Three more states on Monday unveiled new strategies to contain Ebola, both of which stop short of the mandatory quarantines set by New York and New Jersey over the weekend.
Anyone known to have direct exposure to the disease in Maryland, Georgia and Virginia will be asked not to leave their homes, a restriction that officials say is less severe than state-ordered isolation.
“From our perspective, something like that is an option, but is not the first thing to reach for,” Sharfstein told The Hill.
"We have a lot of experience with active monitoring in Maryland, and how to do that well, and sometimes that involves public health orders, and most of the time, it doesn't."
In Maryland, anyone with potential exposure to Ebola must sign an agreement not to attend public gatherings or use mass transportation. They will also be asked to check in daily with state or local health officials.
Individuals who could have potentially carried the disease in Virginia, specifically healthcare workers, will only be asked to stay home if they report “breaches in protective protocol.” All others could be told to avoid public transportation, mass gatherings and clinical care, depending on the level of their exposure.
“These restrictions are based on the best scientific evidence about transmission of the virus, and will be tailored to the known risks for each healthcare worker,” Gov. Terry McAuliffe (D-Va.) said in a statement.
All travelers arriving from Ebola-stricken areas will also be asked to self-monitor for 21 days, according to Virginia’s health commissioner, Marissa Levine. Those who do not comply could face a quarantine order.
"I would not hesitate to issue this order, if necessary, to protect Virginians’ health,” Levine said.
Georgia Gov. Nathan Deal (R) similarly announced Monday that anyone known to have direct exposure to an Ebola patient will be quarantined, though the order excludes healthcare workers.
Healthcare workers in Georgia must have their temperatures monitored twice daily by state officials, but will not be quarantined in state facilities unless they fail to comply with the rules.
Officials in both Maryland and Virginia said they worked with federal health officials, including those at the Centers for Disease Control and Prevention (CDC), to craft the regulations.
That stands in stark contrast to the New York and New Jersey restrictions, which were announced simultaneously late Friday. Neither Gov. Andrew Cuomo (D-NY) nor Gov. Chris Christie (R-NJ) fielded input from the White House, drawing scrutiny from public health officials who said the rules ignored the science of how the disease spreads.
Outrage over the policies mounted after a nurse who recently returned from treating Ebola patients in Sierra Leone was quarantined in a tent outside a New Jersey medical center.
Facing pressure, Cuomo clarified the state’s policies late Sunday and said health workers could be quarantined in their homes. Still, he defended the state’s mandatory orders.
“If the CDC thinks that another policy would work in another part of the country, that’s great, but I think this is the right policy for New York,” Cuomo said during a news conference.
Christie said Sunday that he would not reverse the restrictions, though he said on Monday that the quarantined nurse could be sent home after she twice tested negative for the disease.
New York, New Jersey, Maryland, Virginia, Georgia and Pennsylvania, were told to create new protocols for travelers from West Africa as part of federal guidelines. About 70 percent of travelers from the region affected by the Ebola outbreak arrive in the U.S. in one of those six states.
Florida and Illinois have also announced new rules that are stricter than the federal standards. Both will now require mandatory monitoring similar to Maryland and Virginia, with more severe rules for “high-risk” travelers, including medical personnel.
“State and local officials have the prerogative to tighten the regimen as they see fit," Florida Gov. Rick Scott (R) said.
"When it comes to the federal standards set by the CDC, we will consider any measures that we believe have the potential to make the American people safer."
— This story was last updated at 5:10 p.m.