House Panel Questions U.S. Quarantine Procedures

Daily News Article   —   Posted on October 27, 2014

Witnesses are sworn in before the House committee on Friday: from left, Assistant Secretary of Defense Michael Lumpkin, Major General James Lariviere, Homeland Security Inspector General John Roth, Assistant Secretary for Preparedness and Response Nicole Lurie, co-president of National Nurses United Deborah Burger and Rabih Torbay, senior vice president at the International Medical Corps. (Photo: Michael Reynolds)

(by Louise Radnofsky and Siobhan Hughes, The Wall Street Journal)  WASHINGTON — Lawmakers from both parties Friday called for clearly defined protocols for military personnel and aid workers returning to the U.S. after working in Ebola-stricken countries in West Africa, with some saying a 21-day quarantine should be required for anyone who could have been exposed to the disease.

Administration officials said separately they were reviewing Ebola quarantine protocols while reassuring the public that the risk of contracting the virus was still extremely low, a day after a doctor in New York who returned from treating patients in West Africa was diagnosed with the disease.

At a Friday hearing on Capitol Hill, Rep. Michael Turner (R., Ohio) said plans to monitor people at risk of contracting Ebola were inadequate if those people were allowed extensive public contact, including a flight back to the U.S., during a period in which they could be sick. The issue was fueled by the news Thursday night that Craig Spencer, a 33-year-old physician in New York, was found to have the disease, and that he had some public contact soon before he reported being ill.

The newest development “has raised even more questions about the procedures for treating patients and risk to Americans responding with great courage and generosity” to the affected areas, said Rep. Darrell Issa (R., Calif.), who chaired a House Oversight and Government Reform Committee hearing Friday on the U.S. response to the outbreak.

Members of the panel grilled Defense Department officials about procedures to monitor troops who may be returning from the region, expressing concern that military personnel could contract the virus and bring it back to the U.S. Some suggested that a 21-day quarantine may be necessary in such cases.

The back and forth captured a growing debate over the appropriateness of quarantines for people returning from the region. Among the questions is how to balance any benefits of imposing a quarantine of 21 days—the full incubation period of the virus—against any obstacles it would impose on efforts to treat and contain the virus. [WSJ reporters are implying here that medical professionals will not want to treat anyone with Ebola if they will have to be quarantined for 21 days after doing so.] 

At the White House Friday, Press Secretary Josh Earnest said the administration is reviewing U.S. protocols for monitoring and quarantining individuals seeking to travel to the U.S. from one of the three West African countries most affected by the virus. He said the White House is continually reviewing such protocols in response to questions about whether the New York doctor should have been isolated after returning to the U.S.

“These kind of policy decisions are going to be driven by science and by the best advice of our medical experts and by our scientists that have four decades of experience in dealing with Ebola outbreaks in West Africa,” Mr. Earnest said.

Mr. Earnest also sought to calm any fears of Ebola in New York, saying President Barack Obama would feel safe traveling on the subway or visiting the bowling alley Dr. Spencer had patronized shortly before his diagnosis. “The risk that is facing the people of New York and the people of America continues at this point to be exceedingly low, according to our medical experts,” he said.

Separately, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, also said strict quarantine for people exposed to Ebola is under active discussion, noting that it’s not strictly a federal decision. “The states have an awful lot to say about what happens when people come in,” Dr. Fauci told reporters.

Defense officials say that under the current protocols, all U.S. troops are monitored in the region, and checked 12 hours before their departure. Some may also be subject to a period of up to 10 days in a controlled environment before being allowed to depart. In the U.S., they will be monitored for 21 days and required to stay near their base, but their movements aren’t otherwise restricted. Some 686 troops are currently stationed in West Africa, as part of a mission that could involve as many as 4,000.

Other people allowed back into the U.S. but who believe they could be at risk have generally been left to voluntarily restrict their own movements and monitor their symptoms on their return, as appears to have been the case with Dr. Spencer. City, state and federal powers to forcibly quarantine people exist, but haven’t typically been applied.

The officials, Assistant Secretary of Defense Michael Lumpkin and Major General James Lariviere, deputy director of political-military affairs for Africa, said the U.S. is undertaking important work in the region, but that direct care for patients is not part of its mission.

“Our risk is much, much lower,” said Mr. Lumpkin.

Maj. Gen. Lariviere said the military was adhering to protocols from the Centers for Disease Control and Prevention (CDC), as well as its own infectious diseases experts.

Their reassurances were insufficient for lawmakers, who noted that the Liberian patient who died in the U.S. hadn’t been engaged in direct care for patients.

“We’re talking about people who’ve come in direct contact with Ebola patients. Why we wouldn’t hold them for 21 days…I don’t understand,” said Rep. Jason Chaffetz (R., Utah.).

Democratic Rep. Gerry Connolly of Virginia also signaled his willingness to support a 21-day quarantine for people coming in from affected areas.

“Right now, until we know something more about the disease, yes,” Mr. Connolly said in an interview outside the hearing room. “Anyone who comes from the affected areas should be subject to quarantine for 21 days. That’s the incubation period. Our first obligation is protecting the broader public. If that leads to inconvenience for others—a 21-day quarantine, for example—that is a necessary action for the common good.”

Rep. Matt Cartwright (D., Penn.) also asked the military officials at the hearing to consider a 21-day period of quarantining troops before they were allowed to return to the U.S.

Deborah Burger, co-president of the National Nurses United union, said in response to a question from Rep. Jim Cooper (D., Tenn.) that health workers treating Ebola patients should be monitored by a team of other professionals, rather than being left to make their own decisions about their health and movements.

“I think it’s unrealistic to expect that any health-care professional that’s working under extremely stressful situations” to monitor themselves, she said. “You have to remember that they’re humans, you can’t expect them to use their common sense at that point because they’re patients.”

Rabih Torbay, the senior vice president for international operations of International Medical Corps, a nonprofit group caring for Ebola patients in Liberia and Sierra Leone, told lawmakers that his group followed slightly different protocols to quarantine people it believed to be at some risk for the virus, including barring them from traveling on commercial airlines for a full 21 days.

But he also said tougher restrictions for returning volunteers could pose further obstacles for aid groups seeking to recruit health-care workers to treat and contain the outbreak. “Putting people in quarantine goes against our ability to recruit and retain” volunteers to travel to West Africa to try to contain the illness, Mr. Torbay said.

Some members of the committee were unsympathetic.

“What you’ve got in place doesn’t work,” said Rep. John Mica (R., Fla.). “I don’t care if it’s inconvenient…they’re the most exposed.” …..

—Stephanie Armour and Carol E. Lee contributed to this article. Copyright 2014 Dow Jones & Company, Inc. All Rights Reserved. Reprinted here for educational purposes only. May not be reproduced on other websites without permission from The Wall Street Journal. Visit the website at wsj .com