Federal health officials released a risk scale Monday designed to smooth out state efforts to fight Ebola while bolstering the Obama administration’s plea for calm, even as the Pentagon quarantined troops returning from the West African epicenter of the outbreak.
The Centers for Disease Control and Prevention (CDC) guidelines recommend home isolation for people who may have been exposed to the deadly virus and active monitoring for those at more moderate levels of risk.
It is unclear if the recommendations will work in practice, as states such as New York and New Jersey have already shown they are willing to enforce stricter quarantine measures to combat the disease — and the fear it brings — than the Obama administration wanted.
Georgia Gov. Nathan Deal introduced a three-tier risk scale Monday that aligns with the federal guidance to a degree, while New Jersey Gov. Chris Christie, also a Republican, offered no apologies to a nurse who said she was treated inhumanely when quarantined by the state before hopping on private transport to Maine. In New York City, tensions rose before a feverish 5-year-old boy who just returned from Guinea tested negative for the deadly virus.
All the while, the Obama administration cheered on health care workers and soldiers charged with fighting the virus at its source, while trying to contain public unease.
“It continues to be the view of this administration that stopping the Ebola outbreak in its tracks in West Africa is critically important to our national security and to the safety and health of American citizens,” White House Press Secretary Josh Earnest said. “As we’ve said many, many times, the likelihood of a widespread outbreak in this country of Ebola is exceedingly low.”
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New Jersey, New York, Illinois and Florida led the way in announcing special quarantine or monitoring measures for their states over the last 48 hours, raising concerns that the U.S. approach to fighting Ebola could become deeply fragmented.
“In some ways you can kind of take this up with James Madison,” Mr. Earnest said, referring to the American balance of federal and state powers.
But the administration does not have a blanket policy to govern its own ranks. The Pentagon announced Monday that a dozen U.S. soldiers returning from Liberia were isolated Sunday at a U.S. base in Vicenza, Italy, out of an “abundance of caution.” No one has shown signs of Ebola there, although more personnel will flow into the isolation area in the coming days.
A Pentagon official said the policy applies only to the Army, and a militarywide policy may come later this week. For now, it is unclear how the administration planned to monitor or quarantine up to 3,000 American soldiers heading into the hot zone in West Africa.
“We’re going to let science drive that process, and as soon as we have a policy to announce on this, we’ll let you know,” Mr. Earnest said, noting military personnel will be working on projects that assist the Ebola fight, not treating patients.
Quarantined nurse
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The apparent quarantine — or “enhanced monitoring,” in the Pentagon’s words — mirrored the clash that developed over the effort to keep tabs on Kaci Hickox, a 33-year-old nurse who was placed in an isolation tent next to a Newark hospital over the weekend when she returned from helping Ebola patients in Sierra Leone with the organization Doctors Without Borders.
She complained that she was treated “inhumanely” before she was allowed to leave Monday and spend her 21-day quarantine at home at the northern tip of Maine, and even raised the prospect of legal action.
Mr. Christie, a tough-talking leader and potential presidential candidate in 2016, said Ms. Hickox’s release was consistent with the state’s policy and did not amount to a reversal. She exhibited a fever at Newark Liberty International Airport, the governor contended, but had been symptom-free for 24 hours in isolation.
“Our preference always is to have people quarantined in their homes,” said Mr. Christie, who, somewhat ironically, will head to Maine Tuesday to campaign for Republican Gov. Paul LePage.
Mr. Christie offered no apologies for the state’s handling of Ms. Hickox’s case, and noted that cities such as Chicago and states like Maryland are moving toward the more restrictive approach that New Jersey had adopted.
“My job is not to represent” Ms. Hickox, Mr. Christie told reporters. “My job is to represent the people of New Jersey.”
The CDC hopes its new, four-tier monitoring scale will help states match an individual patient’s situation with appropriate restrictions. The highest-risk tier would encompass people who were exposed to Ebola without protection or, for instance, were stuck by a needle that had been used on an infected patient. They should mainly stay at home and away from the workplace or public gatherings.
“Fundamentally, people want to do the right thing,” CDC Director Dr. Tom Frieden told reporters.
Lower tiers require local officials to exercise judgment in their monitoring, and include U.S. health workers returning from the field in West Africa, or people who were near infected persons but did not have direct contact with them.
Dr. Frieden said roughly 100 people come to the U.S. every day from Liberia, Sierra Leone and Guinea, and that 5 to 6 percent are identified as health care workers.
Those at no risk, the lowest level, would include people who traveled to the affected countries more than 21 days ago.
Dr. Frieden noted that only four people have been diagnosed with Ebola in the U.S. — two people, both nurses in Texas, contracted it here — in the month since a Liberian national brought the viral disease to Dallas.
But, he added, “We’re still far from out of the woods.”
• Maggie Ybarra contributed to this report.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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