Scared states in Ebola quarantine

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Published: Saturday 25th October 2014 by The News Editor

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Alarmed governors of New Jersey and New York have ordered a mandatory, 21-day quarantine of all medical workers and other arriving airline passengers who have had contact with victims of the deadly Ebola disease in west Africa.

The first person to fall under the order was a health care worker returning from treating Ebola patients in west Africa. She had developed a fever and was being evaluated, New Jersey officials said.

The move came after a doctor who returned to New York City a week ago from treating Ebola patients in Guinea fell ill with the virus. Many New Yorkers were dismayed to learn that in the days after he came home, Dr Craig Spencer travelled on the tube system, took a taxi, went bowling, visited a coffee shop and ate at a restaurant in the city of eight million.

New Jersey governor Chris Christie and New York’s Andrew Cuomo said the case led them to conclude that the two states needed precautions more rigorous than those of the US Centres for Disease Control and Prevention.

The CDC recommends monitoring of exposed people for 21 days but does not require quarantine, in which they are kept away from others.

“It’s too serious a situation to leave it to the honor system of compliance,” Mr Cuomo said.

Those who are forcibly quarantined will be confined either to their homes or, if they live in other states, to some other place, most likely a medical facility, the governors said. Those quarantined at home will receive house calls from health officials. The incubation period for the Ebola virus is 21 days.

The woman who was quarantined arrived at Newark Liberty International Airport. The New Jersey Department of Health said she had no symptoms upon arrival. She is in isolation at University Hospital, Newark.

Dr Howard Zucker, acting New York state health commissioner, said any medical staff who have treated Ebola patients in the three ravaged west African countries – Sierra Leone, Guinea and Liberia – would be automatically quarantined.

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

The governors gave no estimate of how many travellers would be subject to quarantine, but Mr Cuomo said “we’re not talking about a tremendous volume of people coming in from these areas” and added that there were no plans to hire more screeners at airports.

The two states are home to Kennedy Airport and Newark Liberty in New Jersey, both major international portals.

Officials said they would track flight connections and screen passengers upon disembarking. But they offered few details on how the quarantine would be enforced and the consequences for people flouting the restrictions by going out in public.

A spokesman for New York City mayor Bill de Blasio said the city’s Department of Health was not consulted before the quarantine order came down, but Mr de Blasio and Mr Cuomo had since spoken.

The de Blasio administration expressed some concern with the policy change.

“The mayor wants to work closely with our state partners, but he wants to make sure that there will not be any sort of chilling effect on medical workers who might want to go over to help,” said spokesman Phil Walzak.

The White House did not have an immediate reaction to Mr Cuomo and Mr Christie’s directives.

An official said national officials had been considering similar quarantine requirements for some time, but the Obama administration was not yet ready to take that step at federal level.

The measures were discussed as recently as yesterday but are still under review.

The CDC said it set baseline recommended standards, “but state and local officials have the prerogative to tighten the regimen as they see fit”.

The agency added: “When it comes to the federal standards set by the CDC, we will consider any measures that we believe have the potential to make the American people safer.”

Dr Spencer, 33, an A and E medic, returned to the US on October 17 and sought treatment on Thursday after suffering diarrhoea and a 100.3-degree fever.

He is in a stable condition at a special isolation unit at Bellevue Hospital Centre, and a decontamination company was sent to his Harlem home. His fiancee, who is not showing symptoms, is being watched in a quarantine ward at Bellevue.

Dr Spencer’s illness led politicians on Capitol Hill, scientists and ordinary New Yorkers to wonder why he was out on the town after his return – and why stronger steps were not being taken to quarantine medical workers.

Health officials said he followed US and international guidelines 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 the 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.

Aid organisations such as Doctors Without Borders, the group Dr Spencer was working for, have argued that mandatory quarantines are unnecessary because people with Ebola are not contagious until symptoms begin, and even then it requires close contact with body fluids.

Groups have also warned that many health care volunteers would not go to Ebola hotspots if they knew they would be confined to their homes for three weeks on their return.

Published: Saturday 25th October 2014 by The News Editor

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