Top Obama administration officials publicly warned Sunday that mandatory quarantines in the U.S. of doctors, nurses and other healthcare workers who have traveled to Africa to help Ebola patients risked worsening the epidemic.
Mandatory 21-day quarantines, now in place in New York, New Jersey and Illinois, are "a little bit draconian" and could discourage people from helping to fight the disease, Dr. Anthony Fauci, the top Ebola expert at the National Institutes of Health, said in several television interviews Sunday.
Fauci's public remarks came as the administration privately pushed states to reconsider.
New York Gov. Andrew Cuomo defended the quarantine policy during a Sunday night news conference, but outlined a version that appeared less onerous than the treatment that has been accorded so far to the one person in quarantine, in New Jersey. Cuomo and New Jersey Gov. Chris Christie had ordered the quarantine policy Friday but had left details unclear.
"My personal practice is to err on the side of caution," Cuomo said. Healthcare workers returning to New York who were exposed to Ebola patients in West Africa would be required to stay home for three weeks, he said. The state would work with hospitals to encourage doctors and nurses to travel to Africa to fight the disease and, if necessary, would pay the salaries of healthcare workers while they were in quarantine, he added.
The three states with quarantine orders are among five with airports used by travelers arriving from West Africa. The other two states, Georgia and Virginia, have not taken similar action. Florida has ordered enhanced monitoring of people in contact with Ebola patients, but not a quarantine.
The federal government could soon propose new rules for dealing with returning healthcare workers that would not involve quarantines, a senior administration official said.
As controversy grew over how to handle healthcare workers, the nurse who was the first person subjected to quarantine called her treatment in New Jersey "inhumane." New York Mayor Bill de Blasio said the nurse had been mistreated.
Kaci Hickox, a nurse and epidemiologist for Doctors Without Borders, returned from Sierra Leone on Friday and was detained at Newark International Airport. She has been held since then in what she described to CNN's Candy Crowley as a "tent structure" outside University Hospital in Newark, N.J., with a port-a-potty and no shower.
"I feel physically completely strong and emotionally completely exhausted," she said, noting that she has no fever or any other symptom of the disease. "This is an extreme that is really unacceptable, and I feel like my basic human rights have been violated."
Doctors Without Borders said the tent was not heated, "and she is dressed in uncomfortable paper scrubs."
Hickox's lawyer, Norman Siegel, a former New York Civil Liberties Union executive director, said he would go to court to seek her release.
De Blasio likened her to a "hero, coming back from the front" -- a word also used by Fauci and other administration officials. De Blasio said Hickox had been "treated with disrespect, was treated as if she has done something wrong, which she hasn't."
The mayor made his comments at a midafternoon news conference at Bellevue Hospital in Manhattan, where Ebola patient Dr. Craig Spencer is being treated. A spokesman for the hospital said the doctor was in "serious, but stable condition" and "looking a little bit better than he looked yesterday." De Blasio also appeared with Cuomo Sunday night.
Earlier in the day, Christie defended the quarantine policy that he and Cuomo had ordered after Spencer's diagnosis.
"I don't believe that when you're dealing with something as serious as this that we can count on a voluntary system," Christie told "Fox News Sunday." "This is government's job. If anything else, the government's job is to protect the safety and health of our citizens."
After criticism of the nurse's treatment, Christie's office released a statement late Sunday that did not mention Hickox, who has a home in Maine.
"New Jersey is not changing its quarantine protocol. The protocol is clear that a New Jersey resident with no symptoms, but who has come into contact with someone with Ebola, such as a healthcare provider, would be subject to a mandatory quarantine order and quarantined at home," the statement said. "Nonresidents would be transported to their homes if feasible and, if not, quarantined in New Jersey."
The quarantine order from Cuomo and Christie requires 21-day confinement for anyone who has come into contact with Ebola patients in Sierra Leone, Guinea or Liberia, the three countries hardest hit by the epidemic.
They announced the move after Spencer, who had treated Ebola patients in Guinea, came down with the virus. Spencer had visited several places in the city, including a restaurant and a bowling alley, before developing a fever and contacting health officials on Thursday. Health officials have stressed that he was not contagious before developing symptoms.
Shortly after Christie and Cuomo acted, Illinois Gov. Pat Quinn issued a similar quarantine order. "This protective measure is too important to be voluntary," Quinn said. "We will continue to take every safeguard necessary to protect first responders, healthcare workers and the people of Illinois."
Fauci, the director of the National Institute of Allergy and Infectious Diseases, said that the public could be protected without going as far as a quarantine and that ordering people confined for an extended period could result in "unintended consequences."
"Let's not forget the best way to stop this epidemic and protect America is to stop it in Africa," he said on ABC's "This Week." "And you can really help [stop] it in Africa if we have our people, our heroes, the healthcare workers, go there and help us to protect America."
A senior administration official, speaking anonymously in accordance with White House policy, said Sunday that the administration was working on new guidelines for returning healthcare workers. Administration officials had let Cuomo, Christie and other governors "know that we have concerns with the unintended consequences of policies not grounded in science may have on efforts to combat Ebola at its source in West Africa," the official said.
New rules for healthcare workers returning from Africa could include mandatory temperature check-ins twice a day or daily visits from public health workers, Fauci said on NBC's "Meet the Press."
Samantha Power, the U.S. ambassador to the United Nations, who is on a fact-finding mission to West Africa, similarly warned against measures that might discourage healthcare workers from volunteering to fight the epidemic, which has killed nearly 5,000 people in Africa.
"We have to find the right balance between addressing the legitimate fears that people have and encouraging and incentivizing these heroes," she said in an interview on NBC after landing in Guinea.
"We need to find a way when they come home that they are treated like conquering heroes and not stigmatized for the tremendous work that they've done."