New Ebola guidelines issued in US

Published: Tuesday 28th October 2014 by The News Editor

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The US organisation leading the fight against Ebola has recommended new restrictions for people at highest risk for coming down with the disease, and symptom monitoring for those at lower risk.

The Centres for Disease Control and Prevention (CDC) yesterday issued the new guidelines, but some state governors and even an Army commander have gone beyond that guidance.

As contradictory state policies proliferate in response to Ebola fears, the CDC’s recommendations mark an effort to create a national standard, one that would protect public health without discouraging people from helping fight its spread overseas.

The CDC now says even if they have no symptoms and are not considered contagious, people should stay away from commercial transportation or public gatherings if they have been in direct contact with the bodily fluids of someone sick with Ebola – perhaps by touching their fluids without protective gear, or by suffering an injury from a contaminated needle.

Simply caring for Ebola patients or travelling in West Africa does not warrant quarantine conditions, the public health agency said.

But quarantines are determined state by state in the US, and the CDC is only empowered to issue guidelines.

Even within the federal government, authorities are improvising. A US Army commander in Italy said he and all his troops returning from Liberia would remain in isolation for 21 days, even though he feels they face no risk and show no symptoms.

The Army’s chief of staff, General Ray Odierno, directed the 21-day controlled monitoring period for all redeploying soldiers returning from the Ebola fight in West Africa.

A nurse who volunteered with Doctors Without Borders in Africa was released after being forced to spend the weekend quarantined in a tent in New Jersey upon her return, despite showing no symptoms other than an elevated temperature she blamed on “inhumane” treatment at Newark International Airport.

President Barack Obama has told his Ebola team that any measures involving health care workers should be crafted to avoid unnecessarily discouraging people from responding to the outbreak.

That is already happening, Doctors Without Borders said – some medical workers are reducing their time in the field to include potential quarantines afterwards.

“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,” said Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

But the governors of New York and New Jersey defended their quarantine policies as necessary precautions in dealing with a virus that already has killed nearly half the over 10,000 people infected this year in West Africa.

Major General Darryl Williams said the decision to isolate returning troops was taken to ensure their family members’ comfort, even though none is showing symptoms, and he does not believe any soldier under his command is at risk.

Speaking from a US base in Vicenza, Italy, he said he and his soldiers will be living in isolation under controlled monitoring during the three weeks it takes to be sure Ebola has not infected them.

He returned to Italy on Sunday with 10 soldiers with another 65 due back in two groups by Saturday.

Defence secretary Chuck Hagel is expected to review the recommendations on Ebola, but has made no decision.

There is no uniform response within the US to the increasing number of people and medical volunteers returning from Ebola-stricken countries in Africa.

New York’s and New Jersey’s governors announced on Friday that any health care workers returning from West Africa to their states would face mandatory 21-day quarantines.

Other states including Illinois, Maryland, Minnesota and Georgia have since announced measures of their own.

Some other governors, like Rhode Island Democrat Lincoln Chafee, urged his colleagues to “ratchet down some of the hysteria,” since scientists have repeatedly said that people carrying the virus are not contagious until they show symptoms.

Meanwhile, nurse Kaci Hickox was on the road, driving in a private car from New Jersey to her home in Maine. She was freed yesterday from the quarantine tent where Governor Chris Christie said had been kept since Friday “because she was running a high fever and was symptomatic” at the outset.

Ms Hickox denied that – she said she never had symptoms and tested negative for Ebola.

Her criticism of the quarantines was backed by the White House, American Civil Liberties Union, the United Nations secretary-general, and the American Medical Association’s president.

The New England Journal of Medicine said governors imposing mandatory quarantines on health workers “have it wrong”.

Published: Tuesday 28th October 2014 by The News Editor

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