- The Washington Times - Monday, November 3, 2014

The holiday season could present a major problem for the fight against Ebola, as states and aid workers try to figure out how — or even whether — American doctors and nurses treating patients in West Africa will be able to come home for Christmas.

Even as the White House tries to recruit medics to fight the disease in Ebola hot zones, the fight over their eventual return to the U.S. is roiling.

A Maine nurse who worked with patients in Sierra Leone told Gov. Paul LePage that she would not stay indoors while she remains symptom-free, and aid workers say a hodgepodge of quarantine rules makes it difficult to determine whether a worker can return to the U.S. without being stuck for three weeks.

“Logistically, it really hurts us, because we’re trying to move our teams into and out of West Africa,” said Gavin Macgregor-Skinner, a Penn State University professor who manages Ebola response efforts for the Elizabeth R. Griffin Research Foundation.

“People want to go out there for two or three weeks and come back for New Year’s and Christmas for a week,” he said. “They don’t want to come back for 21 days.”

Workers returning from difficult conditions in Liberia, Sierra Leone and Guinea say some U.S. states’ measures designed to protect public health lack scientific merit, violate their liberties and unreasonably extend their sacrifices in the fight against a virus that has killed nearly 5,000 in West Africa.

President Obama said last week that health care workers fighting Ebola abroad should be hailed as heroes and not inconvenienced at home — an implicit rebuke to states with strict isolation measures. In White House speeches, he said the fight in West Africa is paramount to protecting Americans at home.

In response, New Jersey Gov. Chris Christie, who established one of the stricter policies, said Wednesday that he doesn’t need “seven-minute lectures from the South Lawn.”

Lawrence O. Gostin, a global health law professor at Georgetown University, said he thinks workers should be able to go back to the affected region if they do not pose risks to fellow travelers.

“Going back would mean getting on a crowded plane, but if there were screening for fever and symptoms, it appears to me that this is well within reason,” he said. “The problem is that political actors always haven’t behaved reasonably. But if we don’t allow respite for health workers, we are digging ourselves in deeper by discouraging the dedicated volunteers that we urgently need.”

Governors have been swift to commend health care workers fighting Ebola, but a fearful public is an influential counterweight and has shaped their policymaking.

Maine officials lost their court battle with nurse Kaci Hickox, who refused to stay in her home until Nov. 10. But states do possess wide latitude to impose quarantines under policing powers. As a result, legal scholars say, nuance may have to suffer.

“Quarantines are inherently overbroad. People might miss kids’ birthday parties, weddings, the last Rolling Stones tour,” said Eugene Kontorovich, a law professor at Northwestern University. “They might also miss a flight out of the jurisdiction. It seems hard to work around that, without potentially exposing people at the airport on the return leg.”

Under new guidelines from the Centers for Disease Control and Prevention, a person in a “high-risk” or “some-risk” category would be unable to get back onto a plane to travel to West Africa, but someone in a low-risk category who helped the effort in West Africa without treating patients could be cleared for travel.

Aid workers are quick to note that Ebola is not taking a holiday, so they will not be resting from fighting the viral disease at its source.

As a practical matter, it is unclear how many people would be caught up in quarantine.

Flights to and from West Africa are infrequent and pricey, so some American aid workers could not return within three weeks, said Jim Walker, a retired Marine brigadier general and deputy director of Samaritan’s Purse, which has 17 field staffers, most of them Americans, in West Africa.

Even so, he said, “we would not bring anyone back to the U.S. because we think in some way or form they would be caught up in the 21 days” of quarantine.

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