WASHINGTON — The federal government on Monday announced a new set of monitoring guidelines for people arriving from West Africa that stopped short of the tough measures instituted in New York and New Jersey last week, an effort to bring uniformity to a messy patchwork of responses by states.  The new policy, which federal health officials said was an effort to strike a balance between safety and civil liberties, would require returning heath care workers, or people who had been near Ebola patients, to submit to an in-person checkup and a phone call from a local public health authority.  That is looser than the stay-home quarantine policies in New York and New Jersey, and many believed that the long-awaited federal response would be unlikely to satisfy the governors of those states, who believe the government needs to be more proactive in preventing potential Ebola patients from spreading the virus.  Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention, who announced the new measures, said: "We believed these are based on science. These add a strong level of protection.”  But the C.D.C. does not have regulatory authority, and it will be up to states to enforce the policy, and a number of states have already indicated that they believe stronger measures should be taken, including Illinois and Florida.  Approximately 100 people a day arrive to the United States from Sierra Leone, Guinea and Liberia, most of them American citizens or permanent residents. About 70 percent of the people arrive to six states – New York, Maryland, Pennsylvania, Georgia, New Jersey and Virginia. Dr. Frieden argued that his agency was in discussions with states, but did not specify which ones.  “We found that health departments generally do follow C.D.C. guidelines,” he said. “If they wish them to be more stringent, that is within their authority.”  Gov. Terry McAuliffe of Virginia said Monday that his state would begin to monitor travelers arriving from Guinea, Liberia, and Sierra Leone for having symptoms consistent with the Ebola virus, and might prohibit returning health workers from taking public transit or attending large gatherings for three weeks after their arrival.  Federal, state and local officials are identifying hospitals to be used as Ebola treatment centers. A full list is expected later this week. Of the nation’s 100 state public health laboratories, 24 are ready to test for Ebola. Full Q. and A. »  Health workers who cared for Ebola patients in West Africa will also be required to sign agreements that restrict their activities, the state said. Those health workers who had “known breaches of protective protocol” will be required to stay at home for 21 days — with the possibility of mandatory quarantine, Mr. McAuliffe said in a statement.  Health care workers who treated Ebola patients in West Africa will be “evaluated on a case-by-case basis and may be restricted from public transportation, mass gatherings, and clinical care,” the statement said. All travelers arriving in Virginia from the three West African nations will be asked to take and record their temperature at least twice each day, with local health officials contacting them daily for three weeks to check on their condition.  Even if a traveler has tested negative for the virus, but develops symptoms that suggest Ebola has been contracted, Mr. McAuliffe said the traveler might be asked to remain at home for 21 days under the close supervision of state health officials.  In announcing the new policy for returning health care workers, federal officials are seeking to strike a delicate balance between getting the medical details right and making sure the public is comfortable with the approach the government is taking. This is important because, should the virus begin to spread, health workers will need the public to trust them enough to reveal information.  “If something is going to scare someone, an Ebola guy on the subway is a pretty good way,” said Howard Markel, a professor of the history of medicine at the University of Michigan, Ann Arbor. “You have to be concerned with the public ramification of your actions.”  The differences between the federal government and the governors have already erupted into a political test of wills just days before the midterm elections. Administration officials over the weekend harshly criticized the quarantine plans in New York and New Jersey, saying they went too far and could have the unintended consequence of discouraging health care workers from going to West Africa.  But Andrew M. Cuomo, the governor of New York, and Chris Christie, the governor of New Jersey, have refused to back down, saying they are putting in place policies that they think are necessary to protect the public.  Mr. Christie on Monday did agree to allow a nurse who had been quarantined in a tent at a New Jersey hospital to travel to her home in Maine.  Timothy Williams contributed reporting from New York.
The federal government announced the new ground rules in an effort to apply uniformity for travelers entering the United States from nations with Ebola outbreaks.