U.S. health officials presented a united front on Sunday morning, dismissing suggestions that the Ebola virus, now running rampant in three West African nations, could gain a foothold in the United States, just a week after a man visiting from Liberia developed the disease in Dallas.
The man, Liberian national Thomas Duncan, flew to the United States from Liberia, where several days before he had helped care for a woman sick with Ebola. As of Sunday morning, Duncan’s condition had worsened and he was listed as being in “critical” condition in a Dallas area hospital.
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“We are going to stop the outbreak in its tracks,” said Dr. Thomas Frieden, director of the Centers for Disease Control in an appearance on CNN. He said that the CDC and health officials in Texas have identified all Duncan’s contacts since he arrived in the U.S. and became symptomatic.
“That’s how we break the chain of transmission,’ he said. “Every one will be monitored every day for fever…If they develop fever they will be isolated.”
Not everyone is so sanguine about stopping an outbreak. At a press conference today, Sen Charles Schumer (D-NY) said he wanted passengers coming in from West Africa to receive special screening, including having their temperatures taken. That’s the protocol that China used during the outbreak of SARS in Hong Kong 2002 and 2003.
Schumer also wants Homeland Security to establish a temporary database of people who have traveled to West Africa (or any other area where there’s been an Ebola outbreak). That list would be given to hospitals and given special scrutiny in the event one of those people was admitted.
Frieden acknowledged that there had been a series of failures when Duncan first began to show symptoms of the disease, the most significant being that he was sent home from the hospital with antibiotics despite informing a nurse that he had recently been in Liberia.
“This missed diagnosis is concerning,” Frieden said, calling it a “teachable moment” for the U.S. healthcare community.
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There was also considerable worry about the fact that potentially contaminated materials, such as bed sheets and other items with which Duncan had close contact, were left in the apartment with the members of the family who had been hosting him.
Frieden said the delay was due to “a glitch in the government system to approve a waste removal company to do that,” adding, “That’s been resolved.”
The CDC is stepping up its outreach to healthcare professionals, said Dr. William Frohna, chair of the emergency department Medstar Washington Hospital Center, a major medical center in Washington, DC.Frohna said his staff is in contact with the CDC multiple times per day, and that it has taken steps to prevent an Ebola case from escaping diagnosis or being transmitted further.
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People entering the emergency room with a fever or a cough are immediately asked to don a surgical mask. Anyone with those symptoms who had traveled to Africa or been in contact with a potential Ebola patient “is immediately escorted to an isolation room.”
Frohna warned that the public should expect more and more reports of patients being under investigation for Ebola. That does not necessarily mean the disease is spreading, but that health officials “are casting a wider net” when it comes to identifying potential patients.
Indeed, two potential cases were admitted to DC area hospitals on Friday, only to be declared free from the disease over the weekend.
Health officials also continued to push back against calls to block international air travel between affected countries and the rest of the world.
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“Experience is that when you close off a country you create such stress and fear that you amplify the problem,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in an appearance on Fox News Sunday.
By keeping travelers within the existing travel infrastructure, it allows them to be monitored as they leave affected countries, so that symptomatic individuals can be identified and prevented from boarding a plane.
“The crux of preventing an outbreak in Dallas or everyone else what CDC is doing,” said Fauci, adding that the existing public health system in the U.S. is more than adequate to address Ebola. “West Africa is not the United States. It could be we’ll see another case. But we won’t have an outbreak.”
Asked whether concerns about immigrants coming over the porous Southern U.S. border with Ebola, Fauci was dismissive, calling the idea “far-fetched.” He also said that worries about Ebola mutating into a form that is transmissible through the air are baseless.
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A virus mutating in a way that completely changes its method of transmission he said, is “extremely rare if not unprecedented.”
Dr. Frieden, who appeared on multiple talk shows Sunday morning, stressed the importance of fighting Ebola on the ground in Africa, saying that right now, its unchecked spread there is the greatest danger faced by the rest of the world.
He admitted that the initial response of the international public health community had been slow, but said, “We’ve never seen an Ebola epidemic before in the world.”
“In Africa, it’s going to be a long, hard fight,” he said, adding that the effort now under way to set up diagnostic and treatment facilities in the affected countries of Liberia, Sierra Leone, and Guinea, is absolutely essential.
“We need to make sure that we have these available in these countries…if we don’t do that we are all going to be at higher risk,” he said.
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