Governors, scientists at odds over quarantines

NEW YORK – The gulf between politicians and scientists over Ebola widened on Sunday as the nation’s top infectious-disease expert warned that the mandatory, 21-day quarantining of medical workers returning from West Africa is unnecessary and could discourage volunteers from traveling to the danger zone.

Late Sunday night, the governors of New York and New Jersey stressed separately that the policies allowed for home confinement for medical workers who have had contact with Ebola patients if the workers show no symptoms. They will receive twice-daily monitoring from health officials.

The emphasis on home confinement was at odds with the widely criticized treatment of a nurse returning from Sierra Leone who was forcibly quarantined is a New Jersey hospital isolation unit even though she said she had no symptoms and tested negative for Ebola.

New York Gov. Andrew Cuomo said such quarantines in medical facilities would only be used 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, and friends may visit with the approval of health officials. Workers displaying any symptoms will go to the hospital.

“My personal practice is to err on the side of caution,” Cuomo said. Under the protocols Cuomo detailed Sunday night, the state also will pay for any lost compensation if the quarantined workers are not paid by a volunteer organization.

For much of the weekend, the governors had been under fire from members of the medical community and the White House.

“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.

Meanwhile, Kaci Hickox, the first nurse forcibly quarantined in New Jersey under the state’s new policy, said in a telephone interview with CNN that her isolation at a hospital was “inhumane,” adding: “We have to be very careful about letting politicians make health decisions.”

Saying the federal health guidelines are inadequate, Cuomo and New Jersey Gov. Chris Christie announced a mandatory quarantine program Friday for medical workers and other arriving airline passengers who have had contact with Ebola victims in West Africa, either in their homes or in medical facilities, and Illinois soon followed suit. Twenty-one days is the incubation period for Ebola.

“We’re staying one step ahead,” Cuomo said Sunday night. “We’re doing everything possible. Some people say we’re being too cautious. I’ll take that criticism.”

The Obama 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 insisted on anonymity.

Fauci made the rounds on five major Sunday morning talk shows to argue that policy should be driven by science – and that science says people with the virus are not contagious until symptoms appear. And even then, infection requires direct contact with bodily fluids.

He said close monitoring of medical workers for symptoms is sufficient and warned that forcibly separating them from others, or quarantining them, for three weeks could cripple the fight against the outbreak in West Africa – an argument that humanitarian medical organizations have also made.

“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.

Hickox, the quarantined nurse who just returned from Sierra Leone, said she had no symptoms and tested negative for Ebola in a preliminary evaluation.

“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.”

President Barack Obama met Sunday with his Ebola response team and other public health and national security officials. According to a statement released by the White House, Obama said any measures concerning returning health care workers “should be crafted so as not to unnecessarily discourage those workers from serving.”