancies are
shown on the the viral monitors.
According to the National Conference of State Legislatures, an individual who has been
subject to being quarantined because of being in direct contact with a communicable
disease may not be terminated from employment. All this statute explains is the fact that
people will not lose their current jobs, but it does not say anything about individuals
being compensated while being quarantined.

How does the Dallas metroplex benefit from this project?

As long as the United States has not been declared Ebola-free, every state, county, and
city must continue to express concern over this matter. Especially here in Dallas where
the city has been infamously began to be known as Ground Zero for the Ebola
Outbreak. The citys image and readiness for this outbreak has been exposed, and
what better way to repair and rebuild it than by showing the strength of our community.
Even though the public will be aware and sensitive of high risk individuals roaming
freely throughout the city, the viral monitors will give them a better sense for their safety
and of hope that the Ebola outbreak is soon to be a thing of the past Professor Paul

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Slovic, of the University of Oregon, said it best when he explained that ...emotions and
science must be given equal weight.

What if Dallas is declared Ebola-free?

The fact that Mr. Duncan could not get the appropriate care definitely showed how

unprepared medical staffs were. The virus may no longer spread, but at least the
awareness has grown largely enough to where everyone will be prepared. Just
because we are declared free does not mean traces of the virus is completely gone.
This shall be our time to monitor and understand the virus should an incident like this
occur in the near future.

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Works Cited
Cost to treat Ebola in the U.S.: $1.16 million for 2 patients. Retrieved November 19,
2014, from http://www.washingtonpost.com/news/post-nation/wp/2014/11/18/cost-totreat-ebola-in-the-u-s-1-16-million-for-2-patients/
"Ebola Virus Disease." World Health Organization. N.p., 1 Sept. 2014. Web. 5 Nov.
2014. <www.who.int/mediacentre/factsheets/fs103/en/>.
"State Quarantine and Isolation Statutes." National Conference of State Legislatures.
N.p., 29 Oct. 2-14. Web. 7 Nov. 2014. <www.ncsl.org/research/health/state-quarantineand-isolation-statutes.aspx>.
"The High Cost of Quarantine." The Wall Street Journal. N.p., 29 Oct. 2014. Web. 2
Nov. 2014. <wsj.com/articles/the-high-cost-of-quarantine-and-who-pays-for-it1414546114?>.

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