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Public Health Implementation Considerations for State-Level Ebola Monitoring and Movement Restrictions

Published online by Cambridge University Press:  20 April 2020

Tara Kirk Sell*
Affiliation:
Johns Hopkins Center for Health Security; Assistant Professor, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health
Matthew P. Shearer
Affiliation:
Johns Hopkins Center for Health Security; Assistant Professor, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health
Diane Meyer
Affiliation:
Johns Hopkins Center for Health Security; Assistant Professor, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health
Mary Leinhos
Affiliation:
Office of Applied Research, Center for Preparedness and Response, US Centers for Disease Control and Prevention
Erin Thomas
Affiliation:
Public Health Preparedness Oak Ridge Institute for Science Fellowship, Office of Applied Research, Center for Preparedness and Response, US Centers for Disease Control and Prevention
Eric G. Carbone
Affiliation:
Office of Applied Research, Center for Preparedness and Response, US Centers for Disease Control and Prevention
*
Correspondence and reprint requests to Tara Kirk Sell, Johns Hopkins Center for Health Security, 621 E. Pratt St., Suite 210, Baltimore, MD21230 (e-mail: [email protected]).

Abstract

Objective:

This article describes implementation considerations for Ebola-related monitoring and movement restriction policies in the United States during the 2013–2016 West Africa Ebola epidemic.

Methods:

Semi-structured interviews were conducted between January and May 2017 with 30 individuals with direct knowledge of state-level Ebola policy development and implementation processes. Individuals represented 17 jurisdictions with variation in adherence to US Centers for Disease Control and Prevention (CDC) guidelines, census region, predominant state political affiliation, and public health governance structures, as well as the CDC.

Results:

Interviewees reported substantial resource commitments required to implement Ebola monitoring and movement restriction policies. Movement restriction policies, including for quarantine, varied from voluntary to mandatory programs, and, occasionally, quarantine enforcement procedures lacked clarity.

Conclusions:

Efforts to improve future monitoring and movement restriction policies may include addressing surge capacity to implement these programs, protocols for providing support to affected individuals, coordination with law enforcement, and guidance on varying approaches to movement restrictions.

Type
Brief Report
Copyright
© 2020 Society for Disaster Medicine and Public Health, Inc.

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References

REFERENCES

Chevalier, MS, Chung, W, Smith, J, et al. Ebola virus disease cluster in the United States – Dallas County, Texas, 2014. Morb Mortal Wkly Rep. 2014;63(46):10871088. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6346a11.htm. Accessed December 11, 2018.Google ScholarPubMed
McCarty, CL, Basler, C, Karwowski, M, et al. Response to importation of a case of Ebola virus disease– Ohio, October 2014. Morb Mortal Wkly Rep. 2014;63(46):10891091. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6346a12.htm. Accessed December 11, 2018.Google ScholarPubMed
Regan, JJ, Jungerman, R, Montiel, SH, et al. Public health response to commercial airline travel of a person with Ebola virus infection – United States, 2014. Morb Mortal Wkly Rep. 2015;64(3):6366. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6403a5.htm. Accessed December 11, 2018.Google ScholarPubMed
Somander, T. CDC: monitoring symptoms and controlling movement to stop the spread of Ebola. The White House Blog. October 27, 2014. https://obamawhitehouse.archives.gov/blog/2014/10/27/cdc-monitoring-symptoms-and-controlling-movement-stop-spread-ebola. Accessed April 8, 2019.Google Scholar
Sunshine, G, Pepin, D, Cetron, M, Penn, M. State and territorial Ebola screening, monitoring, and movement policy statements – United States, August 31, 2015. Morb Mortal Wkly Rep. 2015;64(40):11451146. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6440a4.htm. Accessed December 11, 2018.10.15585/mmwr.mm6440a4CrossRefGoogle ScholarPubMed
Sell, TK, McGinty, EE, Pollack, K, et al. US state-level policy responses to the Ebola outbreak, 2014–2015. J Public Health Manag Pract. 2017;23(1):1119. https://journals.lww.com/jphmp/fulltext/2017/01000/US_State_Level_Policy_Responses_to_the_Ebola.3.aspx. Accessed December 11, 2018.10.1097/PHH.0000000000000384CrossRefGoogle Scholar
Stehling-Ariza, T, Fisher, E, Vagi, S, et al. Monitoring of persons with risk for exposure to Ebola virus disease – United States, November 3, 2014–March 8, 2015. Morb Mortal Wkly Rep. 2015;64(25):685689. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4584679/. Accessed December 12, 2018.Google ScholarPubMed
Schemm Dwyer, K, Misner, H, Chang, S, Fajardo, N. An interim examination of the US public health response to Ebola. Health Secur. 2017;15(5):527538. https://www.liebertpub.com/doi/full/10.1089/hs.2016.0128. Accessed December 12, 2018.CrossRefGoogle ScholarPubMed
Sell, TK, Shearer, MP, Meyer, D, et al. Influencing factors in the development of state-level movement restriction and monitoring policies in response to Ebola, United States, 2014–15. Health Secur. 2019;17(5):364371.10.1089/hs.2019.0053CrossRefGoogle ScholarPubMed
Gostin, LO, Hodge, JG Jr, Burris, S. Is the United States prepared for Ebola? JAMA. 2014;312(23):24972498. https://jamanetwork.com/journals/jama/fullarticle/1918850. Accessed December 12, 2018.Google Scholar