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| Katie Orlinsky for The New York Times |
N.Y. TIMES
The governors of New York and New Jersey on Friday ordered quarantines for all people entering the country through two area airports if they had direct contact with Ebola patients in Guinea, Liberia and Sierra Leone.
The announcement signaled an immediate shift in mood, since public officials had gone to great lengths to ease public anxiety after a New York City doctor received a diagnosis of Ebola on Thursday.
A few hours later, New Jersey health officials said a nurse who had recently worked with Ebola patients in Africa and landed in Newark on Friday had developed a fever and was being placed in isolation at a hospital. The nurse, who was not identified, had been quarantined earlier in the day under the new policy, even before she had symptoms. Officials did not know Friday night whether or not she had the virus.
The new measures go beyond what federal guidelines require and what infectious disease experts recommend. They were also taken without consulting the city’s health department, according to a senior city official |
| A passenger on the No. 1 train, one of three trains that Dr. Craig Spencer, New York City’s first Ebola patient, rode on Wednesday. Credit Todd Heisler/The New York Times |
In New York City, disease investigators continued their search for anyone who had come into contact with the city’s first Ebola patient, Dr. Craig Spencer, since Tuesday morning. Three people who had contact with Dr. Spencer, 33, have been quarantined, and investigators have compiled a detailed accounting of his movements in the days before he was placed in isolation at Bellevue Hospital Center on Thursday.
He remained in stable condition on Friday, and doctors were discussing the use of various experimental treatments. He was able to talk on his cellphone and was even well enough to do yoga in his room, according to friends.
Officials from New York and New Jersey said they were still working out many details, including where people would be quarantined, how the quarantine would be enforced and how they would handle travelers who do not live in either of those states.
The mandatory quarantine for nonsymptomatic travelers will last 21 days, the longest documented period it has taken for an infected person to show symptoms of the disease.
On Friday, the White House sidestepped questions about whether a nationwide quarantine of returning health care workers was being considered. Instead, officials defended the procedures the administration has put in place, including enhanced airport screenings and the monitoring of people arriving from Ebola-afflicted countries.
In New York City, health officials said that initial reports were incorrect when they indicated that Dr. Spencer had a 103-degree fever when he notified the authorities of his ill health. He actually had only a 100.3 fever. Officials attributed the mistake to a transcription error and said the lower temperature made it highly unlikely that he could have spread the disease before going to the hospital. Still, out of caution, they were tracing his contacts back to Tuesday, the day he began feeling fatigued. Dr. Spencer had been working with Doctors Without Borders in Guinea, treating Ebola patients, before leaving Africa on Oct. 14 and returning to New York on Oct. 17.
Much of the public’s concern focused on the movements of Dr. Spencer the night before he reported feeling ill.
On Friday, officials added some new details about those movements. He traveled on the A and L subway lines to Brooklyn, where he went bowling in Williamsburg and took a taxi back to Manhattan on Wednesday evening. He assured officials that he did not have symptoms at the time.
Earlier in the day, he went for a three-mile jog along Riverside Drive. On Tuesday, the day Dr. Spencer first began to feel sluggish, he visited the High Line and ate at the Meatball Shop in the West Village.
Dr. William Schaffner, an infectious disease specialist at Vanderbilt University, said Dr. Spencer probably should have stayed home beginning on Tuesday.
“At that point I would have locked myself in, and I would have started checking my temperature hourly,” he said.
Dr. Schaffner also said he saw no need for an automatic 21-day quarantine or isolation period for people arriving from West Africa, not even health workers. There is no medical reason for it, he said, because people are not contagious until they develop symptoms.
Officials both national and local conspicuously conveyed the idea that the public should not overreact. President Obama was photographed in the Oval Office hugging Nina Pham, the Dallas nurse who was just declared Ebola-free after being in isolation since Oct. 16. Mayor de Blasio rode the subway, to demonstrate that the virus could not be spread through casual contact, like holding a subway pole.
The Ebola virus can be transmitted to other people only through bodily fluids when an infected individual begins to show symptoms. At the onset of illness, the amount of virus in the body is generally low, so the risk of infection is also considered small.
As the disease progresses, the amount of virus in the body multiplies and so does the risk of contagion.
Dr. Spencer’s fiancée, Morgan Dixon, has been quarantined at Bellevue Hospital Center. Officials said she would be allowed to return to the apartment she shared with Dr. Spencer, which has been cleaned, and carry out the rest of her quarantine there.
“There is the pure science and the protocols that must be put in place based on that science, in terms of what we know and what can come from that,” said Dr. Irwin Redlener, the director of the National Center for Disaster Preparedness at Columbia University and a special adviser to Mayor de Blasio. “On the other end of the spectrum, there is the world of abundance of caution. Public officials are constantly trying to find the right balance.”
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| A special locked isolation ward at Bellevue Hospital Center is being used to treat New York’s first Ebola patient. Credit Benjamin Norman for The New York Times |