CDC moves to prevent state travel restrictions

NEW YORK – Amid growing controversy over whether or not to quarantine travelers from Ebola-stricken West African nations, the Centers for Disease Control and Prevention announced Monday a set of new procedures that appeared aimed at preventing state health officials from repeating the steps New York Gov. Andrew Cuomo took over the weekend in concert with New Jersey Gov. Chris Christie.

Clearly, the unmentioned background of the CDC new “active monitoring” procedures was the case of forcibly quarantined nurse Kaci Hickox.

Hickox was released from hospital quarantine Monday after protesting publicly her civil rights had been violated when Cuomo and Christie put her in mandatory hospital quarantine despite returning without fever from treating Ebola patients in West Africa.

She objected to being quarantined simply because Dr. Craig Spencer, a physician who treated Ebola patients in Guinea with Doctors Without Borders, has now been hospitalized with the virus after passing airport health screening on his return Oct. 17 to the U.S.

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'Active health monitoring'

The CDC's new procedures sought to toughen the “honor system” of self-monitoring and reporting of temperature and symptoms required for travelers from the three West African nations who enter the U.S. at five gateway U.S. airports.

Now, under “active health monitoring," the CDC is requiring state and local officials to contact daily for 21 days any health workers who arrive in the U.S. after working in the Ebola-affected West African countries.

CDC Director Dr. Thomas Frieden explained that by "direct, active monitoring," his agency means "that someone accountable to the state health department is in direct touch with ‘at risk’ persons, observing their temperature being taken and having a conversation with the individual on a daily basis to determine how they are feeling and to go through a detailed list of symptoms to see if they have anything as vague as fatigue that might be of concern."

“We expect in the ‘direct, active monitoring,’ the state health department will also inquire about travel plans,” Frieden continued. “If the person plans to stay at home, that’s one thing. If the person plans to travel the state, health officials would have to make an individualized assessment of what makes sense for that individual at that time.”

In addition, the CDC recommended state and local public health authorities should determine on a case-by-case basis whether or not additional restrictions should be required for “at risk” cases, such as controlled movement or workplace exclusions.

The CDC explained “at risk” individuals include health care workers who are providing direct care to Ebola patients in West Africa and observers who enter a treatment area where Ebola patients are being cared for.

The CDC failed to specify precisely how state and local health officials would stay in active daily contact monitoring travelers considered “at risk" or what consequences would occur if a traveler simply dropped out of the reporting and monitoring system altogether.

'Heroes,' not health risks

In announcing the new guidelines, Frieden took pains to refer to U.S. health care workers returning from treating Ebola patients as “heroes,” reflecting the political criticism leveled against Cuomo and Christie. The governors suggested over the weekend that mandatory quarantines could be applied to U.S. citizens, including health care workers, returning from affected West African countries.

“Returning health care workers should be treated with dignity and respect,” a CDC press release said.

The CDC press release continued: “They, along with our civilian and military personnel in the region, are working tirelessly on the frontlines against Ebola, and their success is what ultimately will enable us to eliminate the threat of additional domestic Ebola cases. We must not prevent or unduly discourage them from undertaking this indispensable and selfless work.”

As WND reported, the CDC developed a “CARE Kit” to assist international passengers from West Africa that pass initial airport entry screening and are not detained for hospital examination or quarantine.

Under the honor system, travelers from West Africa are required to self-monitor daily by recording their temperature and reporting to state public health officials any changes in their symptom status. They also must report any changes in location or travel plans for the 21 days after arrival in the U.S.

The CDC announced Monday that New York, Pennsylvania, Maryland, Virginia, New Jersey and Georgia, where approximately 70 percent of incoming travelers are headed, will start active monitoring Monday, with the remainder of the states starting in the days following.

The CDC carefully emphasized, “This daily health consultation will give additional confidence to the community that a returning health care worker is asymptomatic and therefore not contagious.”

'Some risk cases'

The CDC distinguished as “some risk cases” U.S. health care workers providing care for Ebola patients in U.S. hospitals.

“There are important differences between providing care or performing public health tasks in Africa versus in a U.S. hospital,” the CDC press release noted.

“A U.S. hospital provides a more controlled setting than a field hospital in West Africa. A U.S. health-care worker would be able to anticipate most procedures that would put them at risk of exposure and wear additional personal protective equipment as recommended. In some places in Africa, the same may not be true, and workers may not have the ability to prepare for potential exposures.”