This Article is From Oct 29, 2014

New York's Rules to Let Travellers Pick Site for Isolation

New York's Rules to Let Travellers Pick Site for Isolation

Crew members from New York Fire Department EMS Station 10 listen to New York City Mayor Bill de Blasio speak at their station in New York, on Oct. 28 (Todd Heisler/The New York Times)

New York: Offering the first detailed account of how New York state's quarantine order for travelers returning from West Africa will be put into effect, Gov. Andrew M. Cuomo's administration has issued guidelines that go beyond federal recommendations but seek to allow people to choose where to spend their enforced isolation.

The state protocols show an effort by the administration to portray the quarantine, which has been criticized as excessive by some experts and doctors' organizations, in a humane manner.

The protocols are meant to ensure "a respectful and supportive approach" to arriving travelers, who are supposed to be "treated with the utmost respect and concern," according to a document prepared by the state Health Department that outlines the screening procedures.

Although Cuomo warned of the possibility of quarantine "at a government-regulated facility" when he and Gov. Chris Christie of New Jersey first announced the policy last week, the state protocols make clear that is not the state's desired option for travelers arriving in New York. "Preference should be given to quarantining the passenger in his or her residence," the Health Department document says.

New York City Mayor Bill de Blasio said on Tuesday that no one had flown into Kennedy International Airport from the affected region since the order was put in place.

Public health experts have said that the restrictions are unnecessary since Ebola patients are not known to be contagious before they show symptoms of illness, and that the rules will discourage doctors and nurses from going to Africa to contain the disease.

The New England Journal of Medicine, in an editorial published on its website, said the approach taken by New Jersey, New York and several other states "is not scientifically based, is unfair and unwise, and will impede essential efforts to stop these awful outbreaks of Ebola disease at their source, which is the only satisfactory goal."

President Barack Obama, speaking at the White House on Tuesday, echoed that sentiment. "I want to make sure that every policy we put in place is supportive of their efforts," he said. While not commenting specifically on the quarantine orders of several states, he said it was important that decisions be made based on science, not fear.

The federal Centers for Disease Control and Prevention issued guidelines on Monday, calling for travelers returning to the U.S. who have been exposed to Ebola patients to isolate themselves voluntarily.

The new guidelines expanded on previous protocols and called for some restricted movement, saying returning medical workers should not, for instance, fly on commercial airlines during the 21-day monitoring period. However, the federal guidelines do not go as far as the mandatory quarantines, imposed under the force of law, in place in New York, New Jersey and several other states.

The New Jersey Health Department did not respond to requests for information about the state's order or about any guidance it was providing to workers at Newark Liberty International Airport about its implementation. Kaci Hickox, a nurse who was quarantined for three days in a Newark hospital and criticized her treatment in an essay on a newspaper's website, was resting in Maine on Tuesday, her boyfriend Ted Wilbur said. He shared a photo of Hickox resting under a blanket, saying, "Finally a bit of well-deserved rest after such a long ordeal."

Maine health officials said they will make "every possible effort to implement an agreed-upon in-home quarantine" of 21 days for workers returning from West Africa.

On Tuesday night, Hickox's lawyers said that they had agreed only to a two-day in-home quarantine and that if state officials moved to legally prevent her from going out, they would challenge those restrictions in court. Hickox has agreed to monitoring and health checks, but feels that the additional requirements by the state are not appropriate, her lawyer Steven Hyman said.

On Tuesday, Cuomo told reporters he was comfortable being criticized for acting too cautiously, and said asking people to remain at home for 21 days was not overly burdensome. "It's not like we're asking people to do hard labor," he said.

Cuomo said the CDC viewed New York's policy as "too cautious," but pointed out that the U.S. Army had adopted a similar approach. "I think the CDC should talk to the Army and work it out with them first," he said.

The New York protocols require a quarantine for people living or staying in the state if they met the definition of "direct contact" while in an Ebola-ravaged country. Examples of "direct contact" include touching the body or bodily fluids of a patient, or a person with symptoms of Ebola, even while in protective clothing; coming within 3 feet of an Ebola patient without protection; living in the same home as an Ebola patient; and being without protection in the same enclosed space as a patient for a "prolonged period of time," as determined on a case-by-case basis.

Local health officials are responsible for visiting quarantined travelers twice a day, checking their health and taking their temperatures. Relatives may stay in the home; visitors must be approved by the local health department. Cuomo has said the state would compensate quarantined people for lost income.

For a traveler meeting the quarantine criteria and who is planning to stay in a hotel, the state would determine if that location was appropriate and, if not, find an alternative. For those with connecting flights, New York will inform the state where they are headed. Depending on circumstances, they may be allowed on the flight or taken by alternative transportation.

© 2014, The New York Times News Service
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