NEW YORK – The governors of New Jersey and New York said Friday they are ordering a mandatory, 21-day quarantine for all doctors and other travelers who have had contact with Ebola victims in West Africa.
The move came after a New York City doctor who returned to the U.S. a week ago from treating Ebola victims in Guinea was diagnosed with the lethal disease.
Many New Yorkers and others were dismayed to learn that in the week before he was hospitalized, Dr. Craig Spencer rode the subway, took a cab, went bowling, visited a coffee shop and ate at a restaurant.
New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo said the case forced them to conclude that the two states need guidelines more rigorous than those of the U.S. Centers for Disease Control and Prevention, which recommends voluntary quarantines.
"It's too serious a situation to leave it to the honor system of compliance," Cuomo said.
Spencer's illness led lawmakers on Capitol Hill, scientists and ordinary New Yorkers to wonder why he was out on the town after his return from West Africa — and why stronger steps weren't being taken to quarantine medical workers.
Health officials said he followed U.S. and international protocols in checking his temperature every day and watching for symptoms, and put no one at risk. But others said he should have been quarantined — that is, kept away from others, either voluntarily or by the government — during Ebola's 21-day incubation period.
An automatic three-week quarantine makes sense for anyone "with a clear exposure" to Ebola, said Dr. Richard Wenzel, a Virginia Commonwealth University scientist who formerly led the International Society for Infectious Diseases.
Doctors Without Borders, the group Spencer was working for, said in a statement that that would be going too far. People with Ebola aren't contagious until symptoms begin, and even then it requires close contact with body fluids.
"As long as a returned staff member does not experience any symptoms, normal life can proceed," the organization said in a statement.
Aid organizations also warned that many health care volunteers wouldn't go to Ebola hot zones if they knew they would be confined to their homes for three weeks after they got back.
On the streets of New York, Michael Anderson was critical of the U.S. government and Spencer.
"He's stupid, a complete idiot" for moving about in public, the longtime Manhattan resident said at Grand Central Station. "It's his responsibility when you come back from Africa" not to put people at risk, he said.
In other developments:
— One of the two Dallas nurses who caught Ebola from a patient was declared virus-free and released from a hospital in Bethesda, Maryland. Nina Pham, 26, said she felt "fortunate and blessed to be standing here today." She later met with President Barack Obama at the White House. The other nurse, Amber Vinson, is in an Atlanta hospital, where she was said to "making good progress."
— Millions of doses of two experimental Ebola vaccines could be ready for use in 2015, and five more experimental vaccines will start being tested in March, the World Health Organization said.
— In Mali, which reported its first case this week, authorities warned that many people are in danger because the toddler who brought the disease to the country was bleeding from her nose as she traveled on a bus from Guinea.
Nearly 4,900 people have died in the Ebola outbreak, most of them in Guinea, Liberia and Sierra Leone.
Spencer, a 33-year-old emergency room doctor, returned from Guinea on Oct. 17 and sought treatment Thursday after suffering diarrhea and a 100.3-degree fever. He was listed in stable condition at a special isolation unit at Bellevue Hospital Center, and a decontamination company was sent to his Harlem home. His fiancee, who was not showing symptoms, was being watched in a quarantine ward at Bellevue.
The idea of broader quarantine is a topic "actively being discussed. It's going to be something that will be discussed at federal level," said Dr. Mary Bassett, New York City's health commissioner.
Lawmakers from both parties criticized the federal government's Ebola response.
Rep. Stephen Lynch, D-Mass., said anyone coming from West Africa should be quarantined for 21 days abroad before even boarding a plane to this country.
"This can't just be about ideology and happy talk," Lynch said. "We need to be very deliberate, take it much more seriously than I'm hearing today."
The World Health Organization is not recommending the quarantine of returning aid workers without symptoms, according to spokeswoman Sona Bari.
"Health care workers are generally self-monitoring and are aware of the need to report any symptoms, as this patient did," she wrote in an email.
Bruce Johnson, president of SIM USA, a Christian organization based in North Carolina, said its staffers are told to follow guidelines established by the federal Centers for Disease Control and Prevention for their first 21 days in the U.S. Beyond that, he said, they are told to avoid crowded public areas.
Johnson said his staff members would not be deterred from serving in Ebola-stricken countries if they were required to remain isolated in their homes for 21 days upon their return. But such measures could discourage volunteers, he said.
Nurses, doctors and others who hold down regular jobs back home would say, "I want to go over and help for a month, but now you're telling me that when I get back I can't go to work for 21 days?" Johnson said. "Yes, I think that will dampen the generous spirit of people in the U.S. who want to go help."
Johnson was echoed by Dr. Rick Sacra, a Massachusetts physician who was infected with Ebola while doing medical aid work in Liberia. He was evacuated to a specialized treatment center in Nebraska, recovered and was released last month.
"A three-week complete quarantine would eliminate two-thirds to three-quarters of the volunteers from the U.S." going to West Africa, he said. "They wouldn't be able to spare the time."
Samaritan's Purse, a Christian relief organization based in North Carolina, said that its returning aid workers spend three weeks quarantined in a "safe house," where their temperatures are monitored.
They can go out for things like a walk in the park or a visit to the drive-thru of a fast-food restaurant, but are asked to stay away from crowds and are isolated from their families, said Franklin Graham, president of the organization.
Graham said the federal government should rent out a hotel — perhaps one in the Caribbean, to ease public fears — and then staff it with doctors and quarantine all returning health care workers there for three weeks.
"They can sit by the pool and eat hamburgers," Graham said. "I would call it a country club quarantine and let them just relax and cool their heels. ... It's an inconvenience, but it is not a hardship."