Health
Mark Lennihan / AP

NY, NJ announce mandatory Ebola quarantines

New York's governor says 'honor system of compliance' was insufficient to deal with Ebola threat

The governors of New Jersey and New York on Friday ordered a mandatory 21-day quarantine for all doctors and other travelers who have had contact with Ebola patients in West Africa.

The move came after a New York City doctor who returned to the U.S. a week ago from treating Ebola victims in Guinea was diagnosed with the lethal disease.

Many New Yorkers and others were dismayed to learn that after he came home, Dr. Craig Spencer rode the subway, took a cab, went bowling, visited a coffee shop and ate at a restaurant.

New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo said the case led them to conclude that the two states needed guidelines more rigorous than those of the U.S. Centers for Disease Control and Prevention (CDC), which recommends monitoring exposed people for 21 days but doesn't require quarantine.

In the first instance of the new move, a female health care worker who had treated patients in West Africa and arrived at the Newark, New Jersey, airport was ordered into quarantine.

"It's too serious a situation to leave it to the honor system of compliance," Cuomo said.

Dr. Howard Zucker, acting New York state health commissioner, said that any medical personnel who have treated Ebola patients in the three Ebola-ravaged West African countries — Sierra Leone, Guinea and Liberia — "will be automatically quarantined."

Spencer, a 33-year-old emergency room doctor, returned from Guinea on Oct. 17 and sought treatment Thursday after suffering diarrhea and a 100.3-degree fever. He was listed in stable condition at a special isolation unit at Bellevue Hospital Center, and a decontamination company was sent to his Harlem home. His fiancée, who was not showing symptoms, was being watched in a quarantine ward at Bellevue.

Cuomo said anyone arriving from the three countries will be questioned at the airport about their contact with Ebola patients.

The two governors said the number of travelers subject to quarantine is unlikely to be large. The two states are home to John F. Kennedy Airport and Newark Liberty, both major international portals.

Just days ago, U.S. airports began screening travelers arriving from West Africa, and JFK was the first to implement the measures. Yesterday the CDC named New York as one of six states that will begin active post-arrival monitoring of these travelers.

Spencer's illness led lawmakers on Capitol Hill, scientists and ordinary New Yorkers to wonder why he was out on the town after his return from West Africa — and why stronger steps weren't being taken to quarantine medical workers.

Health officials said he followed U.S. and international protocols in checking his temperature every day and watching for symptoms and put no one at risk. But others said he should have been quarantined — either voluntarily or by the government — during Ebola's 21-day incubation period.

An automatic three-week quarantine makes sense for anyone "with a clear exposure" to Ebola, said Dr. Richard Wenzel, a Virginia Commonwealth University scientist who formerly led the International Society for Infectious Diseases.

Doctors Without Borders, the group Spencer was working for, said in a statement that that would be going too far. People with Ebola aren't contagious until symptoms begin, and even then it requires close contact with body fluids.

"As long as a returned staff member does not experience any symptoms, normal life can proceed," the organization said in a statement.

Aid organizations also warned that many health care volunteers wouldn't go to Ebola hot zones if they knew they would be confined to their homes for three weeks after they got back.

At a news conference Thursday night, New York Mayor Bill de Blasio sought to reassure the public. "Being on the same subway car or living near someone with Ebola does not in itself put someone at risk," he said. Health officials said the chances that the average New Yorker will contract Ebola, which is spread through direct contact with the bodily fluids of a symptomatic infected person, are slim. The virus is not airborne.

Nearly 4,900 people have died in the Ebola outbreak, most of them in Guinea, Liberia and Sierra Leone. The World Health Organization (WHO) warned that about 1.4 million people might become infected by January if additional containment and prevention actions aren't provided.

Broader quarantine?

The idea of broader quarantine is a topic "actively being discussed. It's going to be something that will be discussed at federal level," said Dr. Mary Bassett, New York City's health commissioner.

Lawmakers from both parties criticized the federal government's Ebola response.

Rep. Stephen Lynch, D-Mass., said anyone coming from West Africa should be quarantined for 21 days abroad before even boarding a plane to this country.

"This can't just be about ideology and happy talk," Lynch said. "We need to be very deliberate, take it much more seriously than I'm hearing today."

The WHO is not recommending the quarantine of returning aid workers without symptoms, according to spokeswoman Sona Bari.

"Health care workers are generally self-monitoring and are aware of the need to report any symptoms, as this patient did," she wrote in an email.

Bruce Johnson, president of SIM USA, a Christian organization based in North Carolina, said its staffers are told to follow guidelines established by the federal CDC for their first 21 days in the U.S. Beyond that, he said, they are told to avoid crowded public areas.

Johnson said such measures could discourage volunteers. Nurses, doctors and others who hold down regular jobs back home would say, "I want to go over and help for a month, but now you're telling me that when I get back I can't go to work for 21 days?" Johnson said. "Yes, I think that will dampen the generous spirit of people in the U.S. who want to go help."

Al Jazeera and The Associated Press

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