Cuomo and Christie initiate mandatory ebola quarantines

BY MICHAEL RICONDA

unnamedBoth New York Gov. Andrew Cuomo and New Jersey Gov. Chris Christie have enacted strict quarantines on Americans returning from ebola-stricken countries, frustrating top level health officials and organizations who consider the restrictions excessive and counterproductive.

Last week, Cuomo announced a mandatory 21-day home quarantine for any worker back from the medical effort against ebola in Africa. Christie, who enacted a similar measure, became embroiled in a conflict over a mandatory tent quarantine for Kaci Hickox, a nurse who showed a fever during one reading and was held in the state even after further tests definitively showed her to not have the disease.

Several non-governmental health organizations quickly responded in opposition to the quarantines. Both the CDC and World Health Organization have voiced opposition to the mandatory quarantines on the grounds that they complicate the jobs of aid workers while allegedly doing comparably little to contain the disease.

Proponents point to cases such as that of a recent doctor in New York City, who upon returning home from treating Ebola patients in Africa, went galavanting around the city even as he developed Ebola symptoms.

“We do not recommend a mandatory quarantine because we think there should be a balance between what is perceived as protecting the population and the risk of stigmatization,” WHO Spokesperson Tarik Jasarevic said.

Doctors Without Borders, which provides many of the volunteers responsible for ebola response in Africa, also argued against the quarantines. According to them, state-mandated isolation discourages volunteers from traveling to Africa and often mean they must shorten their trips to accommodate time spent in isolation.

“There are other ways to adequately address both public anxiety and health imperatives, and the response to Ebola must not be guided primarily by panic in countries not overly affected by the epidemic,” said Doctors Without Borders U.S. Executive Director Sophie Delaunay stated in a recent release. “Any regulation not based on scientific medical grounds, which would isolate healthy aid workers, will very likely serve as a disincentive to others to combat the epidemic at its source, in West Africa.”

Other organizations have challenged the scientific basis for the quarantines. According to an editorial in the New England Journal of Medicine, the governors’ responses are largely unnecessary and trade critical support for African disease response for a miniscule boost to public safety.

“We understand their motivation for this policy – to protect the citizens of their states from contracting this often-fatal illness,” The editorial read. “This approach, however, is not scientifically based, is unfair and unwise, and will impede essential efforts to stop these awful outbreaks of Ebola disease at their source, which is the only satisfactory goal. The governors’ action is like driving a carpet tack with a sledgehammer: it gets the job done but overall is more destructive than beneficial.”

Facing mounting criticism from both the medical community and civil liberties activists, both Cuomo and Christie softened their positions but declined to lift the aid worker restrictions. In response to the controversy, Cuomo insisted the quarantines could be served at home and would include both visitation by loved ones and state compensation for missed work.

Meanwhile, Christie insisted that though Hickox would be released to her home state of Maine, there was no policy change and he had no responsibility for the nurse.

Though Christie argued there was no change, he had previously referred to Hickox as “symptomatic” and “obviously ill” while she was held in New Jersey. In follow-ups conducted after a temperature check found her to have a fever, Hickox has shown no sign of the disease.

Hickox’s case also opened the door for larger political conflicts between the states and White House. White House Press Secretary Josh Earnest’s reference to Hickox’s treatment as “really inhumane” and criticized the state quarantine procedure, a move some believe pressured Christie and Cuomo to respond.

Public opinion, however, has not been entirely receptive to the views of the medical experts, as a multitude of Americans have expressed support for a mandatory quarantine period.

Since her initial quarantine Hickox has retained ACLU attorney Norman Siegel, who was an official guest at a White House State dinner in February. Siegel has argued Hickox’s civil rights have been needlessly violated due to excessive state-level procedures. Hickox herself has expressed an intention not to follow Maine’s quarantine policy.

On an international stage, a recently-released State Department memo opened the door for further treatment of non-citizens on American soil, though a response from the Department elucidated that there are no current plans to ship patients to the U.S. en masse or transfer specific patients.

In Africa, there have been signs of progress even as the disease continues to spread. The WHO reported Wednesday that new, lab-confirmed cases have appeared to level off and burials have declined.

Over 5,000 deaths have been reported out of an estimated 13,703 ebola cases worldwide.