New York, New Jersey Modify Ebola Quarantine Policy

After an avalanche of negative commentary, the Governors of New York and New Jersey have modified their policy regarding quarantining people returning from west Africa.

Ebola Virus And Caduceus

It was just Friday that New York Governor Andrew Cuomo and New Jersey Governor Chris Christie announced a new policy that would require anyone who had been in any of the three African nations that are most affected by the Ebola outbreak in west Africa and had been in contact with someone who had Ebola would be required to submit to an involuntary quarantine for at least 21 days to ensure that they didn’t show signs of developing the disease. Since the policy followed on the heels of the announcement that Dr. Craig Spencer, a volunteer with Doctors Without Borders, had tested positive for the disease and admitted to a New York City hospital, it was clear that the policy was primarily directed at health care workers returning from the so-called “hot zone.” Indeed, the first person who was impacted by the policy was a nurse from Maine who had just returned from a month in Guinea who was taken into custody at Newark Liberty Airport on Friday afternoon and taken to a Newark hospital where she is remains and is presently being kept in a tent in the parking lot isolated from the rest of the hospital. Yesterday, her case made national headlines thanks in no small part to a column published under her name in the Dallas Morning News and an appearance by phone on CNN’s State of the Union and rather direct criticism from the head of the National Institutes of Health. As the day went on, reports began to leak that Whiite House officials were pressuring both Cuomo and Christie to modify their policy, and, late yesterday, both Governor’s relented and allowed a policy change that would let people who are not symptomatic stay at home under monitoring, but questions remain about how the policy will be implemented, especially as it applies to people who don’t have a residence in either state:

Facing fierce resistance from the White House and medical experts to a strict new mandatory quarantine policy, Gov. Andrew M. Cuomo said on Sunday night that medical workers who had contact with Ebola patients in West Africa but did not show symptoms of the disease would be allowed to remain at home and would receive compensation for lost income.

Mr. Cuomo’s decision capped a frenzied weekend of behind-the-scenes pleas from administration officials, who urged him and Gov. Chris Christie of New Jersey to reconsider the mandatory quarantine they had announced on Friday. Aides to President Obama also asked other governors and mayors to follow a policy based on science, seeking to stem a steady movement toward more stringent measures in recent days at the state level.

The announcement by Mr. Cuomo seemed intended to draw a sharp contrast — both in tone and in fact — to the policy’s implementation in New Jersey, where a nurse from Maine who arrived on Friday from Sierra Leone was swiftly quarantined in a tent set up inside a Newark hospital, with a portable toilet but with no shower.

It was the second striking shift in Mr. Cuomo’s public posture on the Ebola crisis in 72 hours; after urging calm on Thursday night, then joining Mr. Christie to highlight the risks of lax policy on Friday, Mr. Cuomo on Sunday night appeared to try to dial back his rhetoric and stake out a middle ground.

He said his decision balanced public safety with the need to avoid deterring medical professionals from volunteering in West Africa. “My No. 1 job is to protect the people of New York, and this does that,” he said. Those quarantined at home will be visited twice a day by local authorities, he said. Family members will be allowed to stay, and friends may visit with the approval of health officials.

Mayor Bill de Blasio, sitting beside Mr. Cuomo at a news conference in Manhattan, nodded in approval, and praised the governor for developing a set of flexible quarantine guidelines that, the mayor said, would show proper respect to those required to abide by them.

After Mr. Cuomo’s announcement, Mr. Christie issued a statement saying that, under protocols announced on Wednesday, New Jersey residents not displaying symptoms would also be allowed to quarantine in their homes.

Until Sunday night, the quarantine orders by Mr. Christie, a Republican, and Mr. Cuomo, a Democrat, had drawn withering criticism from many medical experts, who said they would discourage aid workers from volunteering to help eradicate the disease at its source. By midday Sunday, Kaci Hickox, the nurse who became the first person isolated under the new protocols in New Jersey, emerged as the public face of the opposition, calling the treatment she received “inhumane” and disputing Mr. Christie’s assertion a day earlier that she was “obviously ill.”

“If he knew anything about Ebola he would know that asymptomatic people are not infectious,” Ms. Hickox told CNN.

Even some who acknowledged the states’ authority to enact the policy took issue with its implementation in New Jersey.

