WATCH ABOVE: The continuing fight against Ebola as states put stricter quarantines in place for certain travelers from West Africa. Ron Allen reports.
TORONTO – High risk, some risk, low risk, no risk. In updated guidelines, the Centers for Disease Control and Prevention created four distinct categories for travellers coming out of West Africa.
Under these measures, high risk travellers should be quarantined at home for 21 days – the longest incubation time for Ebola. They shouldn’t go to large public gatherings and they shouldn’t take public transportation. The tweaked guidelines were released in the wake of sharp criticism about the strict rules certain states implemented last week.
“We are concerned about some policies that we have seen…that may have the effect of increasing stigma or creating false impressions,” CDC director Dr. Thomas Friedan told U.S. reporters.
Keep in mind, Florida, Illinois, New Jersey and New York created state-enforced quarantine mandates that would apply to all fieldworkers who treated Ebola patients in West Africa even if they weren’t showing symptoms.
After a nurse threatened to sue and suggested she was treated like a “criminal” upon her return to the U.S., New Jersey health officials eased up on the mandate and let her complete her monitoring from home.
READ MORE: Why this U.S. nurse fought to be released from Ebola quarantine
Now, the CDC’s risk levels are based on degree of exposure. Here’s an explainer on each of the CDC’s categories:
High risk: This applies to people who have had direct contact with infected bodily fluids either through needles, splashes to the eyes, nose, or mouth or even handling bodily fluids in a lab setting without protective gear. If you were living and caring for a person showing symptoms, you’d also fall into this category.
They’re expected to have direct, daily monitoring, they should restrict public activities and they shouldn’t be travelling. If they aren’t sick, they still shouldn’t be travelling by plane, ship or long-distance bus or train.
“The reason for this is to prevent possible spread of Ebola if the person develops fever or other symptoms during travel,” the CDC said in its guidelines.
Some risk: This applies to people who come into close contact with patients showing Ebola-like symptoms, either in a household or health care setting. (Close contact means being within three feet of the patient with Ebola for a “long time” without wearing protective equipment.)
READ MORE: How does Ebola spread? 5 things you need to know
The CDC suggests this group should have its temperature checked twice a day, while travel and heading into public spaces should be considered on an individual case.
Low risk: This group includes people who have been to a country with widespread Ebola transmission within the past 21 days. They could have been in the same room with a person showing symptoms of Ebola, had brief skin contact with someone showing symptoms or even travelled on an airplane with a person showing symptoms.
In this case, travellers should be watched for symptoms but they don’t need to be restricted in any way.
No risk: This applies to people who came into contact with an Ebola patient before he or she was showing symptoms. It’s also for travellers who went to a country affected by Ebola more than 21 days ago. People in this group don’t need to be monitored at all.
READ MORE: Canadian experts answer your questions about Ebola
Twenty-one days is the outer limit of Ebola’s incubation period. If you aren’t showing symptoms, you aren’t contagious.
Read the full guidelines here.
Frieden told U.S. reporters that fewer than 100 people a day are entering the U.S. from Ebola-affected countries. Right now, every traveller coming onto U.S. soil from affected regions is handed safety kits to monitor temperature and they’re handing over contact information to health officials.
The CDC even offered its guidance on monitoring returning health care workers: they’re “heroes worthy of dignity and respect. Their efforts, along our civilian and military personnel in the region is what ultimately will enable us to eliminate the threat of additional domestic Ebola cases,” the guidelines say.
For the most part, they fall under the “some risk” category. Health care workers within the country who care for Ebola patients should fall into the “low risk” level, the CDC says.
READ MORE: Quarantine may discourage workers from volunteering to treat Ebola patients
In Canada, fieldworkers are advised against working during the 21-day incubation period. The time after their mission abroad is meant to be for rest and recuperation. If they head back to work quickly, they could encounter an illness, like a cold or flu, that might trigger Ebola-related concerns.
Médecins Sans Frontières says that if their fieldworkers encounter symptoms upon their return, they shouldn’t take public transportation, and should contact MSF immediately.
carmen.chai@globalnews.ca
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