Some Ebola quarantine measures becoming clear, others remain undecided

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http://www.stripes.com/news/some-ebola-quarantine-measures-becoming-clear-others-remain-undecided-1.311229

Some Ebola quarantine measures becoming clear, others remain undecided
By Chris Carroll
Stars and Stripes
Published: October 30, 2014

WASHINGTON — Troops who deploy to Africa to fight Ebola will likely return to their home bases before they undergo 21 days of quarantine, including those from a number of major installations in the United States. And simply passing through the Ebola zone in West Africa, or making a quick flight in and out, isn’t enough to require quarantine.
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One returning group already has been placed in what the Pentagon calls “enhanced monitoring” at their home base. Several dozen Army soldiers were ordered into quarantine Sunday in Vicenza, Italy, by Army Chief of Staff Gen. Ray Odierno. The troops, including U.S. Army Africa commander Maj. Gen. Darryl Williams, deployed from Vicenza in September to set up a headquarters in the Liberian capital, Monrovia, and begin construction of treatment units.
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The idea of setting up mass quarantine centers overseas could be politically problematic, with some officials in countries that host U.S. bases expressing reservations about hosting U.S. troops fresh from the Ebola zone.

Thomas confirmed that air crews and other transient personnel who go briefly to West Africa to support Operation United Assistance can avoid the quarantine requirement.
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But Pentagon officials said a decision still needs to be made on whether DOD civilians working in the Ebola area need a quarantine. On Thursday, the American Federation of Government Employees criticized the lack of guidance for civilian employees. “The two groups should be treated the same,” said J. David Cox Sr., the union’s national president. “If DOD considers service in Ebola-affected countries to pose such a high risk for members of the military that they are required to be monitored or quarantined for 21 days upon arrival in the U.S., then civilians with similar exposure should be guaranteed 21 days of administrative leave for either self-isolation and monitoring or quarantine, whichever medical authorities decide is appropriate.”

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1. The latest from DoD

http://www.defense.gov/news/newsarticle.aspx?id=123535

Dempsey, Battaglia Explain Rationale for Monitoring

By Jim Garamone
DoD News, Defense Media Activity

WASHINGTON, Oct. 30, 2014 – The 21-day controlled monitoring program for U.S. service members returning from West Africa is a conservative and prudent approach, the chairman of the Joint Chiefs of Staff and his senior enlisted advisor said today. Army Gen. Martin E. Dempsey and Marine Corps Sgt. Maj. Bryan B. Battaglia said they see the reintegration program troops will undergo upon return from Operation United Assistance as a move that fits the needs of service members and their families. They said military leaders will continue to assess and adapt the program as needed.

Both leaders said the military mission in Africa is unique in several ways. “Our forces are the largest in number, and we are there for the longest duration,” Dempsey said, adding that the vast majority of service members deploying are not medical professionals. Centers for Disease Control and Prevention protocols call for self-monitoring for returning health care workers who are generally traveling alone or in small groups. But service members are not schooled in these protocols and will number in the hundreds and thousands, Dempsey said.
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What the chiefs, the senior enlisted leaders and Dempsey agreed with was a controlled monitoring protocol – where medical personnel will monitor and report to a chain of command. It is “certainly a conservative approach, but also a prudent approach until we learn more about this mission,” Dempsey said.
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But the chiefs will reassess the reintegration protocols in 45 days, he said, and will listen to medical personnel, the service members themselves and the families. “If we think we’ve been too conservative, we will make an adjustment, and I can’t predict what that will be,” Dempsey said. “I feel good where we are now, but I’m open to the possibility that 45 days from now we will adapt.”
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[nitpicker]

2. Snips from the DoD presser 30 Oct 2014

http://www.defense.gov/Transcripts/Transcript.aspx?TranscriptID=5530

Department of Defense Press Briefing by Secretary Hagel and General Dempsey in the Pentagon Briefing Room

Presenter: Secretary of Defense Chuck Hagel; Joint Chiefs of Staff Chairman General Martin E. Dempsey
October 30, 2014
(snip)

The Department of Defense remains focused on helping contain the disease at its source, with over 13,000 cases and some 5,000 deaths in West Africa so far. Halting the spread of Ebola at the center of the outbreak is the most effective way to keep the American people safe here at home.

Working with USAID, the Defense Department is continuing to deploy up to 4,000 troops to provide command and control, engineering, training and logistics support. About 1,100 DOD personnel have already deployed to West Africa, and they're making progress despite difficult weather conditions and rough terrain. They're making a difference in Liberia with the construction of up to 17 Ebola treatment units, the first of which will be completed over the weekend. The second is on track to be completed by mid-November, with a third and fourth units being completed before Thanksgiving.

