In a letter to governors of all 50 U.S. states, prominent leaders in the field of infectious disease and public health write to express their concern over decisions by Governor Chris Christie (NJ) and Governor Andrew Cuomo (NY), as well as other states following their lead, to impose a mandatory 21-day quarantine on all health care workers returning from West African countries where they were responding to an outbreak of Ebola. These six experts urge all governors to adopt procedures that are consistent with public health and human rights standards, and end policies that ultimately serve to spread misinformation and stigmatize health workers returning from affected countries.
The full letter can be read below.
October 29, 2014
Dear U.S. Governors,
We write to express our concern over decisions by Governor Chris Christie (NJ) and Governor Andrew Cuomo (NY), as well as other states following their lead, to impose a mandatory 21-day quarantine on all health care workers returning from West African countries where they were responding to an outbreak of Ebola. We urge all governors to adopt policies that are consistent with public health and human rights standards. To do otherwise contributes to misinformation and stigmatizes health workers returning from West Africa who worked in Ebola treatment centers.
This imposition of mandatory quarantines contradicts scientific and epidemiological evidence on the virus and its transmission, as well as internationally agreed human rights standards for responding to such a crisis. First, it ignores well-established information on how the Ebola virus is spread; second, it reinforces misperceptions about Ebola; and, third, it violates human rights standards dictating when and how quarantines may be imposed in public health situations.
These policies also effectively punish the much-needed volunteer health professionals who are using their expertise to address what is undeniably a crisis in West Africa. It also discriminates against and stigmatizes health professionals who have worked internationally. Such policies are indefensible, and have the potential to deter qualified health workers from volunteering to travel to the region to help treat the sick and prevent further cases of the disease. If much needed resources, including health professionals, do not help bring the outbreak under control in West Africa, the virus is far more likely to spread, including to the United States.
We learned the hard way with HIV/AIDS that misinformation – particularly when disseminated by government officials through laws, policies, and practices – can undermine people’s faith in both the health care system and the government. Instead of imposing policies that pander to the panic and ill-informed fear mongers, the U.S. government, at every level, should be working in a coordinated manner to ensure that there is a strong public education campaign about Ebola.
Furthermore, states should implement systems and adopt protocols reflecting the recommendations outlined in the “Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure,” issued by the U.S. Centers for Disease
Control and Prevention. Public health specialists have been working with Ebola outbreaks since 1976 and are well aware of how to manage the virus at an individual and community level. To disregard decades of experience and feed into the panic just because the virus has crossed the Atlantic is counterproductive and undermines best practices.
Again, we urge that all currently imposed quarantines be lifted and that no new quarantines be authorized.
Deborah D. Ascheim, MD
Board Chair, Physicians for Human Rights, New York, New York
Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York
James W. Curran, MD, MPH
Dean of Public Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
Linda P. Fried, MD, MPH
Dean, Mailman School of Public Health, Senior Vice President, Columbia University Medical Center, DeLamar Professor of Public Health, Professor of Epidemiology and Medicine, New York, New York
Michael J. Klag, MD, MPH
Dean, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Professor Peter Piot, CMG, MD, PhD, DTM, FRCP, FMedSci
Director, London School of Hygiene & Tropical Medicine,
Former Executive Director, UNAIDS, London, United Kingdom
Paul Volberding, MD
Director of University of California, San Francisco AIDS Research Institute,
Director of Research for University of California, San Francisco Global Health Sciences, San Francisco, California
Karen DeSalvo, MD, MPH, MSc, Acting Assistant Secretary for Health in the U.S. Department of Health and Human Services
Tom Frieden, MD, MPH, Director, Centers for Disease Control and Prevention
Lisa Monaco, Assistant to the President for Homeland Security and Counterterrorism
Susan Rice, National Security Advisor
*Please send any responses or inquiries to Susannah Sirkin, director of international policy and partnerships at Physicians for Human Rights, at email@example.com.