U.S.
From Governors, a Mix of Hard-Line Acts and Conciliation Over Ebola
FORT KENT, Me. — In Louisiana, Gov. Bobby Jindal, a Republican, issued a stern warning on Thursday to medical experts coming to an international conference on tropical diseases that they should stay away if they had been in Ebola-affected countries in the past 21 days, and that those who defied would be confined to their hotel rooms.
But in New York, Gov. Andrew M. Cuomo, a Democrat, who last week called for mandatory quarantines for health care workers returning from West Africa, sounded a more conciliatory note, joining Mayor Bill de Blasio to announce financial incentives to encourage health professionals to go to West Africa to treat Ebola patients.
And here in Maine, Gov. Paul R. LePage, a Republican, said he was simply trying to enforce federal guidelines when he called for quarantining a nurse who recently returned from Sierra Leone. But the nurse, Kaci Hickox, has called the quarantine unjustified because she had no symptoms of Ebola — and she went on a bike ride Thursday to register her protest.
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As more doctors and nurses return from Ebola-stricken countries in West Africa, public anxiety has soared about the potential for contagion — even though only one person in the United States has died from the virus, and several have recovered or returned from West Africa and never shown symptoms.
In response, governors of both parties are struggling to define public health policies on the virus, leaving a confusing patchwork of rules regarding monitoring, restricting and quarantining health care workers who have treated Ebola patients, whether domestically or abroad.
Over the past week, both liberal and conservative governors have imposed measures that went beyond what the federal Centers for Disease Control and Prevention and many medical experts have said are necessary to prevent the spread of the disease. Some of the toughest policies have been imposed by governors in tight races — such as Connecticut, where a Democratic incumbent was fighting a tough challenge, and Georgia and Florida, where Republicans were.
But there were also governors with wide leads in their races — including Mr. Cuomo in New York, which has one confirmed Ebola case, and Gov. Jerry Brown of California, which has none — who have imposed strong measures. That suggests, political analysts said, that governors from both parties are worried about potential political damage should their states appear unprepared for an outbreak.
“This nurse is making a good case, but if anybody in Maine or anyplace else catches Ebola, they’ll say, ‘Why didn’t the governor do more?’ ” said Maurice Carroll, the director of the polling institute at Quinnipiac University in Connecticut, where Gov. Dannel P. Malloy has confined at least eight people to their homes under mandatory quarantine policies.
“Is it nice to lock people up, put a lady in a tent without a toilet? No,” Mr. Caroll said, referring to how Ms. Hickox was treated in New Jersey after she landed at Newark Liberty International Airport on Friday. “But the alternative is, if something goes wrong, you get blamed. The decisive is what pays off.”
In Maine, Mr. LePage said in a statement that he had been trying to negotiate an agreement with Ms. Hickox, based on C.D.C. guidelines for how to prevent the spread of Ebola. Those guidelines, he said, would allow her to go about in public as long as she maintained a three-foot distance from others, and submitted to health officials to monitor her temperature and any symptoms.
Those negotiations seemed stalemated Thursday night. But Ms. Hickox, too, seemed to be stepping back from her earlier pledge to defy quarantine, emerging from her house with her boyfriend to go for a bike ride taking a trail that led them west, away from the town’s main street.
Mr. LePage said in his statement that he remained open to an agreement, but also that he would “exercise the full extent of his authority allowable by law,” and said Maine law provided the state “robust authority” to address threats to public health.
Ms. Hickox, 33, had been quarantined in a tent in a Newark hospital for four days after registering a fever of 101 on a forehead scanner at the airport Friday, though she had not registered a fever earlier in the day and has not since. She was released to Maine on Monday after her lawyers threatened legal action in discussions with the state attorney general’s office.
Thursday, the American Nursing Association issued a statement in support of Ms. Hickox, saying that she did not require quarantine under C.D.C. guidelines for monitoring by local health authorities because she had shown no symptoms. The association, which along with the American Medical Association and the American Hospital Association supports those guidelines, cautioned that overly restrictive conditions “will only raise the level of fear and misinformation that currently exists.”
Dr. Alan J. Magill, the president of the American Society of Tropical Medicine and Hygiene, said the move by Louisiana to block doctors who had treated Ebola patients from its conference this weekend would harm crucial sessions where scientists, doctors and administrators who had been in the region were going to teach others.
So far, 10 to 15 participants had scrapped their trips, he said.
“We are clearly going to lose some of our speakers who have had the most experience, and that would deprive the learning from going forward,” said Dr. Magill, also the director for the Global Health Program at the Bill & Melinda Gates Foundation.
The letter from Louisiana officials to conference participants stated that the measures were being taken “out of an abundance of caution.” Governor Jindal earlier urged an outright travel ban and accused the Obama administration of “malpractice” in its handling of the Ebola situation.
California officials said that travelers who had contact with Ebola patients in the three countries stricken by the virus in West Africa — Sierra Leone, Liberia and Guinea — would be evaluated by county health officials and issued orders outlining their activities and monitoring for 21 days. All orders will be legally binding.
“The governor has said publicly about this issue that he is not inclined to make any political decisions about something as serious and dangerous as Ebola,” said Diana S. Dooley, the secretary of the California Health and Human Services Agency. “He wants this to be science-driven to protect the public, protect workers and to respect those health professionals that are going to Africa to fight this disease.”
Mr. Cuomo had taken among the toughest stances when he appeared last week with Gov. Chris Christie of New Jersey, a Republican, to announce mandatory quarantines — for which Ms. Hickox was the first test case. He backed off a few days later, saying that he had always intended for people to be quarantined at home, not in hospitals.
Thursday, he was taking pains to show that he did not want to deter health workers from going to West Africa to treat Ebola patients, announcing plans to offer financial incentives for such work.
“The depth of the challenge we face in containing Ebola requires us to meet this test in a comprehensive manner on multiple fronts, and part of that is encouraging and incentivizing medical personnel to go to West Africa,” the governor said in a statement.
The military, too, was trying to explain its Ebola policy, announced Monday, which is significantly tougher than the C.D.C.’s guidelines, requiring that all troops returning from West Africa be isolated on bases and not allowed to see their families for 21 days. Gen. Martin E. Dempsey, the chairman of the Joint Chiefs of Staff, noted Thursday that American troops would be in West Africa for longer than the typical civilian health care worker, and in greater numbers.
“We did factor in science,” General Dempsey told reporters. “Physics is the science we factored in.”
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