Ebola nurse 'made to feel like criminal' on return to US

*        Kaci Hickox tests negative but stays in New Jersey isolation

*        ACLU raises concerns over ‘abuse of police powers’

*        WHO: Ebola cases pass 10,000 mark
<http://News%20World%20news%20Ebola%20Ebola%20cases%20hit%2010,000%20mark> 

*        NY and NJ introduce tough new quarantine measures
<http://www.theguardian.com/us-news/2014/oct/24/ebola-quarantine-new-york-ne
w-jersey-west-africa> 

*        Lauren Gambino <http://www.theguardian.com/profile/lauren-gambino>
in New York 

*         

*        theguardian.com <http://www.theguardian.com/> , Saturday 25 October
2014 16.41 EDT 



NYPD officers ask a man wearing a Halloween costume to move away near the
building where Dr Craig Spencer lives in New York. Photograph: Eduardo
Munoz/Reuters 

A nurse who treated Ebola patients in Sierra Leone has criticized her
treatment under a mandatory 21-day quarantine policy implemented by three US
states
<http://www.theguardian.com/us-news/2014/oct/24/ebola-quarantine-new-york-ne
w-jersey-west-africa> , in an article written in a New Jersey hospital where
she remained in isolation despite testing negative for the virus on
Saturday.

Kaci Hickox was placed in quarantine under a policy announced on Friday by
New Jersey governor Chris Christie and New York governor Andrew Cuomo, which
requires anyone flying into the states after having contact with Ebola
sufferers in west Africa to be subject to mandatory isolation for 21 days,
thought to be the disease’s maximum incubation period. 

The mayor of New York, Bill de Blasio, told reporters on Saturday that Cuomo
had not informed city officials before announcing the new quarantine plans.
He declined to offer an opinion on the new rules, but said the city would
co-operate with them. The Illinois department of public health imposed
similar restrictions.

Cuomo and Christie acted after a New York doctor, Craig Spencer, who worked
with Ebola patients in Guinea, tested positive for the disease
<http://www.theguardian.com/world/2014/oct/24/doctor-tests-positive-for-ebol
a-at-new-york-hospital> . He remained in stable condition at Bellevue
hospital in New York on Saturday. 

As officials sought to allay public concerns about the disease, Barack Obama
used his presidential address to urge Americans to base their response to
domestic Ebola cases on “facts, not fear”.

The restrictions imposed on health workers returning from Africa exposes a
dilemma for authorities who are keen for American experts to help staunch
the disease in Africa but mindful of public concerns at home.

In a first-person account published by the Dallas Morning News
<http://www.dallasnews.com/ebola/headlines/20141025-uta-grad-isolated-at-new
-jersey-hospital-as-part-of-ebola-quarantine.ece> , Hickox had sharp
criticisms of the additional restrictions. She wrote: “This is not a
situation I would wish on anyone, and I am scared for those who will follow
me.”

Hickox, a volunteer nurse with Doctors Without Borders, was stopped at
Newark airport in New Jersey, where she told an immigration official she had
travelled from Sierra Leone. She endured several hours of questioning from
officials wearing protective coveralls, gloves, masks and face shields. Her
temperature was taken, and registered 98F. Then, she said, her temperature
was taken a second time.

“Four hours after I landed at the airport, an official approached me with a
forehead scanner. My cheeks were flushed, I was upset at being held with no
explanation. The scanner recorded my temperature as 101,” she wrote.

Hickox said she was left alone in a room for another three hours before
being taken to the hospital, where her temperature was again recorded. This
time it was 98.6F.

“I sat alone in the isolation tent and thought of many colleagues who will
return home to America and face the same ordeal,” she wrote. “Will they be
made to feel like criminals and prisoners?” 

The New Jersey department of health said Hickox would remain in isolation
for the time being. Speaking on Friday, Christie said the state’s health
department had determined a quarantine order should be issued; it was not
clear on Saturday if it would be issued in New York, where Hickox was
traveling to, or New Jersey, where she is in hospital. Hickox is not from
the area, Christie said.

Civil liberties activists raised concerns about the constitutionality of the
new rules, warning they could discourage health workers from volunteering to
fight Ebola in Africa. 

“We understand the importance of protecting the public from an Ebola
outbreak,” the American Civil Liberties Union said in a statement reported
by the New York Times, adding that the mandatory orders for isolation “raise
serious constitutional concerns about the state abusing its police powers by
detaining people who are exhibiting no Ebola symptoms”.

Aid groups have expressed concerns about the effect of the new rules on a
region where more doctors and nurses are desperately needed to fight a virus
that the World Health Organisation said on Saturday has now infected more
than 10,000 people
<http://www.theguardian.com/world/2014/oct/25/ebola-10000-world-health-organ
isation-who-figures> . Almost 5,000 people, mostly in Guinea, Liberia and
Sierra Leone, have died.

