New CDC Quarantine Rules Come as Nurse is Released

10/28/14
 
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from The Wall Street Journal,
10/27/14:

Federal Officials Push for Voluntary Isolation of Those at High Risk.

The Obama administration laid out new guidelines Monday calling for voluntary isolation and monitoring of travelers exposed to Ebola, to counter a proliferation of divergent state rules over how to contain the outbreak.

CDC Director Tom Frieden said the guidelines released to state health departments call for those who have had direct exposure to the Ebola virus—such as through a needle stick or caring for an Ebola patient without wearing protective gear—to stay off public transportation and avoid “congregate settings” such as offices.

Those individuals would also be banned from flying and would undergo “direct active monitoring” by a public health worker who would check their temperatures twice daily and discuss possible symptoms, he said.

The CDC announcement came as the Obama administration sharpened its criticism of states that decided to forcibly quarantine medical workers returning from West Africa. Senior administration officials say mandatory quarantines could dissuade volunteers from going overseas to offer much-needed assistance in Ebola-stricken countries.

“If we do things that make it very difficult for people to come back, 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,” Dr. Frieden said, adding that it could also encourage health workers to conceal that they have had contact with patients.

The White House acknowledged the limits of its power to enforce any CDC guidelines, noting that state and local officials ultimately will make their own decisions about how to protect their citizens. A number of states have issued their own rules, which vary in small ways from the federal guidelines.

“States are given significant authority for governing their constituents,” White House press secretary Josh Earnest said on Monday. Mr. Earnest also suggested that Ms. Hickox, the nurse who described the conditions of her quarantine as “really inhumane,” wasn’t shown respect. “Her service and commitment to this cause is something that should be honored and respected,” Mr. Earnest said. “And I don’t think we do that by making her live in a tent for two or three days.”

Dr. Frieden said the CDC is discussing the guidelines with state and local health departments, who make the final decision on whether to adopt them. Health departments around the country do generally abide by CDC recommendations, but decisions about whether to quarantine are up to them.

The latest moves came as the New York City Health and Hospitals Corp. said Monday that a 5-year-old boy who had been showing Ebola-like symptoms after recently returning from West Africa doesn’t have the disease.

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