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Cuomo Softens Tone in Outline of Ebola Plan Amid Criticism - New York Times


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N.Y. / Region |Cuomo Softens Tone in Outline of Ebola Plan Amid Criticism



http://nyti.ms/1pUyfUk






N.Y. / Region |​​NYT Now





Gov. Chris Christie of New Jersey answering questions Monday about Kaci Hickox, the nurse who was placed in quarantine at a New Jersey hospital, then released. Jessica Hill/Associated Press




Offering the first detailed account of how New York State’s quarantine order for health care workers returning from West Africa will be put into effect, the Cuomo administration has issued guidelines that go beyond federal recommendations but seek to allow individuals to spend their enforced isolation in a location of their choosing.


The state documents, copies of which were obtained by The New York Times, show an effort by Gov. Andrew M. Cuomo’s administration to portray the quarantine in a humane manner.


President Obama, speaking at the White House on Tuesday, said that it was critical that policies dealing with returning health care workers do nothing that might discourage them from going to fight the disease where it is most needed in West Africa.



“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 orders issued by several states, which go beyond the federal guidelines, he said it was important that decisions were made based on “science,” not “fear.”





OPEN Document



Document: Guidelines for Screening J.F.K. Passengers


The protocols in New York, as outlined in the documents, 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 Mr. 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.


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.


Mr. Christie continued to defend his state’s mandatory quarantine program on Tuesday morning, even as a growing number of scientists and public health experts condemned the restrictions as overly broad and possibly harmful in the fight against Ebola in West Africa.


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.”


Jim Yong Kim, the president of the World Bank, said on Tuesday that thousands more workers were desperately needed in West Africa, and he worried about the impact that travel restrictions might have on their recruitment.


“Right now, I’m very much worried about where we will find those health care workers,” he said while traveling in Ethiopia. “With the fear factor going out of control in so many places, I hope health care professionals will understand that when they took their oath to become a health care worker it was precisely for moments like this.”


Dr. Bruce Ribner, an infectious disease specialist who directed the care of several Ebola patients at Emory University Hospital, added his voice to those concerned about the impact of mandatory quarantines, warning officials to be “mindful of unintended consequences” that could impede the fight against Ebola.





OPEN Document



Document: Order for Imposing Mandatory Ebola Quarantines


He made his comments at a news conference to announce the recovery of one of his patients, Amber Vinson, a nurse who contracted Ebola while caring for a patient in Dallas.


The federal Centers for Disease Control and Prevention issued guidelines on Monday, calling for travelers returning to the United States who have had exposure to Ebola patients to voluntarily isolate themselves.


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 some states want.


At least six states have called for mandatory quarantines, which are imposed under the force of law.


The patchwork of policies, many announced before the details of how they would be carried out, have created confusion.


While the C.D.C. issues guidelines, it does not have the power to police public health matters, so it is up to the states to carry out the policy.


Mr. Christie made it clear on Monday he had no intention of following the lead of the federal agency.


“We want stricter things than they were willing to impose,” he said on NBC’s “Today” show. He said federal authorities were not acting in the best interest of the public in refusing to impose stricter guidelines.



More Ebola Coverage




]]>

“This is because they don’t want to admit that we were right and they were wrong,” Mr. Christie said.


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.


In New York, according to the documents, every effort would be made to allow people to serve out their quarantine in the location of their choice.


The definition of a person considered at high risk and subject to the order includes any person who had exposure to an Ebola patient or the body of an Ebola victim, even if the individual was wearing protective equipment.


For those who are arriving in New York with a connecting flight, the state order says that transportation will be arranged when possible so that the person can monitor his or her health under the guidelines of the local health authorities, whom the state will inform before arrival. It was not immediately clear if people would be allowed to board their connecting flight or whether some alternative transportation would be arranged.


In the event that a traveler who meets the criteria for quarantine had been planning to stay in a hotel, the state would determine if that location was appropriate and, if not, find an alternative location.


But even as New York sought to find the right balance between protecting the public and not causing returning health care workers undue burden, some public health professionals say that governors ordering mandatory quarantines are letting politics guide their decision making in a way that could prove dangerous.


“The governors’ action is like driving a carpet tack with a sledgehammer: it gets the job done but overall is more destructive than beneficial,” according to the editorial in the New England Journal of Medicine.


The article lays out the science behind the spread of the disease, as it is currently understood.


“We have very strong reason to believe that transmission occurs when the viral load in bodily fluids is high, on the order of millions of virions per microliter,” according to the editorial. “This recognition has led to the dictum that an asymptomatic person is not contagious; field experience in West Africa has shown that conclusion to be valid. Therefore, an asymptomatic health care worker returning from treating patients with Ebola, even if he or she were infected, would not be contagious.”



