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Facing fierce resistance from the White House and medical experts to a strict new mandatory quarantine policy, Gov. Andrew M. Cuomo said on Sunday night that medical workers who had contact with Ebola patients in West Africa but did not show symptoms of the disease would be allowed to remain at home and would receive compensation for lost income.
Mr. Cuomo’s decision capped a frenzied weekend of behind-the-scenes pleas from administration officials, who urged him and Gov. Chris Christie of New Jersey to reconsider the mandatory quarantine they had announced on Friday. Aides to President Obama also asked other governors and mayors to follow a policy based on science, seeking to stem a steady movement toward more stringent measures in recent days at the state level.
The announcement by Mr. Cuomo seemed intended to draw a sharp contrast — both in tone and in fact — to the policy’s implementation in New Jersey, where a nurse from Maine who arrived on Friday from Sierra Leone was swiftly quarantined in a tent set up inside a Newark hospital, with a portable toilet but with no shower.
It was the second striking shift in Mr. Cuomo’s public posture on the Ebola crisis in 72 hours; after urging calm on Thursday night, then joining Mr. Christie to highlight the risks of lax policy on Friday, Mr. Cuomo on Sunday night appeared to try to dial back his rhetoric and stake out a middle ground.
He said his decision balanced public safety with the need to avoid deterring medical professionals from volunteering in West Africa. “My No. 1 job is to protect the people of New York, and this does that,” he said. Those quarantined at home will be visited twice a day by local authorities, he said. Family members will be allowed to stay, and friends may visit with the approval of health officials.
Mayor Bill de Blasio, sitting beside Mr. Cuomo at a news conference in Manhattan, nodded in approval, and praised the governor for developing a set of flexible quarantine guidelines that, the mayor said, would show proper respect to those required to abide by them.
After Mr. Cuomo’s announcement, Mr. Christie issued a statement saying that, under protocols announced on Wednesday, New Jersey residents not displaying symptoms would also be allowed to quarantine in their homes.
Until Sunday night, the quarantine orders by Mr. Christie, a Republican, and Mr. Cuomo, a Democrat, had drawn withering criticism from many medical experts, who said they would discourage aid workers from volunteering to help eradicate the disease at its source. By midday Sunday, Kaci Hickox, the nurse who became the first person isolated under the new protocols in New Jersey, emerged as the public face of the opposition, calling the treatment she received “inhumane” and disputing Mr. Christie’s assertion a day earlier that she was “obviously ill.”
“If he knew anything about Ebola he would know that asymptomatic people are not infectious,” Ms. Hickox told CNN.
Even some who acknowledged the states’ authority to enact the policy took issue with its implementation in New Jersey.
“We have to think how we treat the people who are doing this noble work,” Mr. de Blasio said. At a late afternoon news conference, he said Ms. Hickox’s treatment was “inappropriate,” adding: “We owe her better than that.”
Yet amid heightened public anxiety about the government’s handling of the crisis, state authorities have increasingly calculated that the mandatory quarantines will prove prescient. Since the governors’ announcement, Illinois and Florida have said they were instituting similar measures.
“I think this is a policy that will become a national policy sooner rather than later,” Mr. Christie said in an interview on Fox News Sunday.
The Cuomo and Christie administrations began seriously considering a quarantine on Tuesday, aides said, after federal officials decreed that travelers returning from countries affected by Ebola in West Africa could enter the United States only at five designated airports, including Kennedy and Newark Liberty International.
Mr. Christie had grown increasingly frustrated by mid-October, aides said, over the failure of medical professionals to properly isolate themselves on a voluntary basis after returning from West Africa.
He was startled to learn that Dr. Nancy Snyderman, an NBC News correspondent who had traveled to Liberia and whose cameraman had contracted Ebola, left her home in Princeton, N.J., on Oct. 9 to pick up food at a favorite local restaurant.
When a doctor, Craig Spencer, tested positive in New York City on Thursday, the two governors watched as city officials strained to trace his every movement — on the subway, at a bowling alley, at a meatball shop.
What appeared to be a triumph of meticulous forensic work by city health officials, in retracing Dr. Spencer’s every step late last week, looked like a potential nightmare to governors who suddenly contemplated having to repeat such an exercise over and over.
