New Jersey officials released a nurse Monday who had been controversially detained in a state hospital since returning to the US on Friday from Sierra Leone, where she worked with Ebola patients as part of the international response to the outbreak that has now killed nearly 5,000 people.
According to New Jersey public health officials, Doctors Without Borders (MSF) volunteer Kaci Hickox tested negative for the hemorrhagic fever on Saturday and was cleared for release from isolation at University Hospital in Newark.
"Since the patient had direct exposure to individuals suffering from the Ebola virus in one of the three West African nations, she is subject to a mandatory New Jersey quarantine order," a statement from the health department read. "Health officials in Maine have been notified of her arrangements and will make a determination under their own laws on her treatment when she arrives."
Hickox was heading home after a month in Sierra Leone, a country that, along with Liberia and Guinea, has felt the brunt of the unprecedented Ebola outbreak. More than 1,200 people in Sierra Leone have died from the virus.
The nurse was quarantined when she arrived in Newark on Friday, despite having a normal temperature. A fever is one of the main symptoms of Ebola, and an individual is not contagious until they become symptomatic. The nurse described the conditions of her captivity as "inhumane." Photos show Hickox wearing a hospital gown behind a tent-like quarantine structure.
"This is an extreme that is really unacceptable, and I feel like my basic human rights have been violated," she told CNN on Sunday.
Dr. Michael Klag, the Dean of the Johns Hopkins Bloomberg School of Public Health, told VICE News that the nurse's quarantine was egregious and highlights everything that could be done wrong in that situation. Hickox is a graduate of the program at Johns Hopkins.
"It made no sense, this woman tested negative for Ebola, why would you continue to quarantine her? That's punishment," said Klag, who publicly disagreed with the policy in a letter to New Jersey Governor Christie. "[The quarantine] wasn't evidence-based and creates more hype and panic."
Hickox was the first person to be put through the mandatory quarantine issued by Christie on Friday, a response that came after MSF doctor Craig Spencer tested positive for the virus in New York City within 24 hours of riding the subway and taking trips to a bowling alley and restaurants. Spencer had been taking his temperature and monitoring for symptoms — he said he exhibited none the night before at the bowling alley — and went to the hospital immediately upon registering a fever the next day, on October 23.
On Monday, the American Civil Liberties Union of New Jersey requested that Christie provide more information about how he determined that it was "medically necessary" to institute a mandatory quarantine for healthcare workers.
"Ebola is a public health issue and the government's response should be driven by science and facts and not by fear," Udi Ofer, the ACLU of New Jersey's executive director, said in a statement Monday.
New York Governor Andrew Cuomo implemented mandatory quarantines the same time as Christie. The governor of Illinois followed suit, and, most recently, Virginia implemented a mandatory 21-day monitoring period for those traveling from the region, also requiring that healthcare workers avoid public transport and stay at home.
After Hickox was quarantined, MSF said it was "very concerned about the conditions and uncertainty she is facing." The organization did not comment directly on the guidelines themselves, saying they were trying to clarify the details.
"There is a notable lack of clarity about the new guidelines announced yesterday by state authorities in New York and New Jersey," Sophie Delaunay, executive director of MSF, said Saturday.
The organization has been on the front lines of Ebola response efforts since the hemorrhagic fever began its spread in Guinea in December, with more than 50 American staff members having worked in West Africa and 31 currently on the ground. MSF has stressed that it has strict protocols for healthcare workers when they return home from West Africa. The organization said it amended its protocols in accordance with new guidelines issued by the US government issued last week.
Public health officials, doctors, and epidemiologists alike have slammed New York and New Jersey's new quarantine policies. National Institutes for Allergies and Infectious Disease director Dr. Anthony Fauci called the policies "a little draconian" on NBC's Meet the Press on Sunday.
"There's a big, big difference between completely confining somebody so that they can't even get outside and doing the appropriate monitoring based on scientific evidence," Fauci told CNN. "The harm is that it is totally disruptive of their life. We want them to go because they are helping us to protect America to be over there."
One of the larger concerns has been that mandatory quarantines will prevent healthcare workers from offering their critical skills to response efforts in West Africa. According to Klag, the mandatory 21-day quarantine brings both psychological and monetary costs to the volunteers. He said the policy "seems designed for discouraging people from going to help."
"I think that Christie and Cuomo are probably motivated by concern for people of their states, but they have a responsibility to do what make sense and is based on knowledge," Klag said.
The White House also raised concerns about the new state measures. "We have let the governors of New York, New Jersey, and others states know that we have concerns with the unintended consequences of policies not grounded in science may have on efforts to combat Ebola at its source in West Africa," a White House official said.
Samantha Power, the US ambassador to the United Nations, said in an NBC interview Sunday that healthcare workers should be "treated like conquering heroes and not in any other way."
On Sunday evening, Cuomo backpedaled, saying returning workers could be quarantined at their own homes with mandatory temperature checks. Christie said healthcare workers who are New Jersey residents and do not have symptoms could stay quarantined in their homes, stressing that this policy had not changed since Friday.
According to Klag, it's important to focus efforts on the continued spread in West Africa, where the true risk of Ebola lies and medical volunteers are badly needed. He said officials need to concentrate on encouraging people to help in response efforts. Whether it's isolating West Africans with travel bans or discouraging volunteers from going there with mandatory quarantines, Klag said we are only putting ourselves at greater risk.
"There have been thousands of deaths from Ebola in West Africa and that's where the risk is," he said. "To punish people for going to West Africa is not in the best interest of people of New York and New Jersey."
Follow Kayla Ruble on Twitter: @RubleKB