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N.Y. / Region |Cuomo Softens Tone in Outline of Ebola Plan Amid Criticism



http://nyti.ms/1pUyfUk






























































N.Y. / Region |​​NYT Now





Gov. Chris Christie of New Jersey answering questions Monday about Kaci Hickox, the nurse who was placed in quarantine at a New Jersey hospital, then released. Jessica Hill/Associated Press




Offering the first detailed account of how New York State’s quarantine order for health care workers returning from West Africa will be put into effect, the Cuomo administration has issued guidelines that go beyond federal recommendations but seek to allow individuals to spend their enforced isolation in a location of their choosing.


The state documents, copies of which were obtained by The New York Times, show an effort by Gov. Andrew M. Cuomo’s administration to portray the quarantine in a humane manner.


President Obama, speaking at the White House on Tuesday, said that it was critical that policies dealing with returning health care workers do nothing that might discourage them from going to fight the disease where it is most needed in West Africa.



“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 orders issued by several states, which go beyond the federal guidelines, he said it was important that decisions were made based on “science,” not “fear.”





OPEN Document



Document: Guidelines for Screening J.F.K. Passengers


The protocols in New York, as outlined in the documents, 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 Mr. 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.


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.


Mr. Christie continued to defend his state’s mandatory quarantine program on Tuesday morning, even as a growing number of scientists and public health experts condemned the restrictions as overly broad and possibly harmful in the fight against Ebola in West Africa.


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.”


Jim Yong Kim, the president of the World Bank, said on Tuesday that thousands more workers were desperately needed in West Africa, and he worried about the impact that travel restrictions might have on their recruitment.


“Right now, I’m very much worried about where we will find those health care workers,” he said while traveling in Ethiopia. “With the fear factor going out of control in so many places, I hope health care professionals will understand that when they took their oath to become a health care worker it was precisely for moments like this.”


Dr. Bruce Ribner, an infectious disease specialist who directed the care of several Ebola patients at Emory University Hospital, added his voice to those concerned about the impact of mandatory quarantines, warning officials to be “mindful of unintended consequences” that could impede the fight against Ebola.





OPEN Document



Document: Order for Imposing Mandatory Ebola Quarantines


He made his comments at a news conference to announce the recovery of one of his patients, Amber Vinson, a nurse who contracted Ebola while caring for a patient in Dallas.


The federal Centers for Disease Control and Prevention issued guidelines on Monday, calling for travelers returning to the United States who have had exposure to Ebola patients to voluntarily isolate themselves.


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 some states want.


At least six states have called for mandatory quarantines, which are imposed under the force of law.


The patchwork of policies, many announced before the details of how they would be carried out, have created confusion.


While the C.D.C. issues guidelines, it does not have the power to police public health matters, so it is up to the states to carry out the policy.


Mr. Christie made it clear on Monday he had no intention of following the lead of the federal agency.


“We want stricter things than they were willing to impose,” he said on NBC’s “Today” show. He said federal authorities were not acting in the best interest of the public in refusing to impose stricter guidelines.



More Ebola Coverage




]]>

“This is because they don’t want to admit that we were right and they were wrong,” Mr. Christie said.


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.


In New York, according to the documents, every effort would be made to allow people to serve out their quarantine in the location of their choice.


The definition of a person considered at high risk and subject to the order includes any person who had exposure to an Ebola patient or the body of an Ebola victim, even if the individual was wearing protective equipment.


For those who are arriving in New York with a connecting flight, the state order says that transportation will be arranged when possible so that the person can monitor his or her health under the guidelines of the local health authorities, whom the state will inform before arrival. It was not immediately clear if people would be allowed to board their connecting flight or whether some alternative transportation would be arranged.


In the event that a traveler who meets the criteria for quarantine had been planning to stay in a hotel, the state would determine if that location was appropriate and, if not, find an alternative location.


But even as New York sought to find the right balance between protecting the public and not causing returning health care workers undue burden, some public health professionals say that governors ordering mandatory quarantines are letting politics guide their decision making in a way that could prove dangerous.


“The governors’ action is like driving a carpet tack with a sledgehammer: it gets the job done but overall is more destructive than beneficial,” according to the editorial in the New England Journal of Medicine.


The article lays out the science behind the spread of the disease, as it is currently understood.


“We have very strong reason to believe that transmission occurs when the viral load in bodily fluids is high, on the order of millions of virions per microliter,” according to the editorial. “This recognition has led to the dictum that an asymptomatic person is not contagious; field experience in West Africa has shown that conclusion to be valid. Therefore, an asymptomatic health care worker returning from treating patients with Ebola, even if he or she were infected, would not be contagious.”



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