Quarantined nurse who treated Ebola patients headed home to Maine

Kaci Hickox, a nurse who was quarantined in New Jersey after working with Ebola patients in West Africa, was released on Monday after being symptom-free for 24 hours, the state’s Health Department said. Hickox, who has made high-profile complaints about what she called her "inhumane" isolation, was returning to her home in Maine by private transportation, the department said Monday night.

Maine officials announced that Hickox would be quarantined at home for 21 days after the last possible exposure to the disease under state health protocols.

Hickox agreed to be quarantined at her home in Fort Kent, but her lawyer Steven Hyman and state officials disagreed over how long she'll have to stay out of public places.

Hyman said he expected Hickox to remain in seclusion for the "next day or so" while he works with state health officials. He said he believes the state should follow federal Centers for Disease Control and Prevention guidelines that require only monitoring, not quarantine, for health care workers who show no symptoms after treating Ebola patients.

The development comes as the White House on Monday recommended voluntary home quarantine for people at the highest risk for Ebola infection — but said most health workers returning from West Africa would simply require daily monitoring without isolation.

Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC), said high-risk individuals would include health care workers who get scratched by a needle while caring for an Ebola patient or who have tended to a patient without protective gear. Under new guidelines that spell out four risk categories, most health care workers returning from West Africa's Ebola hot zone would be considered to at “some risk” for infection, while those tending to Ebola patients at U.S. facilities would be seen as a “low but nonzero” risk.

Hickox had complained about her treatment at University Hospital in Newark, New Jersey, and talked about filing a lawsuit. She became the first person forced into a mandatory quarantine in the state amid fears of Ebola, after New Jersey Gov. Chris Christie on Friday announced the measure for people arriving at Newark Liberty International Airport from Sierra Leone, Guinea and Liberia — the three West African countries most affected by the current outbreak — who have been in contact with Ebola patients. 

Hickox said in a telephone interview with CNN on Sunday that her isolation at a hospital was "inhumane," adding, "We have to be very careful about letting politicians make health decisions."

"It's just a slippery slope, not a sound public health decision," she said of the quarantine policy. "I want to be treated with compassion and humanity and don't feel I've been treated that way."

Christie argued that public safety trumps other concerns. 

"I know she didn’t want to be there," he told reporters Monday. "No one ever wants to be in the hospital, I suspect. And so I understand that. But the fact is, I have a much greater, bigger responsibility to the people of the public. So I think when she has time to reflect, she’ll understand that as well."

The New Jersey Health Department said Monday that "every effort was made to ensure that [Hickox] remained comfortable, with access to a computer, cellphone, reading material and nourishment of choice."

Prominent New York civil rights attorney Norman Siegel, hired by Hickox while she was quarantined, said he has not ruled out legal action.

Also Monday, multiple news reports said that a child who arrived from Guinea was being observed at Bellevue Hospital in New York City for possible Ebola symptoms. The New York City Health Department said that a patient at Bellevue developed a fever while under observation and is undergoing tests for Ebola. Results were expected within hours.

The governors of New York and New Jersey stood firm in their backing of a 21-day quarantine for medical workers returning from West Africa, despite facing opposition from nation's top infectious-disease expert, who warned that such restrictions are unnecessary and could discourage volunteers from going to help people in the disease ravaged countries.

Christie and New York Gov. Andrew Cuomo insisted late Sunday that their policies permit home confinement for medical workers who have had contact with Ebola patients, even if the workers show no symptoms. Those workers would receive twice-daily monitoring from health officials, the governors said. 

Both governors had said federal health guidelines were inadequate after announcing a mandatory quarantine program on Friday for medical workers and other arriving airline passengers who have had contact with Ebola victims in West Africa. Illinois soon followed suit.

"My personal practice is to err on the side of caution," Cuomo said at a news conference. "The old expression is hope for the best, but prepare for the worst."

"We need to protect the public safety of the folks in the most densely populated area in the country, and that’s what we’re going to do," Christie told reporters. 

For much of the weekend, the governors were under fire from members of the medical community and the White House. Barack Obama's administration considers the policy in New York and New Jersey "not grounded in science" and conveyed its concerns to Christie and Cuomo, a senior administration official told The Associated Press earlier Sunday. The official was not authorized to speak to the press and asked to remain anonymous. The source said that the White House stopped short of asking the governors to change course. 

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that "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." 

He spoke on five major Sunday talk shows to argue that public health policy should be driven by science — and that science says people with the virus are not contagious until symptoms appear. Even then, infection requires direct contact with bodily fluids.

Fauci said close monitoring of medical workers for symptoms is sufficient, and he warned that forcibly separating them from others for three weeks, the maximum incubation period for Ebola, could cripple the fight against the outbreak in West Africa — an argument also made by humanitarian medical organizations.

"If we don't have our people volunteering to go over there, then you're going to have other countries that are not going to do it, and then the epidemic will continue to roar," Fauci said.

Meanwhile, Samantha Power, the U.S. ambassador to the United Nations, who is on a trip to West Africa, said returning U.S. health care workers should be "treated like conquering heroes and not stigmatized for the tremendous work that they have done."

Cuomo said quarantines in medical facilities would be used only in some cases, such as if the health care workers were from states other than New York or New Jersey. For workers under home confinement, family members will be allowed to stay with them, and friends may visit with the approval of health officials. Under the protocols he detailed, the state will pay for any lost compensation if the quarantined workers are not paid by a volunteer organization.

He had criticized New York City resident Craig Spencer, who tested positive for Ebola on Thursday, for not obeying a 21-day voluntary quarantine after his recent return from Guinea. But on Sunday, Cuomo called health care workers like Spencer "heroes" and said his administration would encourage more medical workers to volunteer to fight Ebola.

Hospital officials said Sunday that Spencer was in "serious but stable condition" and that he was looking better than he did the day before and had tolerated a round of plasma treatment well.

Experts previously spoke out against the merits of quarantines, saying the government’s right to impose such measures is “very, very limited.” 

“If you want to quarantine U.S. citizens, they should be afforded the right to see an attorney and to appeal their quarantine,” Joel Kupferman, executive director at the New York Environmental Law and Justice project, told Al Jazeera earlier this month. 

Al Jazeera and wire services