I started my Ebola column yesterday by relating a question from reporter Scott Gordon of KXAS News in Dallas: "Hospital reviewing why patient wasn't properly diagnosed on Friday when he was evaluated and sent home. Dismissed with antibiotics."
I thought that was an excellent question, especially since the patient in question had arrived from Liberia, ground zero of the Ebola outbreak. We've been told for months that our medical system and government agencies were ready to pounce on Ebola the instant that good-for-nothing virus arrived on our shores. Show your face in America and you're going down, Ebola! And yet, when it finally arrived, the very first case involved a man who presented symptoms consistent with Ebola, and told doctors he had just returned from the hot zone, but the hospital gave him an arm full of antibiotics and sent him on his merry without bothering to screen him. "Regretfully, that information was not fully communicated through the full teams. As a result, the full import of that information wasn't factored into the full decision-making," a Texas hospital official helpfully explained.
Somehow most of the media missed that detail in the early reporting, but by noon the mainstream press said, "Wait, what?" and flooded the zone with articles informing readers that Patient One roamed Dallas for two days with Ebola active in his system, before returning to a hospital and being properly isolated. Initial reports breezily dismissed the number of people he might have infected as a mere "handful." By Thursday morning, that "handful" was up to eighty people, including small children.
We've been assured the highly trained agents of the TSA would immediately spot incoming passengers from West Africa who presented an Ebola risk, and place them in the care of special teams on standby at international airports. I recall hearing those assurances the very first time I wrote about Ebola. But Patient One had a three-hour layover at Dulles International Airport in Washington, D.C. before jetting on to Dallas, and was not detected. The Centers for Disease Control decided to notify United Airlines but not the Ebola victim's fellow passengers, because he didn't manifest symptoms until after he had been in the United States for a few days, so the disease probably wasn't infectious while he was in transit. And yet, for some reason, even through there's absolutely no risk whatsoever, the CDC still assigned someone to research all of the other passengers...
Fox News has a report that he was "seen vomiting on the ground outside an apartment complex as he was bundled into an ambulance," while his screaming family watched, in a scene straight out of a horror movie. The family has ordered to stay home until the Ebola incubation period has passed, and will face criminal charges if they disobey. "A security officer blocked the entrance to the complex, with instructions only to let residents in and out," says the Fox report. Is that guy also supposed to make sure nobody from the potentially infected family disobeys the orders and leaves? How about the people they've come into contact with already?
The Ebola patient has been identified as Thomas Eric Duncan. His time in Liberia is chronicled at the New York Times:
Mr. Duncan???s case began with him playing the part of good Samaritan on another continent. Mr. Duncan ??? a Liberian national in his mid-40s who had come to America to visit relatives in Dallas ??? had direct contact with a woman stricken by Ebola in Monrovia, the Liberian capital, on Sept. 15, days before he left Liberia for the United States, the woman???s parents and Mr. Duncan???s neighbors said.
The family of the woman, Marthalene Williams, 19, took her by taxi to a hospital with Mr. Duncan???s help after failing to get an ambulance. Ms. Williams was turned away for lack of space in the hospital???s Ebola treatment ward, the family said, and they took her back home in the evening, hours before she died. Mr. Duncan helped carry her because she was no longer able to walk. In the taxi, Ms. Williams, who was seven months pregnant, had been convulsing.
But he was willing and able to hop on a plane and fly to the United States, no problemo. Every single layer of our vaunted defense against Ebola failed during its first test. Passengers are still allowed into the U.S. from affected areas, and like Duncan, they could be carrying Ebola infections that won't become visible and contagious for days after they arrive.
The Times chronicles some panicked reactions from people in the Dallas area, some of which are based on misunderstandings of how it spreads, but at this point, it's more about distrust of the system than incorrect understanding of the virus itself. The director of the CDC just got his own organization's Ebola contamination protocols wrong during a national TV interview. Early estimates of possible contamination rapidly bloomed from a "handful," to perhaps 18 people, to over 80. Hopefully none of them will actually develop Ebola infections, and this story will end with a single patient who makes a full recovery. But there's no reason for anyone to look down their noses at those who worry that the authorities will make mistakes or withhold information, for they have already done both.
Update: The BBC reports the number of people potentially exposed to Ebola by Duncan has risen to "as many as 100." No confirmed infections yet, and hopefully there won't be any.
