The growing list of states pushing beyond the quarantine guidelines set by the Centers for Disease Control and Prevention may heighten debate between elected officials who put stricter policies in place and healthcare professionals who say they could deter caregivers from volunteering to fight the disease at its West Africa source.
Governor Andrew Cuomo and his counterpart in New Jersey, Chris Christie, announced the mandatory quarantines on Friday, shortly after a top US health official said the federal government also was considering tighter measures nationwide. Illinois announced its move on Friday.
“This protective measure is too important to be voluntary," Illinois governor Pat Quinn said in a statement. “While we have no confirmed cases of the Ebola virus in Illinois, we will continue to take every safeguard necessary to protect first responders, health-care workers and the people of Illinois."
The new policy in New Jersey and New York goes beyond guidelines from the CDC. Under the changes, quarantines for high-risk travelers from any of three West African nations affected by the Ebola outbreak would last 21 days. Others who travel from the region and haven’t had direct patient contact will be actively monitored and quarantined only if necessary.
A possible change in federal rules is “something that is right now under very active discussion, and you’ll be hearing shortly about what the guidelines will be," Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Friday at an event in Bethesda, Maryland.
The stricter quarantine measures for travelers come after Craig Spencer, a New York doctor, was confirmed as having Ebola after traveling from West Africa, where he treated patients with the disease as a volunteer with the international aid group Doctors Without Borders.
While Spencer followed that group’s protocol for returning workers, checking his temperature twice a day, he also travelled around the city using public transportation, visited a restaurant and went bowling, spurring an ongoing campaign by health authorities to determine whom he may have had contact with. The doctor’s fiancee is being monitored closely by health officials after spending time with him in New York.
Ebola is transferred through one-on-one contact with body fluids after a person has shown symptoms that can include a higher temperature, body aches and nausea.
Representative Tim Murphy, a Pennsylvania Republican, said he supports stricter measures. Quarantining health workers “sets a strong perimeter of defense to protect public health here in the US while allowing for infectious-disease experts to gain a better understanding of this virus," Murphy wrote in an editorial on Friday in the Pittsburgh Post-Gazette.
“As we learn more, we can adjust these policies. But let’s start from the strongest line of defence and work our way down, not begin with the weakest line of public-health protections and scramble our way up."
In the New York area, John F. Kennedy International and Newark-Liberty International airports receive international passengers. Cuomo and Christie, a 52-year-old Republican, oversee the Port Authority of New York and New Jersey, which run the airports.
Christie said increased efforts to contain the spread of the virus have already meant the quarantine of one traveler, a woman who landed at Newark on Friday after helping treat Ebola patients in West Africa.
“This woman, while her home residence is outside the area, said her next stop was going to be here in New York," Christie said. “Governor Cuomo and I discussed it before we came out here and a quarantine order will be issued."
On Saturday, officials said preliminary tests suggested she didn’t carry the virus, though she remains under quarantine.
Cuomo on Friday cited Spencer’s case as an example for why the state needs to enforce stronger infection control measures.
Spencer, “didn’t follow the guidelines for the quarantine, let’s be honest," Cuomo said. The patient returned to New York via JFK on 17 October after working with Doctors Without Borders. The aid agency has argued against mandatory quarantines, saying they may keep trained doctors from volunteering to help in West Africa, where more than 10,000 people have been infected, and half of that number has died.
Its volunteers already take their temperature twice a day and contact the group if they get a fever or other symptoms. Tim Shenk, a spokesman for the aid agency, said it didn’t yet have a comment on the new measures.
“Extremely strict procedures are in place for staff dispatched to Ebola-affected countries before, during and after their assignments," Sophie Delaunay, executive director of Doctors Without Borders in the US, said before the new guidelines were released. “Despite the strict protocols, risk cannot be completely eliminated."
The governors didn’t say if people would be compensated for lost wages during the quarantine period. Columbia-affiliated New York-Presbyterian Hospital said on 23 October that employees who travel to Ebola-affected areas will be furloughed with pay for 21 days on their return.
President Barack Obama sought to reassure Americans about the threat posed by Ebola in his weekly address to the nation on Saturday, the second consecutive one focused on the disease.
“We have to be guided by the facts, not fear," Obama said. He noted “you cannot get Ebola easily" and recounted how Ebola patients have been cured.
Fewer than 150 people, or less than 0.1% of the 275,000 daily air travelers to the US, come from Liberia, Sierra Leone and Guinea—the three countries affected. US policy requires them to go through one of five airports that has established enhanced screening, including JFK and Newark. The others are Chicago O’Hare International, Dulles International Airport and Hartsfield-Jackson Atlanta International Airport.
About half the people who came to the US from those three countries in the 12 months ending July 2014 arrived through JFK, according to Thomas Frieden, director of the CDC.
Spencer, the New York patient, is in an isolation ward at Bellevue Hospital Center, one of the hospitals New York has designated specifically as Ebola treatment centers. His condition is stable, city officials said on Friday.
Health officials are working to track down anybody he might have had contact with close to the time he developed a fever and gastrointestinal distress, was rushed to the hospital and eventually confirmed positive for Ebola. They have also been decontaminating his apartment, throwing out items he touched and cleaning surfaces. Bloomberg
Henry Goldman and Shannon Pettypiece in New York and Toluse Olorunnipa in Tallahassee, Florida also contributed to this story.