A nurse who had recently worked with Ebola patients in West Africa and was placed under quarantine shortly after she landed in Newark on Friday under a new order by the governors of New York and New Jersey has tested negative for the Ebola virus, New Jersey officials said on Saturday.
The nurse, who had no symptoms when she landed at Newark Liberty International Airport but developed a fever while quarantined there, will have additional tests to confirm that finding, the New Jersey Department of Health said in a statement. She was taken to University Hospital in Newark from the airport and will remain under mandatory quarantine for 21 days in accordance with the policy announced late Friday afternoon by Gov. Andrew M. Cuomo of New York and Gov. Chris Christie of New Jersey.
The governors ordered quarantines for all people entering the country through Newark Liberty and Kennedy International Airport if they had direct contact with Ebola patients in Guinea, Liberia and Sierra Leone.
The announcement signaled an immediate shift in mood, since public officials had gone to great lengths to ease public anxiety after a New York City doctor received a diagnosis of Ebola on Thursday.
The new measures go beyond what federal guidelines require and what infectious disease experts recommend. They were also taken without consulting the city’s health department, according to a senior city official.
But both Mr. Cuomo and Mr. Christie portrayed them as a necessary step. “A voluntary Ebola quarantine is not enough,” Mr. Cuomo said. “This is too serious a public health situation.”
In New York City, disease investigators continued their search for anyone who had come into contact with the city’s first Ebola patient, Dr. Craig Spencer, since Tuesday morning. Three people who had contact with Dr. Spencer, 33, have been quarantined, and investigators have compiled a detailed accounting of his movements in the days before he was placed in isolation at Bellevue Hospital Center on Thursday.
He remained in stable condition on Friday, and doctors were discussing the use of various experimental treatments. He was able to talk on his cellphone and was even well enough to do yoga in his room, according to friends.
The new protocols at the airports, outlined by the governors in an afternoon news conference, raised a host of questions, including how the screening process would work and whom it would target. The two airports in question are Kennedy International and Newark.
Officials from New York and New Jersey said they were still working out many details, including where people would be quarantined, how the quarantine would be enforced and how they would handle travelers who do not live in either of those states.
The mandatory quarantine for nonsymptomatic travelers will last 21 days, the longest documented period it has taken for an infected person to show symptoms of the disease.
On Friday, the White House sidestepped questions about whether a nationwide quarantine of returning health care workers was being considered. Instead, officials defended the procedures the administration has put in place, including enhanced airport screenings and the monitoring of people arriving from Ebola-afflicted countries.
There was immediate concern that the move by New York and New Jersey might have an adverse effect on getting workers to West Africa, where more than 4,500 people have died of the virus and medical workers are in short supply.
The United Nations emergency Ebola mission says that 19,000 doctors, nurses and paramedics are needed by Dec. 1 and that it is nowhere near that number.
“We will not hesitate to take any action that we feel has the potential to fortify us against additional imported Ebola cases,” a senior Obama administration official said. “At the same time, we must do so in a manner that is coordinated and that minimizes any unintended consequences, including those that would hinder our ability to eliminate this threat at its source in West Africa.”
Mr. Christie, a Republican, said he and Mr. Cuomo, a Democrat, had decided to take action because the federal guidelines were not strict enough. “We are no longer relying on C.D.C. standards,” he said, referring to the federal Centers for Disease Control and Prevention.
Ebola: Keep Calm, Carry On
On the subway lines and in the streets traveled by a doctor infected with Ebola, New Yorkers voiced some concern, but mostly went about their normal routines.
Video by Stephen Farrell and Natalia V. Osipova on Publish Date October 24, 2014.The C.D.C., in a terse statement, said that it would make its decisions based on the best available science but that the states were within their legal rights to institute the measures.
In New York City, health officials said that initial reports were incorrect when they indicated that Dr. Spencer had a 103-degree fever when he notified the authorities of his ill health. He actually had only a 100.3 fever. Officials attributed the mistake to a transcription error and said the lower temperature made it highly unlikely that he could have spread the disease before going to the hospital. Still, out of caution, they were tracing his contacts back to Tuesday, the day he began feeling fatigued. Dr. Spencer had been working with Doctors Without Borders in Guinea, treating Ebola patients, before leaving Africa on Oct. 14 and returning to New York on Oct. 17.
Since March, three international staff members and 21 locally employed staff members of Doctors Without Borders have fallen ill while battling the Ebola outbreak in Guinea, Liberia or Sierra Leone, according to the group. Thirteen have died.
As a hazardous material team arrived at Dr. Spencer’s apartment in Harlem to sanitize the residence, public officials took to the airwaves seeking to reassure wary residents that the risk to the general public was exceedingly small.
Three Quarantined in New York Ebola Case
Two friends and the fiancée of the Manhattan doctor infected with Ebola have been quarantined, according to officials at a news conference.
