Gov. Andrew M. Cuomo on Sunday night outlined New York State’s mandatory quarantine policy for health care workers returning from West African nations with Ebola outbreaks , bringing the state closer into line with federal protocols and marking a significant break with the way the policy has been carried out in New Jersey.
The announcement comes after the Obama administration pressed New York to revive its order, issued only two days ago in a joint press conference with New Jersey’s governor, Chris Christie. New Jersey officials, who stood by their decision on Sunday, have yet to explain many details of their quarantine policy. The state has come under scathing criticism for the treatment of a nurse returning from Sierra Leone, who was forced into quarantine in a hastily erected tent at a New Jersey hospital even though she had not displayed any signs of illness and tested negative for Ebola.
Earlier in the day, Mayor Bill de Blasio said that the treatment of the nurse, Kaci Hickox,had been shameful and vowed that New York City would do all it could to honor the work of the health care workers here and those who go to help fight the epidemic in West Africa.
Kaci Hickox. Kara Hickox
“The problem here is, this hero, coming back from the front having done the right things, was treated with disrespect,” Mr. de Blasio said.
“We have to think how we treat the people who are doing this noble work,” he said. “We owe her better than that.”
Under the revised guidelines, New York State would allow all returning health care workers who have had contact with Ebola patients but have no symptoms of illness to return to their homes, where they would be confined; their health would be monitored for 21 days.
They would be transported by private vehicle, arranged by the New York State Department of Health or the local health department. While under confinement, there would be at least two unannounced visits by local officials, in coordination with state health officials, each day to check the individual’s condition as well as ensure that the individual is complying with the state order.
The New York State or local health department will, if needed, coordinate care services such as food and medicine.
If a person arrives from one of the affected areas with no symptoms and had no direct contact with anyone infected with the Ebola virus, there will be no home confinement. Health officials will monitor these individuals twice a day for temperature and other symptoms until the 21-day incubation period is over.
Governor Cuomo, who asked for patience from those who will be affected, also said the state would provide financial assistance where needed.
“If their organization does not pay for the three weeks, we will,” he said.
The move comes as President Obama met with his top advisers at the White House to craft a policy that reassures Americans that they are protected from the virus while following the guidance of the government’s scientific advisers. Officials said that policy will be ready in days and that the government would urge all states to follow it.
The rapidly escalating events played out both privately, in intense negotiations and phone calls between federal and state officials, as well as publicly in Ms. Hickox’s pointed criticism of the New Jersey governor.
Ms. Hickox who has called her treatment “inhumane,” planned to mount a legal challenge to the quarantine order.
Ever since Mr. Cuomo, a Democrat, and Mr. Christie, a Republican, announced the plan at a hastily called news conference on Friday evening, top Obama administration officials have been speaking with Mr. Cuomo daily and have also been in touch with Mr. Christie, trying to get them to modify the order. But Mr. Christie said at a fund-raiser in Florida that he had “gotten absolutely no contact” from the White House.
But in that time, two more states — Illinois and Florida — announced that they were instituting similar policies, as some members of the public expressed outrage that the infected patient in New York City had used the subway and gone bowling just before developing symptoms.
Federal officials made it clear that they do not agree with the governors about the need or effectiveness of a total quarantine for health care workers, though they were careful not to directly criticize the governors themselves.
A senior administration official, who did not want to be identified in order to discuss private conversations with state officials on the issue, called the decision by the governors “uncoordinated, very hurried, an immediate reaction to the New York City case that doesn’t comport with science.”
Indeed, Mr. Christie said he did not consult with the White House about the decision. “I did not let them know,” he said in a brief interview in Boca Raton, Fla., where he was campaigning for the state’s Republican governor, Rick Scott.
The United States is sending thousands of military personnel and other federal workers to the West African countries hit hardest by the virus, and a mandatory quarantine could make sending personnel to those countries more difficult, officials said.
The decision to institute a mandatory quarantine came after a New York doctor, Craig Spencer, received a diagnosis of Ebola on Thursday, having contracted the virus while working in Guinea for Doctors Without Borders. He is being treated at Bellevue Hospital Center, where he is in serious but stable condition. “The patient looks better than yesterday,” Dr. Ramanathan Raju, the president of the city’s Health and Hospitals Corporation, said on Sunday.
The decision for mandatory quarantines has not only opened a rift with federal officials, but also between New York City and the state.
Having seen the disorganized way officials in Dallas implemented quarantine orders for people who came into contact with Thomas Duncan, the first person to be diagnosed with Ebola in the United States, New York City officials were determined to do better.
One key part of their strategy was to ensure that they were able to meet all the needs of those placed in isolation, making their time as comfortable as possible.
The plans called for monitors to be assigned to each quarantined family or individual and dedicated solely to help them get meals, stay in contact with loved ones and have a clear line of communication with officials.
On Friday night, those carefully laid plans were thrown aside when Mr. Christie and Mr. Cuomo called for the mandatory quarantine.
“The entire city was not informed, even the mayor’s office,” according to a city official involved in New York’s Ebola response. “The mayor was caught unaware.”
“The big picture decision was made in the absence of any deep thinking about what implementing the policy would entail,” the official said.
Source: http://www.nytimes.com/2014/10/27/nyregion/ebola-quarantine.html?_r=0
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