WASHINGTON—ThefederalgovernmentonMondayannouncedanewsetofmonitoringguidelinesforpeoplearrivingfromWestAfricathatstoppedshortofthetoughmeasuresinstitutedinNewYorkandNewJerseylastweek,anefforttobringuniformitytoamessypatchworkofresponsesbystates.華盛頓——周一，聯(lián)邦政府針對來自西非的人員，公布了一套新的監(jiān)控指導(dǎo)方針。此舉旨在讓各州的響應(yīng)措施趨于統(tǒng)一，擺脫目前混亂無序的局面。但這些方針的嚴(yán)厲程度，不及紐約州和新澤西州上個星期出臺的措施。Thenewpolicy,whichfederalhealthofficialssaidwasanefforttostrikeabalancebetweensafetyandcivilliberties,wouldrequirereturningheathcareworkers,orpeoplewhohadbeennearEbolapatients,tosubmittoanin-personcheckupandaphonecallfromalocalpublichealthauthority.聯(lián)邦衛(wèi)生官員稱，新的政策是為了在安全和公民自由之間取得平衡。該政策將要求從西非回國的醫(yī)護(hù)工作者或曾經(jīng)接觸埃博拉患者的人，接受當(dāng)?shù)毓残l(wèi)生官員的親自檢查和電話調(diào)查。Thatislooserthanthestay-homequarantinepoliciesinNewYorkandNewJersey,andmanybelievedthatthelong-awaitedfederalresponsewouldbeunlikelytosatisfythegovernorsofthosestates,whobelievethegovernmentneedstobemoreproactiveinpreventingpotentialEbolapatientsfromspreadingthevirus.這種做法比紐約州和新澤西州采取的居家隔離政策更加寬松，許多人認(rèn)為，這個期待已久的聯(lián)邦響應(yīng)措施，不太可能令這些州的州長滿意。后者認(rèn)為，政府需要更積極地防止?jié)撛诘陌２├颊邆鞑ピ摬《尽r.ThomasFrieden,thedirectoroftheCentersforDiseaseControlandPrevention,whoannouncedthenewmeasures,said:Webelievedthesearebasedonscience.Theseaddastronglevelofprotection.宣布上述新措施的是美國疾病控制與預(yù)防中心（CentersforDiseaseControlandPrevention，簡稱CDC）主任托馬斯·弗里登博士(ThomasFrieden)。他說：“我們相信這些措施是有科學(xué)依據(jù)的。它們能夠形成一種強(qiáng)有力的保護(hù)?！盉uttheC.D.C.doesnothaveregulatoryauthority,anditwillbeuptostatestoenforcethepolicy,andanumberofstateshavealreadyindicatedthattheybelievestrongermeasuresshouldbetaken,includingIllinoisandFlorida.但CDC沒有監(jiān)管權(quán)限，這些政策的執(zhí)行取決于各州政府。有幾個州已經(jīng)表示，認(rèn)為應(yīng)該采取更有力的措施，其中包括伊利諾伊州和佛羅里達(dá)州。Approximately100peopleadayarrivetotheUnitedStatesfromSierraLeone,GuineaandLiberia,mostofthemAmericancitizensorpermanentresidents.About70percentofthepeoplearrivetosixstates–NewYork,Maryland,Pennsylvania,Georgia,NewJerseyandVirginia.Dr.Friedenarguedthathisagencywasindiscussionswithstates,butdidnotspecifywhichones.每天有大約100人從塞拉利昂、幾內(nèi)亞和利比里亞飛抵美國，他們多數(shù)是美國公民，或擁有永久居留權(quán)。約70%的人會抵達(dá)以下六個州：紐約州、馬里蘭州、賓夕法尼亞州、喬治亞州、新澤西州和弗吉尼亞州。弗里登稱，CDC正在與各州政府進(jìn)行相關(guān)討論，但沒有具體說明是哪些州。WefoundthathealthdepartmentsgenerallydofollowC.D.C.guidelines,hesaid.Iftheywishthemtobemorestringent,thatiswithintheirauthority.“我們發(fā)現(xiàn)衛(wèi)生部門基本上沒有遵守CDC的指導(dǎo)方針，”他說。“如果它們希望采取更加嚴(yán)格的措施，它們有權(quán)力這樣做?！盙ov.TerryMcAuliffeofVirginiasaidMondaythathisstatewouldbegintomonitortravelersarrivingfromGuinea,Liberia,andSierraLeoneforhavingsymptomsconsistentwiththeEbolavirus,andmightprohibitreturninghealthworkersfromtakingpublictransitorattendinglargegatheringsforthreeweeksaftertheirarrival.