Gov. Andrew Cuomo’s Ebola quarantine policy is drawing strong opposition from people who work closely with him on another infectious disease: AIDS.
New York State’s imposition of a 21-day quarantine on health workers who have had contact with Ebola patients in West Africa “is not supported by scientific evidence” and “may have consequences that are the antithesis of effective public health policy,” according to a letter released Monday with signatures from over 100 H.I.V. activists, researchers and clinicians.
They consider the state’s quarantine policy unacceptable even though, as Governor Cuomo announced Sunday night, affected people will be able to serve their quarantines at home. Mr. Cuomo initially announced the quarantines on Friday, jointly with Gov. Chris Christie of New Jersey. Quarantines of asymptomatic people have come under heavy criticism from public health experts, including Dr. Anthony Fauci, who heads the National Institutes of Allergy and Infectious Diseases, because it is impossible to transmit Ebola if you do not have symptoms.
“I’m disgusted and livid,” wrote Peter Staley, a prominent H.I.V. activist and one of the letter’s organizers, who was appointed just two weeks ago to a gubernatorial task force on H.I.V.
Mr. Cuomo has made the AIDS fight in New York a signature issue. Earlier this month, he appointed that task force to find ways to cut the rate of new H.I.V. infections by three-quarters before 2020. Twelve members of the task force, Mr. Staley among them, have signed the letter criticizing his Ebola policies. Other prominent letter signers include Paul Cleary, the dean of Yale’s school of public health; Dr. Wafaa El-Sadr, who runs the ICAP AIDS prevention research center at Columbia; and Kevin Frost, the chief executive of the American Foundation for AIDS Research.
Alphonso David, who serves as Mr. Cuomo’s Deputy Secretary for Civil Rights, has been in contact with the H.I.V. advocates over the last several days. “We appreciate the concerns they are raising,” he said. “We appreciate that the advocates are operating as advocates; they have a function to perform.”
Mr. David defended the quarantine policy, noting “the governor needs to make sure that we balance public safety and civil liberties.” But he also noted that the policy would continue to be refined as the state gathered new information and the Centers for Disease Control and Prevention revised its guidelines.
Mr. Staley said that while the advocates were even more shocked by actions in New Jersey, where a worker was quarantined in a tent for several days, they were focusing on Mr. Cuomo because “we have been asked to give advice on an illness that has a lot of stigma and fear affecting how we fight it, and this is our governor and we felt strongly that if we could get him to return to the national consensus on this, that in and of itself would put enormous pressure on Governor Christie.”
The letter expresses concern that quarantines will discourage American health care workers from going to fight the Ebola epidemic in West Africa. It draws parallels between what the signers call “hysteria” over Ebola in the United States and early panics around H.I.V., noting that policies that create a stigma around an infectious disease can interfere with efforts to contain that disease. For example, people might choose to conceal their possible exposure to Ebola for fear of being unnecessarily quarantined.
Federal guidance from the C.D.C. calls for twice-daily self-monitoring for Ebola symptoms and certain restrictions on travel, including avoiding commercial airliners; it does not call for people with potential exposure to the disease to be quarantined. Federal guidelines call for isolating patients who display Ebola symptoms.
Mr. Cleary, the Yale dean, expressed concern that the quarantines in New York, and similar policies in New Jersey and Connecticut, would foster misconceptions about how Ebola is transmitted. “If you have a policy that says, ‘Oh my god, this person, even though they’re not symptomatic, we don’t trust them,’ that sends a signal that the information the scientists have been telling us is incorrect,” he said. He compared the quarantines to actions by local government officials in the 1980s that misconstrued H.I.V. risks, including the expulsion of Ryan White, a hemophiliac who contracted H.I.V. from contaminated blood products, from an Indiana middle school.
On Sunday evening, under pressure from public health experts (and, according to Obama administration officials, the White House), Governor Cuomo held a news conference to make clear that quarantines in New York could be served at home and that health workers would be compensated for lost work. Governor Christie issued a statement indicating that New Jersey would also be conducting home quarantines. Illinois and Florida have also announced quarantines for returning Ebola health workers.
The day before, four top Cuomo administration officials, including Dr. Howard Zucker, who heads the state’s health department, Patrick Foye, the executive director of the Port Authority, and Mr. David had a conference call with H.I.V. activists to discuss the quarantines. Two of the letter signers, Gregg Gonsalves and Mr. Staley, described the call as tense.
“I yelled at Zucker, ‘You have shattered the public health consensus on this,’ ” Mr. Staley said.
Mr. Gonsalves, the co-director of the Global Health Justice Partnership at Yale’s law and public health schools, said: "They tried to push us off the irrationality and unsubstantiated nature of the quarantine and talk about how to make it more humane. We don’t want to talk about how to make it more humane.”
On Sunday night, Mr. Cuomo attributed his policies to a desire to protect New Yorkers. He said that he did not see a need to quarantine those who are treating an Ebola patient at New York City’s Bellevue Hospital because Bellevue’s infection control procedures are solid, while those in West Africa are not necessarily reliable.
