The Centers for Disease Control and Prevention held a conference call with reporters Monday to announce new guidelines for dealing with people entering the country from Ebola-impacted countries. The CDC has been under pressure from the White House aid in dissuading the American public from supporting a quarantine for health care workers returning from treating infected patients in West Africa.
These new guidelines, according to CDC director Thomas Frieden, are based in science. He told reporters, “At CDC, we base our decisions on science and experience. We base our decisions on what we know and what we learn. And as the science and experience changes, we adopt and adapt our guidelines and recommendations.”
But Frieden contradicted his own CDC’s pronouncements on how Ebola is transmitted. Frieden said Ebola “only spreads through direct contact with someone who’s sick or their body fluids. The highest risks are in people who are providing care giving, especially as patients become increasingly sick.” (Emphasis added.)
But the new guidelines state there is “some risk” in having “close contact,” not “direct contact,” with a person infected with Ebola.
Under the “some risk” category, someone subject to “direct active monitoring” by health officials is a person who had “Close contact in households, healthcare facilities, or community settings with a person with Ebola while the person was symptomatic.”
The CDC defines “close contact” as “being for a prolonged period of time while not wearing appropriate PPE within approximately 3 feet (1 meter) of a person with Ebola while the person was symptomatic.”
However, the CDC’s previous version of their “Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure” warned of transmission through “close contact” with an Ebola patient.
Last week it read that “close contact” was defined as:
a) being within approximately 3 feet (1 meter) of an EVD patient or within the patient’s room or care area for a prolonged period of time (e.g., health care personnel, household members) while not wearing recommended personal protective equipment (i.e., standard, droplet, and contact precautions; see Infection Prevention and Control Recommendations); or
b) having direct brief contact (e.g., shaking hands) with an EVD patient while not wearing recommended personal protective equipment.
Brief interactions, such as walking by a person or moving through a hospital, do not constitute close contact.
Point (b), shaking hands “with a person with Ebola while the person was in the early stage of disease,” has now been downgraded to “Low (but not zero) risk.”
So being in a room with or sitting next to an infected person on a bus puts an individual in the “some risk” category, but physically touching them (shaking hands) places them in the lower “low (but not zero) risk strata.
At the end of the call, Frieden doubled down on the “direct contact” mantra, saying, “So we’re not out of the woods, but, the science is very clear. That catching Ebola requires direct contact with someone who is ill.”
No explanation was asked for or offered about the conflict between the verbal “direct contact” claim and the “close contact” warning in writing.