弗吉尼亞州長特里·麥考利夫(TerryMcAuliffe)周一表示，將開始對那些從幾內(nèi)亞、利比里亞和塞拉利昂抵達(dá)美國，并呈現(xiàn)埃博拉病毒癥狀的人員進(jìn)行監(jiān)控，而且還可能禁止回國的衛(wèi)生工作者在抵達(dá)后的三周內(nèi)乘坐公共交通工具或參加大規(guī)模聚會。HealthworkerswhocaredforEbolapatientsinWestAfricawillalsoberequiredtosignagreementsthatrestricttheiractivities,thestatesaid.Thosehealthworkerswhohadknownbreachesofprotectiveprotocolwillberequiredtostayathomefor21days—withthepossibilityofmandatoryquarantine,Mr.McAuliffesaidinastatement.該州表示，在西非護(hù)理過埃博拉患者的醫(yī)護(hù)人員，也將被要求簽署限制其活動的協(xié)議。麥考利夫在一份聲明中稱，那些“已知曾違反防護(hù)規(guī)程”的醫(yī)護(hù)人員，將被要求在家里待21天，并可能被強(qiáng)制隔離。HealthcareworkerswhotreatedEbolapatientsinWestAfricawillbeevaluatedonacase-by-casebasisandmayberestrictedfrompublictransportation,massgatherings,andclinicalcare,thestatementsaid.AlltravelersarrivinginVirginiafromthethreeWestAfricannationswillbeaskedtotakeandrecordtheirtemperatureatleasttwiceeachday,withlocalhealthofficialscontactingthemdailyforthreeweekstocheckontheircondition.該聲明稱，在西非治療過埃博拉患者的醫(yī)務(wù)工作者將“逐個接受評估，并可能被限制乘坐公共交通工具、參加大型聚會、參與臨床護(hù)理”。從前述三個西非國家抵達(dá)弗吉尼亞州的人員，將被要求每天至少測量并記錄兩次體溫，并且當(dāng)?shù)氐男l(wèi)生官員將在三周的時間里每天與其聯(lián)系，檢查他們的情況。Evenifatravelerhastestednegativeforthevirus,butdevelopssymptomsthatsuggestEbolahasbeencontracted,Mr.McAuliffesaidthetravelermightbeaskedtoremainathomefor21daysundertheclosesupervisionofstatehealthofficials.麥考利夫稱，如果有旅客出現(xiàn)的癥狀顯示感染了埃博拉病毒，即使該人的病毒檢測呈陰性，也可能會被要求在家里待21天，接受州衛(wèi)生官員的密切監(jiān)督。Inannouncingthenewpolicyforreturninghealthcareworkers,federalofficialsareseekingtostrikeadelicatebalancebetweengettingthemedicaldetailsrightandmakingsurethepubliciscomfortablewiththeapproachthegovernmentistaking.Thisisimportantbecause,shouldthevirusbegintospread,healthworkerswillneedthepublictotrustthemenoughtorevealinformation.聯(lián)邦官員公布針對歸國醫(yī)務(wù)人員的新政策，意在取得一個微妙的平衡：一方面需要搞清楚醫(yī)療細(xì)節(jié)，另一方面又需要讓公眾能接受政府采取的措施。這一點頗為重要，因為一旦埃博拉病毒開始傳播，衛(wèi)生工作者需要贏得公眾足夠的信任，公眾才會透露信息。Ifsomethingisgoingtoscaresomeone,anEbolaguyonthesubwayisaprettygoodway,saidHowardMarkel,aprofessorofthehistoryofmedicineattheUniversityofMichigan,AnnArbor.Youhavetobeconcernedwiththepublicramificationofyouractions.“如果說有什么東西會嚇到人，地鐵上出現(xiàn)埃博拉患者可是個很好的辦法，”密歇根大學(xué)安娜堡分校(UniversityofMichigan,AnnArbor)醫(yī)學(xué)史教授霍華德·馬克爾(HowardMarkel)說?！澳惚仨氷P(guān)心自己的行動對公眾造成的后果?！盩hedifferencesbetweenthefederalgovernmentandthegovernorshavealreadyeruptedintoapoliticaltestofwillsjustdaysbeforethemidtermelections.AdministrationofficialsovertheweekendharshlycriticizedthequarantineplansinNewYorkandNewJersey,sayingtheywenttoofarandcouldhavetheunintendedconsequenceofdiscouraginghealthcareworkersfromgoingtoWestAfrica.