White House Presses States to Reconsider Mandatory Ebola Quarantine Orders

New York Times – by MARC SANTORA and MICHAEL D. SHEAR

The Obama administration has expressed deep concerns to the governors of New York and New Jersey and is consulting with them to modify their orders to quarantine medical volunteers returning from West Africa as President Obama seeks to quickly develop a new, nationwide policy for the workers, according to two senior administration officials.

One administration official said the federal government has been pressing the governors to back off their decisions, which quarantine all medical workers who had contact with Ebola patients. But another official said the administration has not specifically asked the governors to reverse their policies.  

Mr. Obama held a meeting with his top advisers at the White House on Sunday as officials work 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.

On Sunday both governors, Andrew M. Cuomo of New York and Chris Christie of New Jersey, stood by their decisions, saying that the current federal guidelines did not go far enough.

At the same time, the first person to be forced into isolation under the new protocols, Kaci Hickox, a nurse returning from Sierra Leone, planned to mount a legal challenge to the quarantine order. Despite having no symptoms, she has been kept under quarantine at a hospital in New Jersey, where she has been confined to a tent equipped with a portable toilet and no shower. On Sunday, she spoke to CNN about the way she has been treated, describing it as “inhumane.”

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.

Mayor Bill de Blasio said on Sunday that the way Ms. Hickox had been treated was 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 help fight the epidemic in West Africa.

“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.”

He said there have been reports that nurses who work at Bellevue have been stigmatized, with people refusing to serve them food or treating their children differently. Such behavior was unacceptable, he said.

“The people who work at Bellevue are the Marines of our health care system,” he said. “They understand what their duty is, and they are only too proud to perform it.”

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.

As for Ms. Hickox, her plane happened to land precisely at the wrong moment.

“This nurse just happened to land mid-conversation between the two governors,” the official said.

http://www.nytimes.com/2014/10/27/nyregion/ebola-quarantine.html?_r=1