“We have to think how we treat the people who are doing this noble work,” Mr. de Blasio said. At a late afternoon news conference, he said Ms. Hickox’s treatment was “inappropriate,” adding: “We owe her better than that.”

Yet amid heightened public anxiety about the government’s handling of the crisis, state authorities have increasingly calculated that the mandatory quarantines will prove prescient. Since the governors’ announcement, Illinois and Florida have said they were instituting similar measures.

“I think this is a policy that will become a national policy sooner rather than later,” Mr. Christie said in an interview on Fox News Sunday.

Left unstated by the statements about the changes in policy in both states is the question of what would happen to someone who arrived at either John F. Kennedy Airport or Newark Liberty Airport who doesn’t have a residence in New York or New Jersey that they could do so. This is the situation that Ms. Hickcox faces since she she lives in Maine and apparently doesn’t have any family in the area whose residence could be used as a quarantine spot. The changes that Governor Christie announced, for example, seem to make clear that they would only apply to New Jersey residents who would be able to self-quarantine in their homes during the incubation period. Theoretically, I suppose, they could allow someone who lives in another state to do the same thing, but then there would have to be arrangements made for transportation and the local health authorities at their destination would have to be informed, trained, and consent to the arrival of a potential Ebola case.

Even though his announcement doesn’t seem to limit itself to New York residents, the same issues arise with the respect to Governor Cuomo’s modifications. Given the fact that JFK and Newark are, quite often, gateway airports that people arriving from overseas use to travel to other parts of the United States once arriving back in the country from overseas, it seems inevitable that many of the people who fit into the criteria of the quarantine order will be people who don’t live in the Tri-State area. Obviously, one option would be for those people to arrive via Dulles Airport in Virginia given that the authorities in the D.C. area have rejected the idea of a quarantine like the one the Christie and Cuomo announced. However, that may not be an option for everyone and, given reports that we may see a national policy announced this week that mirrors to some extent the modified policy that Cuomo announced last night, the issue of what to do with people who don’t live in the area where the five airports that are receiving travelers from west Africa is one that will have to be dealt with at some point.

Notwithstanding these caveats, the modified policy strikes me as being a fairly good compromise given the issues involved here and the fact that, if someone does begin displaying symptoms of Ebola, quick action is required to get them to a facility where they can be isolated and treated. To some extent, the modifications are similar to the policies that Doctors Without Borders had already recommended that volunteers like Spencer and Hickcox follow, and that Dr. Spencer was in fact following prior to his admission to Bellevue last week. The major difference, of course, is that it would require the people involved to actually confine themselves to a set space for the entirety of the 21 day incubation period, something that isn’t necessarily justified by medical science given the fact that even someone who definitely has the Ebola virus inside them is not contagious until they actually start displaying symptoms.In that respect, the restrictions of movement is clearly intended more to address public anxiety than it is based on science. Additionally, while mandatory at-home quarantine is certainly not as restrictive as mandatory quarantine in a medical facility, it is still a restriction of liberty that could potentially be challenged in the same way that lawyers are apparently planning on challenging the quarantine of Kaci Hickcox. All that being said, though, the modified quarantine announced last night strikes me as something of a reasonable medium between the overreaction that Cuomo and Christie initially engaged in and not doing anything at all.

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Doug Mataconis
About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010. Before joining OTB, he wrote at Below The BeltwayThe Liberty Papers, and United Liberty Follow Doug on Twitter | Facebook

Comments

  1. Eric Florack says:

    let’s recall, please that the very reason Ellis island existed , and why regardless of origin, we had an immigration policy, was not because we were being racist bigots… it was in response to epidemic health concerns.

    (there were cultual concerns as well, but thats another discussion)

    All that said, on what basis do we conclude that this new policy is any more or less effective than the old one? The issue here isnt these specific policies. what im suggesting is few if any governmental policies can fully guard against unintended consequences, particularly where all it takes is one mistake.

  2. stonetools says:

    Note, Doug, that the Obama Admininistration has stood tall for a rational, science-based approach, even in the face of losing political support in the looming elections, whereas your preferred team (Republicans, conservatives) foment and seek to profit from ebola hysteria. The liberals even pushed errant Democrats back into rational policy, whereas Republican legislators, constiutuents, and pundits are continually pushing toward the irrational and anti-civil rights approach. You as an independent might consider whether you want to continue to back Team Irrational and reward them with your vote.