The restrictions imposed by New York, New Jersey and Illinois go beyond
recommendations from the Centers for Disease Control and Prevention (CDC),
the agency managing the federal response to Ebola in the US. The CDC said in
a statement that it “sets the baseline recommended standards, but state and
local officials have the prerogative to tighten the regimen as they see
fit”.

On Friday night Mary Bassett, New York City’s health commissioner, sounded a
cautious note. “People who go and volunteer, we have to look at how the new
quarantine policy would impact them,” she said on Twitter.

Doctors Without Borders, known internationally as Médecins Sans Frontières
(MSF), has warned against a mandatory quarantine on medics returning from
Ebola-stricken countries, saying it would be an “excessive measure”.

The Obama administration is understood to be considering the effectiveness
of imposing a nationwide policy of quarantining health workers returning
from west Africa. Josh Earnest, the White House press secretary, declined to
rule it out during a briefing on Friday.

Tom Skinner, a spokesman for the CDC, told Reuters: “There are a number of
options being discussed pertaining to the monitoring and mobility of
healthcare workers who are returning to the United States from affected
countries.”

Spencer, 33, finished his work in Guinea on 12 October and left the country
on 14 October, flying home to John F Kennedy airport in New York via Europe.
He arrived in New York <http://www.theguardian.com/us-news/new-york>  on 17
October. He checked his temperature twice a day, but despite feeling
fatigued, visited the High Line park on Tuesday, and on Wednesday took a
three-mile jog and went bowling in Brooklyn. As soon as he recorded a fever
on Thursday, he contacted MSF in New York.

Guidelines set out by MSF
<http://www.doctorswithoutborders.org/article/msf-protocols-staff-returning-
ebola-affected-countries> state that returning medics should stay within
four hours of a hospital with isolation facilities, but do not require that
they avoid crowds so long as they do not display symptoms.

“As long as a returned staff member does not experience any symptoms, normal
life can proceed,” the organisation says. “Family, friends, and neighbors
can be assured that a returned staff person who does not present symptoms is
not contagious and does not put them at risk. Self-quarantine is neither
warranted nor recommended when a person is not displaying Ebola-like
symptoms.”

At a Friday press conference, Bassett, the New York health chief, praised
Spencer’s actions in volunteering to help Ebola victims in west Africa and
said he had followed protocols on his return. “There’s this young guy who
went over there, really doing the right thing, the courageous thing, and he
handled himself really well,” Bassett said. “I don’t want anyone portraying
him as reckless.”

De Blasio told the same press conference that American medical professionals
helping to tackle the outbreak in west Africa “are the people who will end
this crisis”. He said: “We have to make sure that that flow of medical
personnel can continue.”

On Saturday, Obama urged calm. “We have to be guided by the science – we
have to be guided by the facts, not fear,” the president said in his weekly
address to the nation.

“Yesterday, New Yorkers showed us the way. They did what they do every day –
jumping on buses, riding the subway, crowding into elevators, heading into
work, gathering in parks. That spirit – that determination to carry on – is
part of what makes New York one of the great cities in the world.

“And that’s the spirit all of us can draw upon, as Americans, as we meet
this challenge together.”

In a conspicuous attempt to allay public fear, on Friday Obama was
photographed hugging Nina Pham, the first of two Texas nurses to recover
from the disease after treating Thomas Eric Duncan, who contracted Ebola in
Liberia and died in Dallas earlier this month. Pham returned home shortly
before midnight on Friday, accompanied by her mother and sister.

Before the latest Ebola case in New York, the CDC had tightened its
monitoring requirements for those arriving in the US from the three west
African countries hardest hit by the outbreak. The new monitoring system
goes into effect on Monday in six states – New York, Pennsylvania, Maryland,
Virginia, New Jersey and Georgia – and will eventually be expanded across
the country.

The new guidelines will require anyone who flies from Liberia, Sierra Leone
or Guinea ­– regardless of whether they are exhibiting symptoms ­– to check
in daily with state and local health officials. They will be required to
report their temperatures and the any appearance of Ebola-like symptoms,
such as severe headaches, fatigue and diarrhoea. They will also be required
to consult with health officials if they need, or want, to travel.

If an affected individual fails to check in, the CDC said health officials
would take immediate action to track the person down and ensure the proper
monitoring is carried out. Concern has been raised over the feasibility of
such proposed action.

                 Thé Mulindwas Communication Group
"With Yoweri Museveni, Ssabassajja and Dr. Kiiza Besigye, Uganda is in
anarchy"
                    Kuungana Mulindwa Mawasiliano Kikundi
"Pamoja na Yoweri Museveni, Ssabassajja na Dk. Kiiza Besigye, Uganda ni
katika machafuko"

 

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