New Jersey officials made a clumsy and insensitive mistake over the weekend when they confined a nurse returning home from West Africa to a tent behind a hospital, while also claiming she had a fever when she did not.
After defending the action for two days, announcing that she would be allowed to go home to Maine.
But New Jersey still has a quarantine policy in place that goes well beyond what federal health officials have said is necessary.
So do New York and Illinois, although the specifics of each policy seem to have changed since the initial announcements.
New York now expects those who have had contact with Ebola patients in Africa to remain at home, although they can be seen by family and friends.
Meanwhile, other states, including Virginia and Maryland, have stepped up programs to monitor those returning from Ebola-stricken countries, with possible quarantine as a last resort.
States have public health responsibilities, so it’s natural for them to respond to the Ebola threat. But confining people who don’t show symptoms and therefore are not contagious could be counterproductive if it deters medical workers from volunteering to join the critical effort in West Africa. It is also scientifically excessive, as The New England Journal of Medicine explained Monday.
“We now know that fever precedes the contagious stage, allowing workers who are unknowingly infected to identify themselves before they become a threat to their community. … This point is supported by the fact that of the nurses caring for Thomas Eric Duncan, the man who died from Ebola virus disease in Texas in October, only those who cared for him at the end of his life, when the number of virions he was shedding was likely to be very high, became infected,” .
That said, state policies to monitor citizens returning from West Africa more closely, rather than rely on self-assessments, do make sense. The federal government must think so, too, since it belatedly weighed in Monday with a new set of monitoring guidelines of its own.
The Centers for Disease Control and Prevention now recommends that those who had direct contact with Ebola patients be contacted twice a day, once in person. That’s similar to what a few states
Maryland will also order those being monitored to avoid mass gatherings and mass transit, although that requirement is probably not strictly necessary.
Dr. Craig Spencer, the doctor who was hospitalized Thursday with a fever after returning from West Africa, had traveled about New York City on the subway, gone bowling and eaten in a sandwich shop. Health officials were able to track his movements, but if such cases become more common, it will be a logistical nightmare to keep track of their contacts. They should be asked to minimize such outings even if they are free of symptoms in order to prevent public concern if they later come down with the disease.
But actual quarantines in which health care workers who return from the noble work of battling Ebola in Africa are confined for three weeks to their homes are something else again. Such policy, however popular with a portion of the public, would amount to punitive overreaction that is not justified by medical science.
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