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Ban Ki-moon criticises Ebola restrictions placed on healthcare workers New federal Ebola guidelines issued in US after criticism from UN
(35 minutes later)
The UN secretary general criticised restrictions being placed on healthcare workers returning to the US after treating Ebola patients on Monday, as the White House insisted that was up to state and local authorities to decide whether to follow national scientific guidelines on quarantines. Federal health officials attempted on Monday to bring some order to a chaotic response to the latest Ebola diagnosis in the United States, after the United Nations criticised earlier restrictions placed on healthcare workers returning from west Africa.
After the governors of New York and New Jersey relaxed new quarantine measures that were criticised by the White House and medical professionals, Ban said in a statement that he was concerned by controls being placed on medics arriving in the US and elsewhere. Medics flying into the US after treating Ebola patients in Guinea, Liberia or Sierra Leone should be more closely monitored by local authorities for 21 days, according to new national guidelines published by the Centers for Disease Control and Prevention (CDC).
“Returning health workers are exceptional people who are giving of themselves for humanity,” said Ban in a statement released by the UN. “They should not be subjected to restrictions that are not based on science. Those who develop infections should be supported, not stigmatised.” However only those deemed “high risk” – those who did not wearing proper protective clothing, or were exposed to the virus via a needle or other injury – should automatically require quarantines in their homes, Tom Frieden, the CDC director, told a conference call.
The secretary general’s criticism came shortly after New Jersey authorities said that a nurse who was confined to a quarantine tent with a portable toilet and no shower, despite showing no symptoms after returning to the US from treating patients in Sierra Leone, would be released and allowed to return to her home to Maine. The new advisory should “increase the level of protection of the health and safety of Americans” while “protecting those who are doing the heroic work of protecting us from Ebola as they fight it on the shores of Africa as well,” said Frieden.
The White House appeared to accept that a patchwork system of Ebola restrictions was inevitable in a federal nation where public health policies were a matter for individual states. “We have a federal system in this country in which states are given significant authority for governing their constituents,” said White House spokesman Josh Earnest. “That is certainly true when it comes to public safety and public health.” His latest guidelines followed a backlash to mandatory quarantines announced by New York and New Jersey last Friday for all healthcare workers who came into contact with infected people in west Africa, after a doctor, Craig Spencer, was diagnosed with Ebola in New York City last week.
The Centers of Disease Control and Prevention (CDC) said later on Monday that healthcare workers returning to the US from treating Ebola patients in west Africa should be more closely monitored by local authorities. The quarantine rules have since been loosened by governors Chris Christie of New Jersey and Andrew Cuomo of New York. Ban Ki-moon, the UN secretary general, in a statement released by the UN, said that returning medics “should not be subjected to restrictions that are not based on science” and “those who develop infections should be supported, not stigmatised”.
However only the highest-risk people – such as those who did not wear proper protective clothing or are known to have been exposed to the virus via a needlestick injury – should require quarantines in their homes, Tom Frieden, the CDC director, told a conference call. His criticism came shortly after New Jersey authorities announced that Kaci Hickox, a nurse who was confined to a quarantine tent with a portable toilet and no shower despite showing no symptoms after returning to the US from treating patients in Sierra Leone, would be released and allowed to return to her home to Maine.
Under the CDC’s suggested “active monitoring” program, all returning healthcare workers should register with regional authorities and have daily temperature checks observed by an official, Frieden said, adding that this would help swifter action in the event of Ebola symptoms developing. The White House appeared to accept on Monday that a patchwork system of Ebola restrictions was inevitable given that public health policies were a matter for individual states. “We have a federal system in this country in which states are given significant authority for governing their constituents,” White House spokesman Josh Earnest told a briefing. “That is certainly true when it comes to public safety and public health.”
