Ebola case in New York brings demands for quarantining doctors

Doctor Craig Spencer is a member of Doctors Without Borders

NEW YORK -- The case of the U.S. doctor stricken with Ebola left lawmakers, scientists and ordinary New Yorkers wondering why he was out on the town after his return from West Africa -- and why stronger steps aren't being taken to quarantine medical workers.

Dr. Craig Spencer rode New York's subway, took a cab, went bowling, visited a coffee shop and ate at a restaurant in the week after returning from Guinea, where he had been treating Ebola victims. Nearly 4,900 people have died from the Ebola outbreak, most of them in Guinea, Liberia and Sierra Leone.

Health officials said Spencer followed U.S. and international protocols in checking his temperature every day and watching for symptoms, and put no one at risk. But others said he should have been quarantined -- voluntarily or by the government -- during Ebola's 21-day incubation period.

Doctors Without Borders, the group Spencer was working for, said in a statement that that would be going too far. People with Ebola aren't contagious until symptoms begin, and even then it requires close contact with body fluids.

"As long as a returned staff member does not experience any symptoms, normal life can proceed," the organization said in a statement.

But even some prominent scientists disagreed.

A three-week quarantine makes sense for anyone "with a clear exposure" to Ebola, said Dr. Richard Wenzel, a Virginia Commonwealth University scientist who formerly led the International Society for Infectious Diseases.

Some health workers could "have a kind of denial there are any exposures," and an automatic quarantine would address that, Wenzel said.

At the same time, he conceded health workers might be leery of volunteering if they knew they would be confined to their homes for three weeks after they got back.

On the streets of New York, Michael Anderson was critical of the government and Spencer.

"He's stupid, a complete idiot" for moving about in public, the longtime Manhattan resident said at Grand Central Station. "It's his responsibility when you come back from Africa" not to put people at risk, he said.

In other developments:

Spencer, a 33-year-old emergency room doctor, returned from Guinea on Oct. 17 and sought treatment Thursday after suffering diarrhea and a 100.3-degree fever. He was listed in stable condition at a special isolation unit at Bellevue Hospital Center, and a decontamination company was sent to his Harlem home. His fiancee, who was not showing symptoms, was being watched in a quarantine ward at Bellevue.

The idea of broader quarantine is a topic "actively being discussed. It's going to be something that will be discussed at federal level," said Dr. Mary Bassett, New York City's health commissioner.

Lawmakers from both parties criticized the federal government's Ebola response.

Democratic Congressman Stephen Lynch said anyone coming from West Africa should be quarantined for 21 days abroad before even boarding a plane to this country.

The World Health Organization is not recommending the quarantine of returning aid workers without symptoms, according to spokeswoman Sona Bari.

"Health care workers are generally self-monitoring and are aware of the need to report any symptoms, as this patient did," she wrote in an email.

Bruce Johnson, president of SIM USA, a Christian organization based in North Carolina, said its staffers are told to follow guidelines established by the federal Centers for Disease Control and Prevention for their first 21 days in the U.S. Beyond that, he said, they are told to avoid crowded public areas.

Johnson said his staff members would not be deterred from serving in Ebola-stricken countries if they were required to remain isolated in their homes for 21 days upon their return. But such measures could discourage volunteers, he said.

Nurses, doctors and others who hold down regular jobs back home would say, "I want to go over and help for a month, but now you're telling me that when I get back I can't go to work for 21 days?" Johnson said. "Yes, I think that will dampen the generous spirit of people in the U.S. who want to go help."

Samaritan's Purse, a Christian relief organization based in North Carolina, said that its returning aid workers spend three weeks quarantined in a "safe house," where their temperatures are monitored.

They can go out for things like a walk in the park or a visit to the drive-thru of a fast-food restaurant, but are asked to stay away from crowds and are isolated from their families, said Franklin Graham, president of the organization.

Graham said the federal government should rent out a hotel -- perhaps one in the Caribbean, to ease public fears -- and then staff it with doctors and quarantine all returning health care workers there for three weeks.

"They can sit by the pool and eat hamburgers," Graham said. "I would call it a country club quarantine and let them just relax and cool their heels. ... It's an inconvenience, but it is not a hardship."