They are in the process of more than doubling their mobile laboratory capacity, going from the current three labs to a total of seven. They began training Liberian health care providers in Monrovia this week, which will scale-up as they fully establish their training site. The 25-bed hospital they have been building in Monrovia will be fully operational next week. And troops in Senegal are supporting all these efforts by coordinating the flow of supplies, equipment and personnel.

Throughout these deployments, DOD will remain vigilant to protect its troops, our families, and their communities. That's why in response to a recommendation from the Joint Chiefs, I directed that all military personnel returning from Ebola-responsive efforts in West Africa undergo a 21-day controlled monitoring regimen. I made this decision in light of the unique role and responsibilities of our military, the scale of their deployments, and DOD's responsibility for the health of these servicemembers and their families. We will continue to review this policy as conditions on the ground evolve.

At the request of the Department of Health and Human Services, DOD is also taking steps to be prepared in case federal health officials request our help in responding to Ebola cases here in the United States. Earlier this week, our 30-person expeditionary medical support team finished training at Fort Sam Houston. And as of this past Tuesday, if needed, they are ready to deploy within 72 hours.
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Q: If we could turn to Ebola, Mr. Chairman, can you talk about some of the specific items that the chiefs were talking about when you made your decision for the 21-day quarantine? And then -- and did the medical science ever factor into the decision? And just the fact that the majority, the vast majority, if not all of the U.S. troops who were down there are not going to be any kind of contact with Ebola -- was that ever factors in before the decision was made?

GEN. DEMPSEY: (snip) These health care workers come and go because it's such an intense environment for them. You know, they may go for, you know, 30 or 60 days, and then leave the -- leave the area because of the intense pressure they're under. We're going to have our young men and women there for six months at a time. That's the duration of our deployment -- not in direct contact with Ebola, but they're there longer.

So more of them, there longer, and we're not health care workers, by the way. You know, we're infantrymen and we're supply clerks. And so when you add those things together, here's what I would tell you. We did factor in science. Physics is the science we factored in. You know, when we do -- you know, this is not about small groups of people who are transient. There's protocols for that. It's also not about health care professionals in direct contact with Ebola. There's protocols for that.

This is about a major military operation and big things on a global scale. And so we took a conservative approach and we'll assess it in 45 days. But we're going to keep them safe.

SEC. HAGEL: And the other thing I would say about that, the science -- science does dictate that there is a 21-day monitoring period. So, and I asked the same question when the chairman and the chiefs came to me with all of this. And this was thoroughly reviewed by health care professionals in each of the services in the Office of the Secretary of Defense.
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3. U.S. military to train more Ebola response teams

http://www.navytimes.com/article/20141030/NEWS/310300063/U-S-military-train-more-Ebola-response-teams

U.S. military to train more Ebola response teams
Military hospitals to care for high-risk troops
Oct. 30, 2014 - 06:23PM |
By Patricia Kime
Staff writer

The U.S. military will train more medical personnel to respond to domestic cases of Ebola should they occur, a senior Defense Department official said Thursday.

Plans are underway to form more military Ebola medical response teams similar to the 30-member group that completed training this week at San Antonio Military Medical Center, Fort Sam Houston, Texas. The official said the Pentagon is anticipating a request from the Health and Human Services Department for more medical personnel who would respond on short notice to civilian medical facilities should they need help treating Ebola patients.
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According to Pentagon sources, any service member who develops Ebola symptoms would be stabilized in-country and evacuated by specially equipped ambulance to a top Ebola treatment facility in the U.S., either at the National Institutes of Health in Bethesda, Maryland; Emory University Hospital in Atlanta; or University of Nebraska Medical Center in Omaha.

Military patients who are considered high risk but are not symptomatic would return to the U.S. and be placed in isolation at Walter Reed National Military Medical Center in Bethesda, Maryland; Portsmouth Naval Hospital, Virginia; or William Beaumont Army Medical Center, Fort Bliss, Texas. Service members deemed to be low risk will be quarantined by their services and monitored for symptoms for 21 days.
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[nitpicker]

4. The latest from AP

http://www.stripes.com/soldier-or-civilian-ebola-protocols-not-the-same-1.311348

By Jim Kuhnhenn and Robert Burns
The Associated Press
Published: October 31, 2014

WASHINGTON -- A U.S. soldier returning from an Ebola response mission in West Africa would have to spend 21 days being monitored, isolated in a military facility away from family and the broader population. A returning civilian doctor or nurse who directly treated Ebola patients? Depends.

The Pentagon has put in place the most stringent Ebola security measures yet, going beyond even the toughest measures adopted by states such as New York, New Jersey and Maine and much further than the guidance set by the federal Centers for Disease Control and Prevention for travelers returning from the afflicted region.
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Why is the Pentagon stricter?

Defense officials maintain that the Pentagon rules are necessary because even through troops will not treat Ebola patients, they will spend more time in the Ebola hot zone than health care workers.
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