In the latest tweak to America's plan to prevent the spread of the deadly Ebola disease, Centers for Disease Control and Prevention leader Dr. Tom Frieden announced changes to the U.S. response to Ebola and the guidance federal agencies are giving to state and local governments.
The new protocol stops short of the mandatory 21-day quarantines that some states have begun requiring. Instead, Frieden said, it relies on individual assessment and close monitoring. He also detailed several categories of risk among both airline passengers and the medical volunteers who he said have been doing "heroic work" in West Africa.
"High risk" individuals, Frieden said, include those who have cared for an Ebola patient and were accidentally poked by a needle or lacked protective gear. Those people, Frieden said, should isolate themselves in their homes and avoid all forms of mass transit and large gatherings.
Those in the group would also undergo "direct active monitoring," in which a medical worker watches as the person's temperature is taken and speaks with him regularly about his condition.
The "some risk" category, Frieden said, includes those who have lived in the same household as an Ebola patient but haven't had direct contact with him, as well as health care workers who have cared for patients without any equipment problems. He stressed that it would be dangerous to treat such medical workers as "pariahs," as it might discourage staff who are trying to prevent the disease's spread.
Frieden also gave more details about people who enter the U.S. after being in countries where the outbreak poses the greatest threat.
Each day, slightly fewer than 100 people travel to the U.S. from Liberia, Guinea, and Sierra Leone, he said, citing the airport-arrivals screening program that began this month. Most of those travelers, he added, are either U.S. citizens or legal residents. Of more than 807 people who have been evaluated, Frieden said, 46 of them are health workers.
The CDC chief noted that Monday marks the start of an increase in post-arrival monitoring that his agency recommended last week for incoming passengers. That program covers six states (New York, Maryland, Pennsylvania, Virginia, New Jersey and Georgia) where the CDC says some 70 percent of incoming travelers are headed after landing in the U.S.
Frieden opened his remarks by citing previous scientific studies about the disease, saying that they had proven the disease is transmissible only via direct contact with an infected person's bodily fluids.
"At CDC, we base our decisions on science and experience," he said.
Frieden spoke after a weekend in which a new public debate erupted over how to treat returning American health workers who have volunteered to fight the Ebola outbreak in West Africa.
Earlier Monday, New Jersey officials said they would allow Kaci Hickox, a Texas-born nurse based in Maine, to leave the hospital where she's been under a mandatory quarantine since she arrived at Newark's airport from Sierra Leone Friday.
Hickox landed as New Jersey, New York and Illinois were installing new policies requiring a 21-day quarantine for anyone who had potential contact with Ebola patients in West Africa. Hickox has maintained that she hasn't had any symptoms of the disease, and a preliminary blood test was negative for the disease. On Sunday, she hired a civil rights attorney to help secure her release.
The nurse works with Doctors Without Borders, which issued a statement Monday saying, "Forced quarantine of asymptomatic health workers returning from fighting the Ebola outbreak in West Africa is not grounded on scientific evidence and could undermine efforts to curb the epidemic at its source."
The agency also warned that if U.S. officials took such steps, they would likely be mirrored in other countries.
The CDC has adjusted its guidelines several times in the past few weeks, as the U.S. has recorded its first case of a Ebola patient being treated domestically — and its first death from the disease that has killed more than 4,900 people.
Earlier this month, the agency issued new protocols for Ebola screening at five U.S. airports: New York's JFK, New Jersey's Newark, Chicago's O'Hare, Virginia's Washington-Dulles and Atlanta's Hartsfield.
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