  3. @stonetools:

    Have you seen me criticize the President on the Ebola crisis? No, not really although I have noted that the CDC’s initial response was less than ideal and that we needed to learn from the mistakes and be prepared for the next case of Ebola that might show up. That seems to be happening if Dr. Spencer’s case is any indication.

    As for the attempt to make this a partisan issue, I will simply note that Andrew Cuomo is very much a Democrat and he was behind the initial quarantine policy that was announced late Thursday/early Friday. Also, an identical policy is also in effect in Illinois thanks to Democratic Governor Pat Quinn.

  4. superdestroyer says:

    @stonetools:

    There is little that is partisan about this issue. I think all of the progressvies a couple of day ago were singing the praises of the blue states and how they would not panic in the face of Ebola. To claim that Republicans in the State of New York have any influence of how the state is handling Ebola is nothing but non-thinking partisanship.

    After hearing an infection control officer from a major hospital in DC speak about Ebola, I would say that even after all of the lessons learned from Texas Health Presbyterian that most healthcare workers are not really prepared for Ebola because it is too far from their normal workplace habits.

  5. gVOR08 says:

    @Doug Mataconis: @superdestroyer: I don’t see how you can accuse @stonetools: of making this a partisan issue. Republicans did that weeks ago. Stone is just asking Doug why he continues to root for team R when he obviously realizes how much stuff they shovel. He obviously sees that one side is far more evidence based, but continues to root for the other side.

  6. superdestroyer says:

    @gVOR08:

    I have been consistent that this is not a partisan issue but a medical issue. Hwwever, as I have read at least one person write, if the Bush Administration was totally responsible for the Katrina response, then the same standard should be applied to the Obama Administration with Ebola.

    The slowness to act when the initial patient in Texas was unidentified, the failure to send CDC personnel to Texas, the conflicting guidance that came out of HHS and CDC, the failure to understand the type of equipment that hospitals use, the failure to understand how large emergency rooms operate falls squarely on the CDC and thus, the Obama Administration. The spokespeople for the CDC and White House should have understood that everything they said would be analyzed yes, they refuse to reconcile their statements with other parts of the government.

    If there is anything partisan in the response, it is the push by progressives to defend the Obama Administration for all of their errors and the failure to hold the Obama Administration accountable for their actions. The progressives claimed that were not going to make the same mistakes that the Republicans did during the Bush II Administration but they keep on making them.

  7. lounsbury says:

    @Eric Florack:

    Really, you pretend it was your country’s habit to quarantine citizens in the past for the mere aspect of having traveling to Scary Foreign Places?

    Of course 19th century solutions are no where near a rational response to a 21st medical problem, although it does rather play to the ignoramus pants-wetter demographic.

  8. C. Clavin says:

    @Eric Florack:

    let’s recall, please that the very reason Ellis island existed , and why regardless of origin, we had an immigration policy, was not because we were being racist bigots… it was in response to epidemic health concerns.

    When Ellis Island opened there was 1 doctor for every 33,000 immigrants. By 1905 there was 1 doctor for every 56,000 immigrants. The medical exam is purported to have taken 6 seconds. Between 1892 and 1924, the percentage of immigrants rejected for a medical condition…including psychiatric and chronic conditions and not just infectious diseases, was less than 1%.
    Once again the facts fail to support your ideology.
    Don’t you ever get tired of making shit up to support your xenophobia????

  9. stonetools says:

    @Doug Mataconis:

    I’m sorry, are you “Both sides doing it” again? The overwhelming percentage of the the “avalanche of negative commentary” is coming from liberals, whereas conservatives overwhelming support the quarantine policy. Liberals are pushing their political leaders to be rational, pro-civil rights, and science based: conservatives are pushing their leaders to the anti-science, anti-civil rights side. Trawl through Red State to see the conservative take on the matter. Better still, here is a quote from your Hot Air buddy Jazz Shaw:

    On Saturday I found myself in the unusual position of praising New York Governor Andrew Cuomo, as he took the bold step of joining with Chris Christie and imposing more sensible travel restrictions on those coming to the United States from Ebola stricken nations via JFK and Newark. For a governor with such a horrible record on so many issues, it was a refreshing and shocking change to be able to point out something both brave and reasonable as the elected executive of the Empire State. Well.. that lasted for less than two days.

