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White House Presses N.Y., N.J. to Rethink Ebola Quarantines
Move follows diagnosis of New York City doctor, but many health experts say quarantine is counterproductive
By Dennis Thompson
SUNDAY, Oct. 26, 2014 (HealthDay News) -- The governors of New York and New Jersey are being pressured by the Obama Administration to rethink tough quarantine measures that require all medical workers returning from West Africa who had contact with Ebola patients to be forced into isolation, according to news reports.
However, The New York Times reported Sunday that Andrew Cuomo of New York and Chris Christie of New Jersey are refusing to budge, saying federal guidelines aren't strict enough.
Meanwhile, Kaci Hickox, a nurse returning from Sierra Leone who was the first to be quarantined under the new measures, plans to challenge the quarantine legally, the Times reported. Despite having no symptoms, she has been kept under quarantine at a hospital in New Jersey, where she has been confined to a tent equipped with a portable toilet and no shower, the newspaper reported.
The tougher measures, which exceed current federal guidelines, mean that health care workers who had contact with Ebola patients would be tested and kept in quarantine for 21 days, the longest known length of incubation of the Ebola virus.
The new quarantine measures were first announced Friday.
However, Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said Sunday that he would not have backed such a quarantine because it could discourage health workers from going to West Africa to help battle the Ebola outbreak there, the Associated Press reported.
"The best way to protect us is to stop the epidemic in Africa, and we need those health care workers so we do not want to put them in a position where it makes it very, very uncomfortable for them to even volunteer to go," Fauci said.
He added that self-monitoring works as well as a quarantine because people infected with Ebola do not become contagious until they start showing symptoms. Ebola is transmitted through direct contact with the bodily fluids of an infected person.
The decision to impose a quarantine in New York and New Jersey came a day after Dr. Craig Spencer, a New York City doctor who recently returned from West Africa, tested positive for Ebola. Spencer's condition has worsened some, which is to be expected with the disease, the Times reported Sunday.
Spencer had been working with the medical aid agency Doctors Without Borders, helping to treat Ebola patients in Guinea, one of three West African countries hit hard by the disease. The other two countries are Liberia and Sierra Leone.
In an article published Saturday in the Dallas Morning News, Hickox described her experience at Newark Liberty Airport, which she called "a frenzy of disorganization, fear and, most frightening, quarantine."
"We need more health care workers to help fight the epidemic in West Africa," she said. "The U.S. must treat returning health care workers with dignity and humanity."
Still, Cuomo and Christie defended the new quarantine measures. "A voluntary Ebola quarantine is not enough," Cuomo said. "This is too serious a public health situation."
But others agree with Hickox that such rules might deter health care personnel from joining the fight against Ebola in West Africa, where staffers are desperately needed. According to the Times, the United Nations' emergency Ebola mission says more than 19,000 medical staffers are needed by Dec. 1 to fight the worsening crisis, the worst Ebola outbreak in history. But the numbers of new doctors, nurses and paramedics in the region remain far too low.
According to Times, Spencer, 33, had returned to New York City on Oct. 14, and by 11 a.m. on Thursday morning he had developed a 100.3-degree fever. He immediately alerted Doctors Without Borders. Emergency medical workers in full personal protective gear transported him from his Manhattan apartment to an isolation unit at Bellevue Hospital in Manhattan.
Three people he had contact with in recent days -- two friends and his fiancee -- have been placed in isolation.
On Oct. 21, Spencer visited the High Line elevated park in Manhattan and ate at a restaurant in the West Village section of the city. On Oct. 22, he traveled on two subway lines from Manhattan into the Williamsburg section of Brooklyn, visited a bowling alley there and then took a taxi back to Manhattan.
According to the Times, the taxi driver had no direct contact with Spencer and is not considered to be at risk.
According to the Times, Spencer is a fellow of international emergency medicine at NewYork-Presbyterian Hospital/Columbia University Medical Center, and an instructor in clinical medicine at Columbia University.
New York City health commissioner Dr. Mary Bassett said Spencer followed all proper protocols upon his return to New York City and should be praised for the work he did in Guinea. "There's this young guy who went over there, really doing the right thing, the courageous thing, and he handled himself really well," she said. "I don't want anyone portraying him as reckless," the Times reported.
In a Twitter post, Bassett also expressed concern that the new measures would be counterproductive in the international fight against Ebola in West Africa, which now exceeds 10,000 cases and has claimed more than 4,900 lives. "People who go and volunteer, we have to look at how the new quarantine policy would impact them," she said.
There has been some good news on the Ebola front. Both of the two nurses who fell ill with Ebola at a Dallas hospital have now been declared free of the virus. Nina Pham, 26, left the U.S. National Institutes of Health Clinical Center in Bethesda, Md., on Friday and met with President Barack Obama at the White House before returning home.
And Amber Vinson, 29, has been declared Ebola-free after being cared for at Emory University Hospital in Atlanta. She will also return home soon, according to media reports.
Both nurses contracted Ebola after caring for Thomas Eric Duncan, a Liberian national who was the first case of Ebola diagnosed in the United States. Duncan died of the disease at Texas Health Presbyterian Hospital on Oct. 8.
For more on Ebola, visit the World Health Organization.
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