Unlike military service members, Defense civilian employees fighting Ebola abroad can opt out of a 21-day quarantine when they leave West Africa, according to new guidance from the Pentagon.
Defense civilian workers deployed to West Africa can choose one of two options upon their departure from Ebola-stricken countries, if they do not show any signs of the disease’s symptoms: resume their normal work and life activities with daily temperature and health checks per guidelines from the Centers for Disease Control and Prevention, or participate in the department’s 21-day “controlled monitoring,” which essentially amounts to a quarantine -- though the department does not use that word.
The Pentagon last week said all service members returning from West Africa as part of Operation United Assistance had to participate in “controlled monitoring,” even if they did not show symptoms or come in direct contact with anyone suffering from Ebola. The first group of service members subject to the policy now are isolated at a Defense facility in Italy.
The post-deployment guidance for Defense civilians, outlined in an Oct. 31 memorandum from Undersecretary for Personnel and Readiness Jessica Wright, further complicates the government’s approach and policies on monitoring federal employees, troops and volunteer health care workers returning from West Africa. For example, CDC’s guidelines stipulate a certain level of monitoring based on an individual’s exposure to Ebola and whether that person is showing symptoms, while the Pentagon’s policy for service members returning from Operation United Assistance is far more blanket (like civilians, transient Defense personnel -- air crew who travel through Ebola-stricken countries and are not exposed to the disease -- are not subject to the 21-day mandatory quarantine). States, including New York and New Jersey, also have been imposing their own restrictions on returning health care workers, drawing criticism from the White House.
Ebola is transmitted through direct contact with an infected person’s blood or bodily fluids. The virus only can be spread after an infected person shows symptoms of the disease, which can manifest from two to 21 days after exposure.
A reporter last week asked President Obama about the various guidance on monitoring and quarantine for those working in Ebola-stricken countries, including the new policy for the military. “Well, the military is a different situation, obviously, because they are, first of all, not treating patients,” he said. “Second of all, they are not there voluntarily. It’s part of their mission that's been assigned to them by their commanders and ultimately by me, the commander-in-chief. So we don't expect to have similar rules for our military as we do for civilians. They are already, by definition, if they’re in the military, under more circumscribed conditions.”
Defense civilians who choose to abide by the CDC guidelines cannot go on temporary duty travel for the 21-day active monitoring period. “For direct active monitoring, a public health authority directly observes the individual at least once daily to review symptom status and monitor temperature; a second follow-up per day may be conducted by telephone in lieu of a second direct observation,” according to the CDC. “Direct active monitoring should include discussion of plans to work, travel, take public conveyances, or be present in congregate locations. Depending on the nature and duration of these activities, they may be permitted if the individual has been consistent with direct active monitoring (including recording and reporting of a second temperature reading each day), has a normal temperature and no symptoms whatsoever, and can ensure uninterrupted direct active monitoring by a public health authority.”
Joyce Wessel Raezer, executive director of the National Military Family Association, said she’s concerned that Defense civilians who opt out of “controlled monitoring” could face backlash from communities based on fear of and misinformation about Ebola and how the disease is transmitted. “I think some of the same community fears that made us come out in favor of the military quarantine in order to avoid stigmatization of military families by their kids’ schools and others will still be present if civilians come back to communities without being quarantined,” she said. “The arguments put forth so far that civilians are different from military in this matter have not been convincing,” Raezer added. “I understand there are union rules and other things that mean there might have to be some different treatment, but I’m not sure the civilian communities these folks will return to will understand the subtleties.”
There are about 55 Defense civilian employees in Liberia and Senegal right now – far less than the number of military personnel, according to Lt. Cmdr. Nathan Christensen, a Pentagon spokesman. The department plans to deploy up to 4,000 service members as part of Operation United Assistance; roughly 1,200 troops are stationed in West Africa now.
The large number of troops involved in the effort abroad, as well as legal issues, determined the Pentagon’s dual policy for the two groups, according to Rear Adm. John Kirby, the Pentagon’s press secretary. “The secretary believes these initial steps are prudent given the large number of military personnel transiting from their home base and West Africa and the unique logistical demands and impact this deployment has on the force,” Kirby said last week.
Legally, the department cannot compel civilians to undergo “controlled monitoring” the same way it can service members. “We cannot legally mandate these measures for DoD civilians or contractors, but we will ensure our monitoring locations are made available to them on a volunteer basis,” said Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, in an Oct. 28 memorandum to Hagel.
The Pentagon plans to review within the next 45 days its policy of “supervised monitoring in a controlled environment” for service members returning from West Africa, and will decide whether to continue it. Secretary Chuck Hagel said last week during the Washington Ideas Forum, sponsored by The Atlantic and the Aspen Institute, that the decision was discussed with military families and that “they very much wanted a safety valve on this.”