    So yeah, it kind of is a partisan issue. and I you would like to see you even once bring yourself to write a sentence praising the Obama administration for its rational approach, rather than simply not criticizing them. After all, you do praise the Republicans whenever they occassionally get something right. But maybe if you actually praise the Administration at any time, you might get read out of Team Conservative, so…

  10. C. Clavin says:

    @superdestroyer:

    There is little that is partisan about this issue.

    Other than the fact that almost all the bed-wetters are Republicanists. And Trump, a Republicanist Presidential candidate, calling for Obama’s resignation over it. And Rush Limbaugh saying that Obama wants America to get Ebola as payback for slavery. And Phyllis Schlafly who said Obama has allowed Ebola to enter the United States so the country would be more like Africa.
    But it’s not partisan.

  11. gVOR08 says:

    @stonetools: Back before the GOPs kind of let David Frum back on the bus I used to occasionally comment on FrumForum accusing him of maintaining his Republican loyalty and his position as a “reasonable conservative” for marketing reasons. The “reasonable liberal” niche was pretty crowded but the “reasonable conservative” niche was, and still is, wide open.

  12. C. Clavin says:

    Here’s a take on why it is a partisan issue…because, as we all know, Republicans have nothing but fear to sell.
    http://www.thedailybeast.com/articles/2014/10/27/republicans-want-you-scared-of-ebola.html

  13. superdestroyer says:

    @C. Clavin:

    None of the people you listed are elected Republicans or even really involved in Republican politics. They are self-promoters. Of course, you are skipping over the left of center types who have claimed that the death of Thomas Duncan was due to racism.

    http://www.cnn.com/2014/10/09/opinion/wright-ebola-racism/

  14. C. Clavin says:

    @superdestroyer:
    Donald Trump, Rush Limbaugh, and Phylis Shafly are not involved in Republicanist politics?
    Nice try.

  15. stonetools says:

    Looks like Christie is caving, again due to liberal pressure. Being in blue New Jersey probably had a lot to do with that.

    For everyone familiar with New Jersey Chris Christie’s brand of smashmouth politics, it seemed like the case of the quarantined nurse was tailor made for him. There he was, up against the White House, the Centers for Disease Control, and Kaci Hickox, who had spent a month in Sierra Leone treating Ebola patients, and was the first person in New Jersey to be subject to a mandatory 21-day quarantine. (He said she was ill. She said she wasn’t.)

    But Christie, used to having the stage and the microphone, hadn’t dealt with the likes of Hickox before. She took to the airwaves to blast the policy, taking Christie on in a series of interviews conducted from a tent where she was kept in isolation. “It is not a sound public health decision and well thought out,” Hickox said during an interview with CNN. “Many of the experts in the field have come out to agree with me. So I think that we need to stress the fact that we don’t need politicians to make these kinds of decisions. We need public health experts to make these decisions.”

    And at first, it seemed like Christie was on pace to win this round as well. It allowed him a kind of reverse Sandy–he had embraced Obama in the runup to the 2012 election after the storm did extensive damage to the Garden State, and come under heavy criticism from Republicans for doing so. This time Christie was very publicly breaking with Obama…..

    “I don’t believe when you’re dealing with something as serious as this that we can count on a voluntary system,” he said Sunday on Fox News. “The government’s job is to protect [the] safety and health of our citizens. And so we’ve taken this action, and I absolutely have no second thoughts about it….

    Except now he is having second thoughts, and Hickox has been released. (Christie still didn’t give up in taking a shot at her, however. “I’m hopeful that this morning if all goes well we’ll be able to release her and send her back to Maine

    Seems Nurse Hickok 02, Northeast Governors 0-with a big assist from the Obama Administration, liberals, and well, science.

  16. @gVOR08:

    Where am I rooting for “Team R?”

    The ironic thing is that Republican and conservative friends of mine accuse me of rooting for Obama.

  17. Matt says:

    @Doug Mataconis: If those friends are like any Republicans and “conservatives” that I know anything short of calling Obama an American hater is rooting for him..

  18. Eric Florack says:

    @lounsbury: Perhaps you should study history a bit more.

    @C. Clavin: well, it appears youve managed to turn this into a partisan issue, Clavin. amazing ability you have. while Im talking about is a medical protocol that has stemmed epidemics for hundreds of years – at least since we’ve discovered it was germs and viruses, youre all worried about offending potential Democrat voters.
    (snort!)