State quarantines amid Ebola threat draw criticism as governors defend actions

WASHINGTON - New York Gov. Andrew Cuomo on Sunday revised a controversial policy of quarantining returning health-care workers from Ebola-stricken nations, under pressure from the Obama administration and medical experts over the aggressive measures.

Elaborating on the procedures, Cuomo said health-care workers who have been in contact with Ebola patients but do not show symptoms of the deadly virus can return to their homes, but will be forced to remain there while being monitored by state health officials for symptoms. He said those being monitored can interact with family and friends.

"It's not like this is the toughest duty," Cuomo said in a news conference late Sunday with New York City Mayor Bill de Blasio.

The change separates the state's quarantine process from that of New Jersey, which has come under scrutiny after the weekend retention of a nurse who showed no symptoms of Ebola.

Kaci Hickox, who returned from Sierra Leone after working with Doctors Without Borders, said in a telephone interview with CNN that her isolation at a New Jersey hospital was "inhumane," adding: "It's just a slippery slope, not a sound public health decision. I want to be treated with compassion and humanity, and don't feel I've been treated that way."

Cuomo said the new policy was more in line with those of the federal Centers for Disease Control and Prevention.

The fast-moving changes by the state come after a top federal health official and medical experts earlier Sunday sharply criticized New York and New Jersey's mandatory quarantines of aid workers returning from Ebola-stricken nations, saying the strict mandates could hamper overall efforts to combat the deadly virus at its epicenters.

But even with growing pressure to reverse the mandates, New Jersey Gov. Christie defended the policies, and he was joined by the governor of Florida, who announced similar measures.

Christie said on Sunday that quarantining was necessary to protect the public and predicted it "will become a national policy sooner rather than later."

"I don't believe when you're dealing with something as serious as this that we can count on a voluntary system," said Christie, who is expected to run for the Republican nomination for president in 2016. He added: "I absolutely have no second thoughts about it."

On Sunday night, Christie's office released a statement: "New Jersey is not changing its quarantine protocol. The protocol is clear that a New Jersey resident with no symptoms, but who has come into contact with someone with Ebola, such as a health care provider, would be subject to a mandatory quarantine order and quarantined at home. Non-residents would be transported to their homes if feasible and, if not, quarantined in New Jersey."

The conflicting interests of federal and state officials highlight a conundrum for the United States as it takes a leading role in fighting the contagion of Ebola in West Africa while also trying to calm rising anxiety about the potential spread of the disease at home.

Cuomo insisted the state would help alleviate any burdens posed by the home-based 21-day quarantine for health-care workers returning from West Africa. If a person loses pay because of workdays missed, he said, he or she will be compensated and state officials will talk to employers if necessary.

If a person arrives with no symptoms and had no direct contact with Ebola patients, there will be no home confinement.

"My personal preference is to err on the side of caution," Cuomo said, saying he and de Blasio would urge New York medical experts to encourage hospital staff to volunteer in Ebola efforts in West Africa. "I understand that some people believe the 21-day home quarantine is a burden. I would ask for their cooperation and understanding and remember what we are trying to balance."

The Obama administration said Sunday that it had expressed concerns to Cuomo and Christie about the "unintended consequences" of the quarantines, saying they could deter volunteers from deploying to West Africa, where the spread of Ebola continues to rage.

On several Sunday news talk shows, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, objected strongly to the quarantine policies. He said sending American volunteers to countries such as Liberia, Guinea, and Sierra Leone is vital to efforts to contain the virus there, and he warned that stringent isolation policies for the aid workers upon their return would hamper the global fight against Ebola.

"The best way to protect us is to stop the epidemic in Africa, and we need those health-care workers, so we do not want to put them in a position where it makes it very, very uncomfortable for them to even volunteer to go," Fauci said on Fox News Sunday.

The White House plans to announce new guidelines for returning health-care workers to help prevent imported cases of Ebola while also encouraging volunteers to combat the disease abroad, the administration official said, adding that it would consult with states on new federal policies.

On Sunday, President Obama convened his top health and security advisers and directed them to create policies that would help mitigate the risk of additional Ebola cases in the United States.

Christie and Cuomo argued Sunday that the potential threat of spreading the disease was too great to leave to self-monitoring by returning aid workers. Already hundreds of volunteers have deployed and hundreds more American health-care workers, military service members and humanitarian workers are expected to join them in coming weeks.

Christie and Cuomo announced their quarantine orders Friday after aid worker Craig Spencer was diagnosed with the virus earlier in the week. Spencer is being treated in isolation at Bellevue Hospital Center.