Dr. Robert Fuller didn't hesitate to go to Indonesia to treat survivors of the 2004 tsunami, to Haiti to help after the 2010 earthquake or to the Philippines after a devastating typhoon last year. But he's given up on going to West Africa to care for Ebola patients this winter.
He could make the six-week commitment sought by his go-to aid organization, International Medical Corps. But the possibility of a three-week quarantine afterward adds more time than he can take away from his job heading UConn Health Center's emergency department.
"I'm very sad that I can't go, at this point," said Fuller, who's helping instead by interviewing other prospective volunteers. Nine weeks or more "gets to be a pretty long time to think about being away from your family and being away from your job."
As Ebola-related quarantine policies have arisen around the United States, some health workers are reassessing whether, or how long, they can be among the hundreds that officials say are needed to fight the outbreak.
Potential volunteers are anxious about what they might come back to, especially after seeing new rules arise so rapidly that nurse Kaci Hickox was sequestered in a medical tent for days because New Jersey announced new regulations the day she flew back from Sierra Leone. Others are facing family qualms. And as the year winds down, some aid workers wonder whether they'll be able to go home for the holidays.
Aid organizations say it's too soon to tell whether quarantine rules are significantly shrinking the number of volunteers, but the measures are complicating an already challenging search for help treating a disease that has killed nearly 5,000 people, including about 310 health care workers.
Some potential volunteers are wary of not only being quarantined but being seen as potential disease-carriers, rather than conscientious professionals.
"People are afraid what will happen when their kid goes back to school, what their family will think," said Dr. Joia Mukherjee, chief medical officer of aid organization Partners in Health.
Doctors and nurses still are offering to help, planning ahead to seclude themselves in settings ranging from medical "safe houses" to solo camping trips.
New Jersey nurse Andrew Wegoye volunteered last month to go to West Africa with AmeriCares after seeing earlier outbreaks strike his native Uganda. New Jersey set its quarantine rules shortly before he left. But he didn't question his plans, which already entailed secluding himself after his four-month stint.
"That would be the least of my worries," Wegoye said by phone this week from Monrovia, Liberia. "Because being in quarantine for 21 days is nothing compared to people dying here without supportive care to help them see another day."
Ebola can be transmitted by direct contact with patients' bodily fluids after symptoms start. The federal Centers for Disease Control and Prevention recommend anyone who's had such contact — say, from touching patients without protective gear — undergo monitoring and avoid crowds during the 21-day window for developing Ebola.
But several states have recently gone further, requiring or requesting three weeks of sequestration.
"We need to do this to protect the public health" in densely populated places, and medical volunteers should understand that, New Jersey Gov. Chris Christie said. Hoping to promote volunteering, New York state has agreed to reimburse health workers and their employers for any quarantine time.
Hickox and aid groups protested her confinement in New Jersey and subsequent efforts to quarantine her at her home in Maine, saying such policies treat humanitarians like criminals, stigmatize people who aren't sick and aren't grounded in science.
Now, some aid workers' families are discouraging them from returning to West Africa, sometimes because the relatives themselves are getting hassled by people afraid of Ebola, said Sophie Delaunay, the U.S. executive director of Doctors Without Borders, the group with which Hickox worked.
International Medical Corps is weighing whether to send longer-term volunteers to other countries, instead of back home to the U.S., for R&R breaks, international recruiting director Brandon Berrett said.
And the Elizabeth R. Griffin Research Foundation's team in West Africa has been apprehensively watching quarantine policies — and the calendar.
"We're working day by day, at the moment, to ensure we can bring them back safely and get them home for Thanksgiving," said Dr. Gavin Macgregor-Skinner, a Penn State University public health professor who manages the charity's project training Ebola care workers.
Even as aid groups decry the mosaic of state quarantine policies as more political reaction than public health benefit, they're sensitive to fears of the disease.
Some organizations tell returning health professionals forgo patient care for three weeks. Samaritan's Purse even sends them to one of its three safe houses, where they can have visitors and venture outside but must avoid crowded places. Each gets a $1,000 bonus recognizing the hardship, president Franklin Graham said.
"Public perception is a real issue," he said. "We can't ignore it."