Will Washington Overrule Governors on Ebola Quarantines?

The debate over how to handle health workers returning from treating Ebola patients in West Africa is shifting back to the federal government this week after several states acted on their own to initiate mandatory quarantines.

Signaling it was unhappy with decisions by Governors Andrew Cuomo and Chris Christie in New York and New Jersey to automatically isolate returning health workers, the White House said Sunday night that officials were considering new federal policies on the matter. The states of Florida and Illinois quickly followed the lead of New York and New Jersey, while Virginia did not.

The maneuvering both in public and behind the scenes underscored the difficulty officials at all levels of government have had in balancing the need to protect the public without contributing to an atmosphere of panic about Ebola. Seeking to demonstrate they had learned lessons from the faulty response in Dallas to the first U.S. Ebola diagnosis a month ago, the two Northeastern governors acted quickly. They said they wanted to err on the side of caution following the diagnosis of Dr. Craig Spencer, who returned from treating Ebola patients in Guinea and traveled in public the day before he reported a fever.

Yet the joint move announced Friday by Cuomo, a Democrat, and Christie, a Republican, prompted a wave of criticism from medical professionals and many Democrats, who said the mandatory quarantines were not necessary based on science and would discourage U.S. doctors and nurses from heading overseas to fight Ebola at its source. Facing the voters in less than two weeks, Cuomo quickly split off from Christie and appeared Sunday with New York City's mayor, Bill de Blasio, to announce that returning health workers could spend the 21-day quarantine in their homes and that the government would provide assistance and help to guarantee they would not suffer professionally for missing work.

Christie soon reiterated that New Jersey residents could also stay at home during their isolation period. And on Monday he backed off his decision to detain Kaci Hickox in a makeshift tent behind a New Jersey hospital after she returned from working with Doctors Without Borders in West Africa, despite showing no symptoms. Citing the New Jersey Department of Health, the governor said Hickox was being "discharged" and would be flown on a private plane to her home in Maine, where officials there would determine whether to keep her isolated.

Hickox had called her conditions "really inhumane" and retained Norman Siegel, a well-known attorney and former executive director of the New York Civil Liberties Union, to file a lawsuit challenging her quarantine. Hickox, a Maine resident, told CNN she has tested negative for Ebola twice and was not symptomatic.

Her ongoing isolation brought increasing urgency to the deliberations in Washington. The White House made clear it was uncomfortable with the decision by Cuomo and Christie, although Cuomo denied on Sunday that he had been pressured to shift course.

In a carefully-worded statement after a high-level meeting on Sunday, the White House said Obama's advisers "updated him on policy considerations for new measures pertaining to returning healthcare workers, whose selfless efforts are critical to fighting this epidemic in west Africa."

"The president underscored that the steps we take must be guided by the best medical science, as informed by our most knowledgeable public-health experts. He also emphasized that these measures must recognize that healthcare workers are an indispensable element of our effort to lead the international community to contain and ultimately end this outbreak at its source, and should be crafted so as not to unnecessarily discourage those workers from serving. He directed his team to formulate policies based on these principles in order to offer the highest level of protection to the American people."

The question now is how quickly the White House and the CDC will announce any policy change, and what will happen to the next batch of health workers who return from West Africa.