A mandatory 21-day quarantine imposed by New York and New Jersey on health care workers returning from West Africa caught local and federal officials by surprise and spurred a heated debate on handling the spread of Ebola. The policy of isolating medical personnel and others arriving from Ebola-affected countries zones was abruptly implemented Friday by the governors of New York and New Jersey, Andrew Cuomo and Chris Christie. The announcement came one day after a New York doctor who treated patients in Guinea became the first Ebola case diagnosed in the city and the fourth in the United States.
The mandate came as a surprise to the federal Centers for Disease and Control and Prevention in Atlanta, according to a federal official familiar with the situation. “They’re not happy,” the official said of the CDC. “These two governors said, ‘Take this, federal government.’ They’re very worried we won’t be able to get physicians or nurses to go (to countries affected by the Ebola outbreak).” A New York City official called more stringent screening “a real stunner.” “They did this without consulting the city, and that’s not a good thing,” the official said of Cuomo and Christie. “They didn’t let anyone know in advance.” On Saturday, the CDC said that it sets the baseline recommended standards, but state and local officials have the prerogative to set tighter policies. “When it comes to the federal standards set by the CDC, we will consider any measures that we believe have the potential to make the American people safer,” the CDC said in a statement.
The two-state policy was implemented the same day that nurse Kaci Hickox landed at Newark Liberty International Airport in New Jersey after working with Doctors Without Borders in treating Ebola patients in Sierra Leone. Hickox, in an Op-Ed piece in The Dallas Morning News, wrote that she was ordered placed in quarantine at a hospital, where she tested negative in a preliminary test for Ebola. Still, hospital officials told her she must remain under mandatory quarantine for 21 days. Hickox wrote that she was held at the airport and questioned by various health workers after her flight landed about 1 p.m. At first, her temperature — taken with forehead scanner — was 98 degrees. Hours later, her cheeks flushed with anger over being held without explanation, another scanner check recorded her temperature as 101 degrees, she wrote. “I explained that an oral thermometer would be more accurate and that the forehead scanner was recording an elevated temperature because I was flushed and upset,” she wrote.
Hickox eventually got a police escort, sirens blaring, to a hospital, when her temperature was again checked in an outdoor tent. On the oral thermometer, her temperature was recorded as 98.6. And she tested negative for Ebola, she wrote in the Dallas newspaper. A second test by the CDC confirmed the finding. New York City Health Commissioner Dr. Mary Bassett is concerned that the mandatory quarantine will discourage doctors and nurses from volunteering to take care of Ebola patients in West Africa, according to her spokeswoman. “We just want to make sure we don’t inadvertently discourage volunteers who are going to West Africa to help control this epidemic,”said health department spokeswoman Jean Weinberg. The new airport screening procedures require anyone who had direct contact with Ebola patients to remain in quarantine for up to three weeks.
In addition, people with a travel history to the affected regions but with no direct contact with Ebola patients will be “actively monitored … and, if necessary, quarantined,” according to the new policy. “This is not the time to take chances,” Cuomo said Friday. “This adjustment in increasing the screening procedures is necessary. … I think public safety and public health have to be balanced and I think this policy does that.” The new guidelines add to the federal policy requiring all travelers coming to the United States from Ebola-affected areas to be actively monitored for 21 days, starting Monday. Already, such travelers landing at five U.S. airports — New York’s Kennedy, Dulles International, New Jersey’s Newark Liberty International, Chicago’s O’Hare International and Hartsfield-Jackson International in Atlanta — must go through enhanced screening.
Ebola has killed nearly 5,000 people, mostly in Liberia, Sierra Leone and Guinea, in what health officials call the worst outbreak of the disease in history. Just four Americans — all health care workers — have contracted Ebola. On Friday, the National Institutes of Health said Nina Pham, a Dallas nurse, had been declared free of the Ebola virus. Public health experts say there’s plenty of scientific evidence indicating that there’s very little chance that a random person will get Ebola, unless he or she is in very close contact — close enough to share bodily fluids — with someone who has it.
New York City health officials updated Ebola patient Dr. Craig Spencer’s condition Saturday night, saying he is “awake and communicating” and “entering the next phase of his illness, as anticipated with the appearance of gastrointestinal symptoms.” The emergency room doctor was admitted to Bellevue Hospital, a specialized Ebola treatment center, on Thursday and tested positive for the virus. His is the first case of the deadly virus diagnosed in the city. Spencer is receiving antiviral medication and plasma, according to a statement issued by the New York City Health and Hospitals Corporation and the city’s Department of Health and Mental Hygiene. “A large CDC team has been actively involved in advising the Bellevue staff and we are very appreciative of the additional guidance,” the statement read, adding that doctors are also receiving input from Emory University Hospital and the Nebraska Medical Center, two facilities that successfully treated Ebola patients.