Frieden stressed that state authorities were free to impose tighter restrictions on the movements of returning healthcare workers. The new CDC guidelines “increase the level of protection of the health and safety of Americans, which is our first and foremost priority, while at the same time protecting those who are doing the heroic work of protecting us from Ebola as they fight it on the shores of Africa as well,” said Frieden. Meanwhile about a dozen US troops, who had been in Liberia as part of an operation to help tackle the Ebola outbreak, were being quarantined in Italy after returning to base in Vicenza and reportedly met by police in hazmat suits.
The fragmented response even among federal agencies has raised questions about the role of Ron Klain, who was appointed two weeks ago to coordinate a “whole of government response”. Under the CDC’s latest “active monitoring” guideline, all returning healthcare workers are deemed to be at “some risk” of Ebola, and should register with regional authorities. They would then have daily temperature checks observed by an official, Frieden said, adding that this would help swifter action in the event of any symptoms developing.These medics should also notify regional authorities at their destinations before travelling away from home, according to the CDC, so that there would be no break in the daily monitoring of their condition.
Even the branches of the federal government seem to be in disagreement over how to respond to workers who may have been exposed to Ebola. By contrast, “for the high-risk individuals, we are recommending voluntary at-home isolation, including not going on public transportation and flying,” Frieden said. Regional authorities may want to impose these rules on returning medics not initially regarded as high risk on “the basis of a specific assessment of an individual’s situation”, the CDC director said.
On Monday, the US Department of Defense confirmed that about a dozen troops who had been in Liberia as part of an operation to help tackle the Ebola outbreak were being quarantined in Italy after returning to base in Vicenza and reportedly met by police in hazmat suits. Following a scaling back in the states’ original plans, those in New York and New Jersey are now allowed to be under home quarantines for 21 days, with friends and family visits confirmed as permitted in New York.
Earnest said decision to quarantine returning US troops in Italy was taken by local commanders and did not yet reflect official Department of Defense policy. Frieden said that fewer than 100 people were travelling to the US from the affected African countries each day, and that between 5% and 6% of these were returning medics. He added that 70% of those returning were coming through the six states of New York, Maryland, New Jersey, Pennsylvania, Georgia and Virginia.
A US defense official told the Guardian the soldiers were being monitored at a “separate location” out of “an abundance of caution”, adding: “None of these individuals have shown any symptoms of exposure.” The official confirmed that the troops are not allowed to leave the location. The CDC director again stressed that Americans were highly unlikely to contract Ebola. “I understand that people are afraid. People are unfamiliar,” said Frieden. “It is a severe disease, but it is not highly contagious.”
The official said that among those being monitored is Major General Darryl Williams, the US army’s commander in Africa, who has been leading the US effort against the virus. Williams visited Ebola treatment centres, said the official, who could not confirm whether other troops had come into contact with infected people. “None them were treating people. None of them are healthcare workers,” the official said. Only one person in the US is confirmed as currently suffering from Ebola – Spencer of Doctors Without Borders, who treated patients in Guinea. Mayor Bill de Blasio said at a press conference on Monday morning that Spencer’s condition at Bellevue hospital remained “serious but stable” and that his fiancee and two friends continued to show no symptoms.
“We are billeted in a separate area (on the base). There’s no contact with the general population or with family. No one will be walking around Vicenza,” Williams told Reuters in a phone interview. De Blasio said that confirmation was being awaited on whether a five-year-old boy admitted to Bellevue on Sunday was in fact suffering from Ebola. The boy had recently returned with his family to the borough of the Bronx from west Africa.
“Our food is dropped off and then we eat and throw it away. Nobody else touches it,” he said. “The child was having some difficulties but it’s not clear they were the sort of symptoms that would be related to Ebola,” said De Blasio. The mayor said that the boy was accompanied at the hospital by his mother.
After initially saying that some US troops would come into contact with patients, the Pentagon retracted this earlier this month and said that some soldiers would be involved with the testing of blood from people who displayed symptoms associated with Ebola.
Dozens more troops are due to return to base from Liberia later on Monday and in the coming days. “There has been no decision to implement this force wide and any such decision would be made by the secretary of defense,” the official said.