NEW YORK // The nurse who was quarantined at a New Jersey hospital because she had contact with Ebola patients in West Africa criticised the way her case was handled, raising concerns from humanitarian and human rights groups over unclear policies for the newly launched quarantine programme.
Kaci Hickox, the first traveller quarantined under Ebola watches in New Jersey and New York, wrote a first-person account of her ordeal for the Dallas Morning News, which was posted on its website on Saturday.
Ms Hickox is a nurse who had been working with Doctors Without Borders in Sierra Leone. Her preliminary tests for Ebola came back negative.
“This is not a situation I would wish on anyone, and I am scared for those who will follow me,” Ms Hickox wrote. “I am scared about how health-care workers will be treated at airports when they declare that they have been fighting Ebola in West Africa. I am scared that, like me, they will arrive and see a frenzy of disorganisation, fear and, most frightening, quarantine ... The US must treat returning health-care workers with dignity and humanity.”
New York governor Andrew Cuomo and New Jersey governor Chris Christie on Friday imposed a mandatory quarantine of 21 days – the incubation period of the deadly virus – on travellers who have had contact with Ebola patients in Liberia, Guinea and Sierra Leone.
A similar measure was announced in Illinois, where officials say such travellers could be quarantined at home.
The hazy details of how such quarantines will be handled are drawing sharp criticism as infectious disease experts say enforcement logistics are unclear. Health officials in all three states with quarantine policies did not return messages seeking details about enforcement.
Mr Cuomo on Saturday acknowledged that the policy might be hard to enforce.
The governor said officials had never considered whether people refusing to go along with the order could face prosecution or arrest, adding: “It’s nothing that we’ve discussed, no.”
In her essay, Ms Hickox described being stopped at Newark Liberty International and questioned over several hours after touching down on Friday. She said none of those who questioned her would explain what was going on.
Officials said she was taken to a hospital after developing a fever, but Ms Hickox said she was merely “flushed and upset” by the process.
Doctors Without Borders executive director Sophie Delaunay complained about the “notable lack of clarity” from officials about the quarantine policies, and an American Civil Liberties Union (ACLU) official said the state must provide more information on how it determined that mandatory quarantines were necessary.
“Coercive measures like mandatory quarantine of people exhibiting no symptoms of Ebola and when not medically necessary raise serious constitutional concerns about the state abusing its powers,” said Udi Ofer, executive director of the ACLU of New Jersey.
Doctors Without Borders said Ms Hickox has not been issued an order of quarantine specifying how long she must be isolated and is being kept in an unheated tent. It urged the “fair and reasonable treatment” of health workers fighting the Ebola outbreak.
Mr Christie said he sympathises with Ms Hickox but said he also needs to ensure public health safety.
“My heart goes out to her,” the governor said, while also noting that state and local health officials would make sure quarantine rules are enforced. Preliminary tests for Ebola came back negative for Ms Hickox but Newark University Hospital would not say if she would be released for the remainder of the quarantine period or remain in the hospital.
In the very early stages of Ebola, patients may still test negative because the virus has not yet reached detectable levels in the blood. The US Centres for Disease Control and Prevention says it may take up to three days after the onset of symptoms for the virus to reach detectable levels in some patients, prompting repeat testing in some cases.
Ms Hickox’s mother, Karen Hickox, said her daughter was probably not expecting to be quarantined upon her return to the United States, but is dealing with it.
“She was more frustrated [on Friday] but there were some tears [on Saturday],” she said. “If you knew her, she’s a very compassionate person but she doesn’t usually get emotional.”
The quarantine measures were announced after a New York physician, Craig Spencer, working for Doctors Without Borders returned from Guinea and was admitted to Manhattan’s Bellevue Hospital Centre earlier this week to be treated for Ebola.
Dr Irwin Redlener, director of the National Centre for Disaster Preparedness, said the logistics of the states’ new quarantine policy are “a problem”.
“The challenge now is how you translate this quarantine plan to operational protocol,” Dr Redlener said.
He warned that quarantines might discourage doctors and nurses from going to West Africa to help, an issue raised by aid groups.
* Associated Press