Morgan Dixon, Spencer’s fiancée, left Bellevue Saturday night but will remain in quarantine at the Harlem apartment she shares with Spencer. Two of the couple’s friends are also being quarantine as a precaution. The quarantine for Dixon and the two others will be lifted on Nov. 14 after the maximum 21-day Ebola incubation period has passed, New York Mayor Bill de Blasio said Saturday. Spencer arrived in New York on Oct. 17 after treating Ebola patients in Guinea with the aid group Doctors Without Borders. “The phase ahead will be a tough one. By definition, the days ahead will be tough for Dr. Spencer,” de Blasio said. “His situation will become worse before it gets better,” he added. The mayor spoke after eating lunch at a Greenwich Village restaurant where Spencer ate earlier this week. Also Saturday, Brooklyn Borough President Eric Adams bowled the first frames at the Williamsburg bowling alley Spencer, Dixon and their friends visited a day before he became ill, CBS New York reported.
In his weekly address Saturday, President Obama noted that every American who has been treated for the virus thus far has recovered. “It’s important to remember that of the seven Americans treated so far for Ebola — the five who contracted it in West Africa, plus the two nurses from Dallas — all seven have survived,” he said. “Let me say that again: seven Americans treated; all seven survived.” “Sadly,” a Liberian man treated for the virus in the U.S., Thomas Eric Duncan, “did not survive,” the president said, “and we continue to keep his family in our prayers.” Neither the U.S. Centers for Disease Control nor Doctors Without Borders ask health care workers returning from the Ebola hot zone to quarantine themselves, but they do recommend that they self-monitor their temperature at least twice a day. Spencer was complying with that guidance, officials have said. International aid groups have warned that such restrictions could deter health care volunteers from traveling to West Africa.
People who worked with Spencer described him as the kind of globe-trotting do-gooder who could walk into a small village in Africa and, even though he didn’t know the language, win people over through hugs alone, according to people who worked with him. Even before leaving for Guinea this, the 33-year-old had amassed an ordinary man’s lifetime worth of world travel, much of which was in the service of the poor. In the past three years alone, Spencer, an attending physician at New York-Presbyterian Hospital/Columbia University Medical Center, had been to Rwanda to work on an emergency care teaching curriculum, volunteered at a health clinic in Burundi, helped investigate an infectious parasitic disease in the Democratic Republic of Congo and traveled to 32 villages in Indonesia to do a public health survey. “He was never afraid of getting his hands dirty or his feet dirty,” said Dr. Deogratias Niyizonkiza, founder of Village Health Works, the aid group that brought him to Burundi for four months in 2012. “He went into this environment, a country that is truly off the mark, without knowing the language and he would make everyone feel so comfortable. It’s really a daunting task and yet he helped the people immensely,” Niyizonkiza said. “He talked to everyone, including the people working in the lab … Their language was just to hug each other and smile.”
Ebola survivor Ashoka Mukpo, who was successfully treated after contracting the virus while working in Liberia as a freelance cameraman for NBC, said Saturday that Spencer is a hero. In an interview with The Associated Press, Mukpo took issue with those who would criticize the doctor for going out in public after returning from West Africa and said there’s no evidence Spencer exposed anyone in New York to any risk. “Dr. Spencer risked his life to treat and lend a hand to people who have very little ability to take care of this problem themselves,” Mukpo said from his family’s home in Rhode Island. “Before we look at what the implications of this case are, I think we need to honor what he did in West Africa and give him the respect he deserves.”
New York Gov. Andrew Cuomo has criticized Spencer, saying he should have stayed home until any danger period for the disease had passed. “Dr. Spencer is a valued fellow and was a volunteer and did great work, but that was a voluntary quarantine situation for 21 days. He’s a doctor and even he didn’t follow the voluntary quarantine, let’s be honest,” Cuomo said. Experts have repeatedly assured the public that there is little chance that Spencer spread the virus prior to developing symptoms, but his case prompted Cuomo and New Jersey Gov. Chris Christie on Friday to establish new, stricter guidelines for people returning to the area from Ebola-stricken countries. A nurse who arrived Friday at Newark Liberty International Airport after recently treating Ebola patients in Sierra Leone was quarantined at a New Jersey hospital, the first traveler isolated under the new protocols. Kaci Hickox tested negative for Ebola in a preliminary screening, state health officials said Saturday, but she remains in isolation at University Hospital in Newark. Like Spencer, Hickox had been working with Doctors Without Borders.
In a first-person account given to the Dallas Morning News on Saturday, Hickox sharply criticized the way her case has been handled. “This is not a situation I would wish on anyone, and I am scared for those who will follow me,” Hickox wrote. Under the new protocols for travelers, health officials in New York and New Jersey will establish a risk level by considering the countries that people have visited and their level of possible exposure to Ebola. The patients with the highest level of possible exposure will be automatically quarantined for 21 days at a government-regulated facility. Those with a lower risk will be monitored for temperature and symptoms, Cuomo explained. The governor of Illinois, Pat Quinn, has implemented similar guidelines. Florida Gov. Rick Scott issued an order Saturday that requires health care workers to self-monitor.
CBS News contributed to this report.