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Amid criticism, Cuomo softens tone in outline of Ebola plan

Governors Andrew Cuomo of New York and Chris Christie of New Jersey last week announced a mandatory quarantine of people returning to the United States through airports in New York and New Jersey who are deemed “high risk” for contracting Ebola. Their announcement set off a firestorm, but some other states have followed suit.
Governors Andrew Cuomo of New York and Chris Christie of New Jersey last week announced a mandatory quarantine of people returning to the United States through airports in New York and New Jersey who are deemed “high risk” for contracting Ebola. Their announcement set off a firestorm, but some other states have followed suit.Mark Lennihan/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 issued guidelines that go beyond federal recommendations, but would 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 Governor 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 fighting the disease where it is needed in West Africa.

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“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.”

The protocols in New York, as outlined in the documents, are meant to ensure “a respectful and supportive approach” to arriving travelers, who should be “treated with the utmost respect and concern,” according to a document prepared by the state Health Department that outlines screening procedures.

Although Cuomo warned of the possibility of quarantine “at a government-regulated facility” when he and New Jersey Governor Chris Christie 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 department’s document says.

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

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Christie continued to defend his state’s mandatory quarantine program Tuesday, even as a growing number of scientists and public health specialists 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, 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 in Ethiopia.

Dr. Bruce Ribner, an infectious disease specialist who directed the care of several Ebola patients at Emory University Hospital in Atlanta, 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.

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 Monday, calling for travelers returning to the United States who have had exposure to Ebola patients to voluntarily isolate themselves.

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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.

While the CDC 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.

Christie made it clear 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.

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

For those who arrive 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 local health authorities. It was not immediately clear if people would be allowed to board their connecting flight or whether some alternative transportation would be arranged.