New York City authorities began decontaminating the apartment of the doctor who tested positive for Ebola as questions mounted over whether health-care workers caring for patients should be isolated.
As officials fanned out today to reassure the public, the doctor, Craig Spencer, 33, was being treated in an isolation unit at Bellevue Hospital Center in Manhattan. Officials are tracing his contacts and monitoring those who have been with him since his return from West Africa. He traveled on the subway, went bowling and had close contact with several people in the days before developing an elevated temperature and alerting authorities.
Spencer’s condition was stable as of this morning, Irwin Redlener, a professor a Columbia University and an adviser to the mayor, told reporters outside Bellevue. “He has been very diligent about following protocol,” Redlener said. None of his close contacts have shown symptoms, he said.
A cleaning crew arrived at his apartment today to begin decontaminating the unit. “We do not believe there are any body fluids in the apartment because the patient reported no vomiting or diarrhea,” New York’s Department of Health and Mental Hygiene said in a statement. The cleaners are throwing out items Spencer may have been in contact with inside, the cleaning surfaces.
With New York City residents expressing a range of emotions, including questioning Spencer’s decision to mix with the public, Governor Andrew Cuomo planned to ride some of the same subway lines that Spencer used.
“We have to separate that fear from the reality,” Cuomo told CNN today, calling Spencer a hero for caring for Ebola patients in Guinea. “We have a dose of irrational fear. Being New Yorkers, a little anxiety can keep you safe, but undo anxiety is unnecessary.”
In Washington, as a House committee held hearings today on the response to the outbreak, Representative Jason Chaffetz said Spencer’s self-monitoring for Ebola symptoms after he returned “didn’t work.”
Chaffetz, a Utah Republican, said people returning from nations gripped by the outbreak should be placed in “some sort of quarantine or isolation” for 21 to 42 days.
“He went into West Africa to help people who have Ebola,” Chaffetz said in an interview today on Bloomberg Television before the hearing. “You gotta love a person like that, but for them to come back, and then be out in the public in such a populous city like New York City. I think that scares a lot of people.”
The West African outbreak, which has infected more than 10,000 people, killing about half, is the worst on record, drawing medical professionals from around the globe to Liberia, Guinea and Sierra Leone, the most affected countries. An Ebola case was also confirmed yesterday in Mali, which shares a border with Guinea.
The second of two nurses in Dallas who were infected at Texas Health Presbyterian Hospital while caring for Thomas Eric Duncan, the first man to die of the virus in the U.S., was today declared virus free. Nina Pham, 26, was discharged from the National Institutes of Health medical center in Maryland. The other nurse, Amber Vinson, 29, is also free of the virus, Emory University Hospital in Atlanta said today.
Spencer, an emergency medicine doctor at Columbia University-New York Presbyterian Hospital, returned to New York on Oct. 17 from Guinea, one of three countries where the Ebola outbreak has been raging, after working there with Doctors Without Borders. He hasn’t been attending to patients at the hospital since returning, New York Presbyterian said in a statement.
Spencer began feeling tired on Oct. 21, and first noticed he had a fever, 100.3 degrees (37.9 celsius), sometime about 10 a.m. yesterday. He then immediately alerted Doctors Without Borders, New York City Health Commissioner Mary Bassett said. The aid group contacted health authorities and Spencer was brought to Bellevue, a state-designated center for such cases, in a special ambulance.
“The individual engaged in regular health monitoring and reported this development immediately,” said Tim Shenk, a Doctors Without Borders spokesman, by e-mail.
Despite strict safety measures by Doctors Without Borders, 14 of their staff members have been infected with Ebola and eight have died since March, the organization said Sept. 24. The greatest risk is believed to be when they are out in the community rather than when working with patients, the group said.
Cuomo said health authorities believe only four people had close contact with Spencer during the “relevant period” while he may have exposed others to the infection. Bassett said they were Spencer’s fiancee, two friends and an Uber car-service driver.
On Oct. 22, Spencer went to The Gutter, a bowling alley in the Williamsburg section of Brooklyn, Bassett said. Spencer has also traveled on the A, 1 and L subway lines while he’s been in New York, officials said.
The fiancee and friends are healthy but under quarantine, according to Bassett. The Uber driver had no direct physical contact, she said.
Uber said it contacted health officials and were told “that neither our driver partner, nor any of his subsequent passengers are at risk,” spokeswoman Kristin Carvell said in statement. “We have communicated this to the driver, and the NYC DOHMH medical team met with the driver in person, assuring him that he is not at risk.”
The bowling alley closed “out of an abundance of caution,” Bassett said.
Bassett said she considered the fever the onset of symptoms that would make the patient contagious. The fatigue, she said, could have been attributed to any number of reasons.
