The Centers for Disease Control and Prevention issued new, tweaked guidelines for how states should handle travelers from Ebola-affected countries, but said measures taken by states such as New York and New Jersey go too far.
The new guidelines separate travelers into four categories of risk, from high to low, but none suggest people should be kept forcibly quarantined unless they try to evade monitoring. Instead, those at highest risk should stay close to home and keep off public transport, and allow state or local health officials to check on them daily to make sure they are well.
“We are concerned about some policies that we have seen … that might have the effect of increasing stigma or creating false impressions,” CDC director Dr. Thomas Frieden told reporters. “It’s not nearly as contagious as the flu, the common cold, measles or any other infectious diseases.”
Frieden said he understood fears that someone might spread infection, but said it’s unlikely, especially health care workers recently returned from fighting Ebola in West Africa. “Health care workers, of all people, understand that if they develop Ebola, the sooner they get care, the more likely they are to survive, and the sooner they are isolated the less likely they are to infect their family members,” he told reporters.
As Frieden spoke, a hospital in New Jersey reported that nurse Kaci Hickox had been allowed to leave for her home in Maine after a contentious weekend kept in an isolation tent on the hospital campus.
The new guidelines allow for judgment calls. People at high or moderate risk should consult with the health official assigned to monitor them. “If they’re planning to stay at home that’s one thing,” Frieden said. “If they are planning other activities there will be an individualized assessment of what makes sense for that individual at that time.”
Jogging in a park is fine; riding on a crowded bus isn’t. People can even travel but they have to be sure they don’t risk exposing others and that they can be monitored so they can be safely whisked into isolation and treatment if they do develop symptoms.
“I understand that people are afraid. Ebola is unfamiliar. It is a severe disease. But it is not highly contagious and it requires direct contact with someone who is sick from Ebola or with their body fluids,” Frieden said.
Frieden said fewer than 100 people a day had been returning from Ebola-affected countries since new guidelines went into effect Oct. 11. Of the 807 people who entered the U.S. since then, 46 have been identified as health care workers.
The new categories:
High-risk - Includes people with very risky exposures such as nurses stuck with a needle that had been used on an Ebola patient or doctors splashed in the face with infectious bodily fluids. These people should have direct, active, daily monitoring and stay away from public areas and public transport.
Some risk - People in close contact with a patient without protective gear. These people should be monitored and common sense should be used in restricting movement.
Low risk - Travelers to an affected country or people who were near a patient but didn't care for him while he has symptoms or caregivers who wore protective gear. They should be monitored for symptoms but not restricted in any way.
No risk - People in contact with a patient before she showed symptoms or who traveled to an affected country more than 21 days ago. There is no need to monitor these people at all.
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— Maggie Fox