States scramble to make Ebola rules
In addition to the automatic quaratines imposed on returning health workers by New York and New Jersey, and the somewhat looser version announced in Georgia Monday, other states are also hastening to create their own rules.
- In Virginia, health workers who cared for Ebola patients in West Africa must sign agreements restricting their activities and may be prohibited from taking public transit or attending large gatherings for three weeks.
- Maryland said travelers from Liberia, Sierra Leone and Guinea may be quarantined at home or barred from using public transit.
- Illinois announced automatic quarantine measures like those adopted in New York and New Jersey but then clarified the rules on Monday to say they don't apply to people who wore personal protective equipment when treating Ebola patients.
Gov. Nathan Deal issued new orders Monday that travelers entering Georgia who had direct contact with an Ebola patient will be “subject to quarantine at a designated facility,” even if they show no symptoms.
In addition, health care workers who have treated Ebola patients will be visually monitored at home — either by video or home visits — for 21 days.
Deal's new rules on Monday seemed to seek a middle ground that would enable supervision of returning health workers without forcing them into quarantine. The restrictions come three days after the governors of New York and New Jersey imposed quarantine for health workers, symptomatic or not.
New Jersey Gov. Chris Christie insisted that “I didn’t reverse any decision,” but the state approved the release of a nurse on Monday who had been quarantined in an isolation tent at a New Jersey hospital since her plane landed at Newark’s airport on Friday.
The woman had worked with Doctors Without Borders in Sierra Leone but had no symptoms and tested negative for the virus on Saturday. The nurse, who quite publicly opposed her quarantine, was permitted to leave the hospital for her home in Maine.
Both governors had received strong resistance from the Obama administration, infectious disease experts and health care workers, who argued that the automatic quarantine of medical workers would discourage them from going to the countries where they are needed most.
Treating health workers as pariahs or heroes?
On Monday, Tom Frieden, the director of the U.S. Centers for Disease Control and Prevention, announced new guidance on for health-care workers.
The CDC is recommending that such workers be divided into categories. The highest-risk category, a health care worker who was exposed, perhaps through a needle stick, but has no symptoms, would not be under quarantine but would be under "controlled" movement.
That means they could not take public transit or go to places like shopping malls or workplaces. But they could drive or even go jogging in a park. They would have to go over their symptoms daily and have their temperature taken.
“If we turn them into pariahs instead of recognizing the heroic work that they’re doing, a couple of things may happen that none of us want to happen,” Frieden said. “They may be less likely to disclose their health care worker status. And then we would lose the opportunity to do that direct active monitoring here and to protect them, their families and their communities.”
He also said such workers might be less inclined to go to West Africa to fight Ebola at its source. "If it spreads further in Africa or longer in the three countries or we can't control it there, the risk to us would increase," he said.
Plan forces some travelers into quarantine
Deal's proposal gives health workers some options, but it would force other travelers into quarantine, raising the question of whether it woudl deter them from being honest on travel documents. According to Frieden, of the 807 people returning from the affected countries since monitoring began, only 6 percent or so were health workers.
At a campaign stop in Cumming on Monday, the governor said, “We intend to be as protective of Georgia citizens as possible. But by the same token, respect the privacy of individuals who may be put in these categories. I would remind you, however, it’s better to be overly cautious than not cautious at all.”
The governor also ruled out compensating lost wages for those who are quarantined.
“I don’t think it’s right to ask the taxpayers of this state to pay for individuals who have perhaps put themselves in this category,” he said. “We are incurring the expense of all the monitoring and all the quarantining that may be associated with it. I certainly don’t think we need to compensate them for their lost time.”
The timing of the announcement, eight days before the election, was criticized by the campaign of Deal’s Democratic challenger Jason Carter. Carter spokesman Bryan Thomas noted that Deal once said “water kills the Ebola virus” and said the governor will “do anything to make it appear he has a handle on the situation.”
"Georgia's Ebola response should be driven by science, not politics," said Thomas, adding: "Georgians don't need a long memory to know that Gov. Deal doesn't handle crises well."
Deal divides arriving travelers into 3 groups
Deal's plan would screen travelers arriving at Hartsfield-Jackson for temperature, Ebola symptoms and possible exposure to Ebola. Those with symptoms would be isolated immediately and transferred to a hospital — a response endorsed by everyone. Travelers who don't exhibit symptoms of Ebola will be divided into three categories:
- Category 1, high risk – Travelers with known direct exposure to an Ebola patient will be subject to quarantine.
- Category 2, low risk – Travelers from affected areas with no known exposure to Ebola will sign a monitoring agreement with the Georgia Department of Public Health requiring them to conduct temperature and symptom self-checks twice a day and report the results. Those who don't report to the state during the 21-day surveillance period may be issued a mandatory quarantine order.
- Category 3 – Medical personnel actively involved in treating Ebola patients will be issued a "21-day active monitoring order and will be visually monitored (video communications or home visit)" twice a day. Those who fail to comply will be quarantined at a state-designated facility.
The Ebola Response Team, made up of health experts and state officials, will meet again Wednesday to continue to hone its recommendations. Deal said he believed the new precautions are “justified” given the potential risk to Georgia residents.
“We’re going to be mindful of their privacy and their necessity to move about,” he said. “But if they pose a potential threat to the citizens of the state of Georgia, we believe a quarantine is appropriate.”
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