“He limited his contact with people,” Bassett said, although before he was showing symptoms he left his apartment and, among other things, rode the subway trains.
The Ebola diagnosis was made by the New York City Department of Health & Mental Hygiene. Samples of Spencer’s blood will be sent to the U.S. Centers for Disease Control and Prevention in Atlanta for confirmation, the CDC said.
“There is no reason for New Yorkers to be alarmed; Ebola is an extremely hard disease to contract,” said New York City Mayor Bill de Blasio at a news conference announcing the infection. “New Yorkers who haven’t been exposed to an infected person’s bodily fluids aren’t at all at risk.”
In Spencer’s Harlem neighborhood, workers were seen handing out informational fliers about the illness. Tanya Thomas, who lives on the 4th floor of Spencer’s building, said everyone who wasn’t home got a card under their door describing Ebola.
Javier Lopez, a city worker looking to trace Spencer’s steps, said he is trying to get the message out to New York’s Hamilton Heights neighborhood that people should be cautious, but not panic.
“This is a very traumatic experience for a lot of the residents,” he said, standing outside Spencer’s 147th Street apartment.
Stan Malone, 45, who resides across the street from Spencer, said that relatives who live about two floors away from Spencer left yesterday to stay in a hotel. He said no city or state officials have reached out to him about potential contact with Spencer.
“I think this building should be quarantined now,” he said. “It’s taken the city or the health department or whoever so long to come in here.”
A CDC ‘Go’ team was dispatched to New York, even before Spencer was formally diagnosed with the disease. It will help health workers at Bellevue safely care for him while trying to track down anybody he may have had close contact with while he was sick, said Tom Skinner, an agency spokesman.
The CDC team is composed of epidemiologists, infection control, data management, and communications officers, he said.
New York state officials have been planning for an Ebola patient for months, Cuomo said, and recently ordered hospitals to go through practice drills and enhance safety protocols.
Bellevue, an 828-bed hospital, has been designated as one of four facilities for Ebola treatment in New York, a city of 8.4 million residents. The facility has four single-bed rooms in its infectious-disease ward to receive high-probability or confirmed cases and a laboratory to handle blood samples, according to New York City Health and Hospitals Corp.
Mount Sinai Hospital and New York Presbyterian in Manhattan, and Montefiore Medical Center in the Bronx, are the other New York City facilities for patients. Four others are on Long Island and in Syracuse and Rochester.
Spencer left Guinea Oct. 14 and arrived at John F. Kennedy International Airport on Oct. 17, Bassett said. He posted a picture on his Facebook page on Sept. 18, saying he was going to Guinea with Doctors Without Borders.
“Please support organizations that are sending support or personnel to West Africa, and help combat one of the worst public health and humanitarian disasters in recent history,” read the caption of a photo showing a man wearing a protective gown, face shield, eye mask and gloves.
In Mali, the government has identified family members of the 2-year-old girl who was infected with Ebola and has started monitoring them, President Ibrahim Boubacar Keita’s office said in a statement. The family traveled with the girl from Guinea and was admitted to a hospital in Mali on Oct. 23. The World Health Organization warned last week that more needs to be done to prevent the disease from spreading through West Africa.
There’s no approved cure for Ebola, though some patients have received experimental drugs. The current standard of care involves supporting patients by replacing fluids and electrolytes, and using antibiotics to fight off any secondary infections.
Early symptoms can be similar to those of malaria such as fever and chills. Ebola also causes headache, stomach pain, weakness, diarrhea, vomiting, and bleeding. During later stages, patients can lose many liters of bodily fluid each day.
Patients are most infectious at late stages when large quantities of the virus are present inside the body. This explains why health-care workers and relatives tending to the gravely ill are most at risk of infection.
The CDC said on Oct. 22 that anyone traveling to the U.S. from Liberia, Sierra Leone or Guinea would be monitored for 21 days, the maximum incubation period for the virus. Travelers leaving the countries are already checked at the airport before boarding a plane, and about 36,000 people have been screened.
--With assistance from Caroline Chen, Martin Z. Braun, Cynthia Koons, Doni Bloomfield, Allyson Versprille, Brian Chappatta, Michelle F. Davis, Sonali Basak, Laura Davison, Jennifer Kaplan and Madeline McMahon in New York, John Lauerman in Atlanta and Alex Wayne and Danielle Trubow in Washington.
To contact the reporters on this story: Henry Goldman in New York at hgoldmanbloomberg.net; Shannon Pettypiece in New York at spettypiecebloomberg.net; Kelly Gilblom in New York at kgilblombloomberg.net To contact the editors responsible for this story: Reg Gale at rgale5bloomberg.net; Stephen Merelman at smerelmanbloomberg.net Larry Reibstein, Alan Goldstein