The federal agency that oversees many American healthcare workers volunteering in Ebola-stricken regions of West Africa says there's been a significant decline in the number of people who are willing to go. International aid groups attribute that drop to the mandatory quarantine rules implemented by New York and New Jersey last month.

"Once the restrictions were issued, we definitely had people who said I'm going to have to back out," says Margaret Aguirre, the head of global initiatives at the International Medical Corps in Los Angeles. The group has about 30 healthcare workers volunteering in West Africa.

Aguirre says Ebola assignments can last six to eight weeks at a time because of all the safety training that's required. "Many of these people are volunteering their time. And to be able to ask them to leave their work and families for that long stretch of time — plus the three weeks, 21-day quarantine — that's just prohibitive for people."

Aid groups have been warning about a possible "chilling effect" on volunteers since the two states' rules were announced in late October. And now there is some data to back up those claims.

The United States Agency for International Development, which handles applications from medical personnel volunteering to serve in West Africa, says applications declined by about 17 percent after October 26th, when the rules for mandatory quarantine rules were announced. "There was an unquestionable drop-off," says USAID spokesman Matt Herrick. "And unfortunately, that decline has continued."

There could be other explanations for the drop-off in volunteers, including the upcoming holiday season or the inherent dangers of treating the Ebola virus. But public health experts believe the mandatory quarantine rules are partly to blame.

New York and New Jersey implemented their rules after a healthcare worker in New York City, Dr. Craig Spencer, tested positive for Ebola after working with Doctors Without Borders in Guinea. Spencer has since been treated and released, with no further Ebola cases reported. The governors of both states say the mandatory quarantines are needed to protect the public.

New Jersey Governor Chris Christie's administration did not respond to our request for comment today. But he defended his policy vigorously at a campaign appearance in Rhode Island in late October. "Your first and most important job is to protect the health and safety of the people who live within your borders," Christie said. "And the fact is we're doing the exact right thing."

Public health officials aren't so sure.

"The word is out on the street: if you go, you're at risk of losing your liberty," says Lawrence Gostin, a professor of global health at Georgetown University Law School. "And people don't volunteer because of it."

Gostin points out that Ebola patients are only contagious when they're showing symptoms of the disease. And he's worried that mandatory quarantine rules may ultimately hurt more than they help by discouraging volunteers. "I call this a kind of misguided self-interest," he says. "We think it's in our self-interest. But in fact, it's probably harmful to our own interests."

Public health experts say it's in everyone's interests to end the Ebola epidemic at its source in West Africa. And that's going to take a lot more volunteers.

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Transcript

MELISSA BLOCK, HOST:

There's been a significant decline in the number of people willing to go to West Africa to fight Ebola. That's according to the U.S. agency that oversees many health care volunteers. International aid groups blame the drop on the mandatory quarantine rules implemented by New York and New Jersey last month. NPR's Joel Rose reports.

JOEL ROSE, BYLINE: Aid groups say they could see a difference as soon as New York and New Jersey announced the new rules.

MARGARET AGUIRRE: Once the restrictions were issued we definitely had people who said, I'm going to have to back out.

ROSE: Margaret Aguirre is with the International Medical Corps in Los Angeles. The group has about 30 health care workers volunteering in West Africa. She says deployments for Ebola can last six to eight weeks at a time because of all the safety training that's required.

AGUIRRE: Many of these people are volunteering their time. And to be able to ask them to leave their work and their families for that, you know, long stretch of time - plus the three weeks to 21-day quarantine - that's just prohibitive for people.

ROSE: Aid groups say the number of volunteers is off significantly since the rules were announced. And now there is some data to back them up. The federal agency that handles applications for medical personnel volunteering to serve in West Africa has seen those applications decline by about 17 percent. Matt Herrick is a spokesman for the United States Agency for International Development.

MATT HERRICK: In the days following October 26, in these announcements there was a questionable drop-off, and unfortunately that decline has continued.

ROSE: New York and New Jersey implemented their rules after a health care worker in New York City tested positive for Ebola. Dr. Craig Spencer has since been treated and released with no further Ebola cases reported. The governors of both states say the mandatory quarantines are needed to protect the public. Here's New Jersey Governor Chris Christie in October.

(SOUNDBITE OF ARCHIVED RECORDING)

GOVERNOR CHRIS CHRISTIE: Your first and most important job is to protect the health and safety of the people who live within your borders. And the fact is that we are doing exactly the right thing.

ROSE: There could be other explanations for the drop-off in volunteers, including the upcoming holiday season. But public health experts believe the mandatory quarantine rules are mostly to blame.

LAWRENCE GOSTIN: The word is out on the street that if you go, you are at risk of losing your liberty for three weeks when you get back. And people don't volunteer because of it.

ROSE: Lawrence Gostin teaches public health at Georgetown University Law School. He points out that Ebola patients are only contagious when they're showing symptoms of the disease. And he's worried that quarantine rules for those who aren't sick may ultimately hurt more than they help by discouraging volunteers.

GOSTIN: I call this a kind of misguided self-interest. We think it's in our self-interest, but in fact, it's probably harmful to our own interest.

ROSE: Public health experts say it's in everyone's interest to end the Ebola epidemic at its source in West Africa. And that's going to take a lot more volunteers. Joel Rose, NPR News, New York. Transcript provided by NPR, Copyright NPR.

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