Publish Date October 24, 2014. Photo by Associated Press.“New Yorkers who have not been exposed to an infected person’s bodily fluids are simply not at risk,” Mayor Bill de Blasio said at a news conference.
“We have the finest public health system, not only anywhere in the country but anywhere in the world,” he added.
Much of the public’s concern focused on the movements of Dr. Spencer the night before he reported feeling ill.
On Friday, officials added some new details about those movements. He traveled on the A and L subway lines to Brooklyn, where he went bowling in Williamsburg and took a taxi back to Manhattan on Wednesday evening. He assured officials that he did not have symptoms at the time.
Graphic
What the New York City Ebola Patient Was Doing Before He Was Hospitalized
Locations visited by Craig Spencer, a Manhattan doctor who has tested positive for Ebola.
Earlier in the day, he went for a three-mile jog along Riverside Drive. On Tuesday, the day Dr. Spencer first began to feel sluggish, he visited the High Line and ate at the Meatball Shop in the West Village.
Health workers are in the process of visiting every location Dr. Spencer visited, said Dr. Mary Travis Bassett, the city health commissioner.
Dr. Bassett praised the work Dr. Spencer was doing in Africa to combat the disease. She also sought to insulate him from criticism about his activities before falling ill, saying he followed all the proper protocols.
“There’s this young guy who went over there, really doing the right thing, the courageous thing, and he handled himself really well,” she said. “I don’t want anyone portraying him as reckless.”
She spoke before the governors’ news conference, in which Mr. Cuomo incorrectly said Dr. Spencer had violated a quarantine; he had not been under quarantine.
Though Doctors Without Borders and the health department said Dr. Spencer followed protocols, Dr. William Schaffner, an infectious disease specialist at Vanderbilt University, said Dr. Spencer probably should have stayed home beginning on Tuesday.
“At that point I would have locked myself in, and I would have started checking my temperature hourly,” he said.
Dr. Schaffner also said he saw no need for an automatic 21-day quarantine or isolation period for people arriving from West Africa, not even health workers. There is no medical reason for it, he said, because people are not contagious until they develop symptoms.
More Ebola Coverage
Dr. Bassett, in a Twitter post, suggested that the new quarantine policy might discourage American doctors and nurses from helping to contain the disease in Africa. “People who go and volunteer, we have to look at how the new quarantine policy would impact them,” she said.
The American Civil Liberties Union of New Jersey also raised an issue. “We understand the importance of protecting the public from an Ebola outbreak,” it said in a statement, but the mandatory quarantine actions “raise serious constitutional concerns about the state abusing its police powers by detaining people who are exhibiting no Ebola symptoms.”
As the disease continues to spread, killing thousands in West Africa and popping up in a growing number of cities around the world, there have been competing pressures on American officials. They are trying to do all they can to prevent the spread of the disease here, while at the same time trying not to take steps that might impede the fight against the virus in West Africa. They are also trying to manage widespread public anxiety.
Officials both national and local conspicuously conveyed the idea that the public should not overreact. President Obama was photographed in the Oval Office hugging Nina Pham, the Dallas nurse who was just declared Ebola-free after being in isolation since Oct. 16. Mayor de Blasio rode the subway, to demonstrate that the virus could not be spread through casual contact, like holding a subway pole.
The Ebola virus can be transmitted to other people only through bodily fluids when an infected individual begins to show symptoms. At the onset of illness, the amount of virus in the body is generally low, so the risk of infection is also considered small.
As the disease progresses, the amount of virus in the body multiplies and so does the risk of contagion.
Dr. Spencer’s fiancée, Morgan Dixon, has been quarantined at Bellevue Hospital Center. Officials said she would be allowed to return to the apartment she shared with Dr. Spencer, which has been cleaned, and carry out the rest of her quarantine there.
Two other friends whom he had contact with have also been quarantined. None of them have shown any symptoms of illness.
Health officials said there was no risk to patrons at any of the businesses Dr. Spencer visited, though one of them, a bowling alley in Williamsburg called the Gutter, said on its Twitter feed Friday night that it was still waiting for a cleaning crew to arrive and had not yet reopened.
The officials decided that subway cars did not need to be taken out of service and disinfected, since Dr. Spencer rode the trains before he developed a fever and, in any case, the virus can survive only a few hours on a surface.
“There is the pure science and the protocols that must be put in place based on that science, in terms of what we know and what can come from that,” said Dr. Irwin Redlener, the director of the National Center for Disaster Preparedness at Columbia University and a special adviser to Mayor de Blasio. “On the other end of the spectrum, there is the world of abundance of caution. Public officials are constantly trying to find the right balance.”
An earlier version of this article misidentified the organization that raised the issue of constitutional concerns surrounding the imposition of a mandatory quarantine for people who have shown no Ebola symptoms. It is the American Civil Liberties Union of New Jersey, not the American Civil Liberties Union.