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How should the US treat health care workers returning from West Africa?

New York City’s first Ebola case is prompting controversial reactions from state leaders

As the Ebola epidemic continues to spiral out of control in West Africa, the U.S. is trying to figure out how to treat the trickle of potential cases landing here.

Over the weekend, a child checked into New York City’s Bellevue Hospital Center with a fever.

“He had a low-grade fever this morning. he has, as was noted, traveled to one of the three affected countries and has a fever, and that's what triggers an assessment,” said Mary Travis Bassett, health commissioner of New York City. “He has no clear exposure to Ebola, but our exposure history is unclear. He will be tested.”

Bellevue is where Ebola-positive doctor Craig Spencer is being treated in quarantine. He returned home to Manhattan earlier this month after working in Guinea and voluntarily isolated himself when he started to feel sick.

“Dr. Spencer is currently going through a phase of the disease, as we expect,” said Dr. Jay Varma, New York City’s deputy commissioner of health. “We have been in consultation with the most advanced clinical expertise around the country, people who have treated this disease in other places, as well as the CDC.  And he is receiving all of the most advanced therapies that are available to him right now.”

New York and New Jersey took the unusual step of ordering mandatory quarantine for any health care workers who return from after treating Ebola patients, whether they had any symptoms or not. 

“We will establish an interview and screening process to determine an individual’s risk level by considering the geographic area of origin and the level of exposure to the virus,” New York Gov. Andrew Cuomo said. “Depending on the risk level, a person could require mandatory 21-day quarantine or at a government regulated facility.”

“These actions that we are taking jointly today I believe are necessary to protect the public health of the people of New Jersey and New York, and it builds on what we have already been doing at the state level in both states,” New Jersey Gov. Chris Christie said.

The first nurse subject to the governors’ plan is Kaci Hickox. When she landed at Newark Airport from Sierra Leone on Friday, she was forcefully quarantined.

“This is an extreme that is totally unacceptable, and I feel like my basic human rights have been violated,” she said.

On Monday, Hickox was released and was headed to Maine, where she will continue her quarantine for at home 21 days. She had been threatening a lawsuit, but now her attorney says that is unlikely.

Regardless, mandatory quarantine for people not showing symptoms of the disease is very controversial.

NBC’s Chuck Todd asked Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, about the policy on “Meet the Press” this Sunday. “Are Govs. Cuomo and Christie overreacting?” Todd asked.

“I don’t want to be directly criticizing what — the decision that was made, but we have to be careful that there are unintended consequences,” Fauci said. “The best way to stop this epidemic is the help the people in West Africa. We do that by sending people over there, not only from the USA, but from other places.”

In a statement released by the White House, President Barack Obama agreed with Fauci. “The president underscored that the steps we take must be guided by the best medical science, as informed by our most knowledgeable public health experts,” the statement said. “And [measures] should be crafted so as not to unnecessarily discourage [health] workers from serving [in West Africa].”

Cuomo’s administration eased its policy late Sunday, saying health care workers may be monitored at home. “During those 21 days, health care workers would check on them twice a day to monitor their temperature and condition,” he said.

And in West Africa, U.S. Ambassador to the United Nations Samantha Power touched down in Guinea, beginning her five-day fact-finding mission on the Ebola crisis. “We need to be part of the solution and not run away from something, because it’ll come to us if we don’t deal with it at its source,” she said.

The World Health Organization says it estimates there have been more than 10,000 cases since the outbreak began earlier this year.

Are mandatory quarantines for health care workers returning from West Africa appropriate or counterproductive?

Should states have the right to form Ebola policies independent of the federal government?

How can U.S. states and cities prevent Ebola from spreading without undermining attempts to stop the epidemic at its source?

We consulted a panel of experts for the Inside Story.

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