In a series of phone conversations starting on Thursday night, shortly after Dr. Spencer’s condition was diagnosed, and continuing Friday morning, Mr. Christie and Mr. Cuomo decided to impose the mandatory quarantines, officials said — essentially declaring that neither state trusted those potentially exposed to the deadly disease to wall themselves off from the rest of society.
Aides to Mr. Cuomo said the notion of a mandatory quarantine had always been considered, and that the plan had been quietly vetted by attorneys and public-health officials.
Neither governor notified the White House.
It did not take long for a test case to arrive at Newark. Ms. Hickox, who had treated Ebola patients in West Africa, landed at around 1 p.m. Friday, and immediately became ensnared in the new order.
In a way, the NBC episode worked to New Jersey’s benefit. Because of it, Mr. Christie and his aides had already developed a legal framework for mandatory quarantines, which they applied to Ms. Hickox.
The benefits, supporters said, were clear: soothing public concerns with more aggressive monitoring at the front end and sparing officials from exhaustive retracing after the fact.
For Mr. Cuomo, though, embracing the policy proved somewhat complicated. Earlier this month, he cast decisions on screening procedures as “a federal issue.” In a news conference on Thursday announcing that Dr. Spencer had tested positive for Ebola, Mr. Cuomo appeared beside Mr. de Blasio and health officials to urge calm. (The city said Sunday that Dr. Spencer “looks better than he looked yesterday.” He remained in serious but stable condition.)
By Friday, appearing with Mr. Christie, the tone had changed starkly.
“In a region like this,” Mr. Cuomo said, “you go out one, two or three times, you ride the subway, you ride a bus, you could affect hundreds and hundreds of people.”
At their announcement, the two governors provided scant detail on how the quarantines would be put in place or enforced.
City officials, who were not consulted on the two governors’ decision, learned of it as the public did. A room-to-room scramble began at City Hall: Who, senior aides asked, had been briefed about this? The answer was no one.
At the White House, Obama administration officials said they sought repeatedly to persuade Mr. Christie and Mr. Cuomo to reconsider the quarantines, which they viewed as not just unnecessary but counterproductive. (Mr. Christie insisted on Sunday that he had “gotten absolutely no contact” from the White House; Mr. Cuomo said he had not been pressured.)
The decisions by the states, White House officials and others warned, could hamstring the effort to staff up to 17 Ebola treatment units that American military personnel are building in Liberia. American health officials had already been facing the difficult task of finding volunteers, and have accepted help from foreign nationals, including Cuba, to aid the effort.
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“Every time someone tightens that noose, health workers from the United States say, ‘Well, I’m not sure it’s worth that sacrifice,’ ” said James P. Mitchum, the chief executive of the charity Heart to Heart International, which has begun training workers at an International Medical Corps treatment unit in Liberia.
A senior Obama administration official, who spoke on background to discuss private conversations with state officials, called the governors’ plan “uncoordinated, very hurried, an immediate reaction to the New York City case that doesn’t comport with science.”
But Mr. Cuomo and Mr. Christie were not out on their own for long. Late Friday, Gov. Pat Quinn of Illinois, a Democrat, issued a mandatory quarantine order for “high-risk” individuals who have come in contact with patients in West Africa. On Saturday, Gov. Rick Scott of Florida, a Republican, signed a similar one.
On Sunday morning, Mr. Christie predicted on Fox News that federal officials would adopt the same standards “sooner rather than later.”
The Obama administration suggested otherwise. Officials said the quarantine rules could create “a system of perverse incentives,” encouraging health care workers to fly into a different airport, like Atlanta or Washington Dulles, outside states that had adopted the new policies.
On Sunday afternoon, President Obama gathered top advisers for a meeting at the White House to work on a new, nationwide standard for returning health care workers. That policy is likely to advise against a total quarantine of those workers, a senior administration official said.
A group of scientists, public health experts and other opponents of the mandatory quarantine addressed a letter on Sunday to Mr. Cuomo, urging him to end the policy.
Ms. Hickox, the nurse, has retained a civil rights lawyer to challenge the quarantine order and get her out of isolation. In the interview with CNN, Ms. Hickox said officials had not informed her about what they planned to do next or why they were isolating her despite her showing no symptoms.
“We can have a conversation about what further measures would look like, but this is an extreme that is not acceptable,” she said. “I feel that my basic human rights have been violated.”
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