At 8:15 a.m. Saturday, Dr. Myron Glick took his temperature.
He wrote the number down on his CDC Ebola Care Kit Symptom Log, then sent an email to the Erie County Health Department.
“97.5. No symptoms,” Glick typed.
This will be the physician’s routine for the next 19 days after returning Thursday night from a two-week trip to Sierra Leone, one of three West African countries where Ebola outbreaks have been identified. He went there not to treat patients but to aid a nurse who had worked for him at the Jericho Road Community Health Center in Buffalo in setting up a new medical clinic.
Glick said Saturday that he feels perfectly healthy and is confident he does not pose any risk to the public.
“As far as I know, I was not exposed to anyone who was a sick Ebola patient,” he said.
While he self-monitors his health and sends twice-daily updates to the Health Department, he has been cleared to start seeing patients again at Jericho Road, the West Side clinic he started with his wife in 1997 to provide health care to low income people, including resettled refugees.
“They’ve cleared me, as long as I don’t have symptoms, to start seeing patients on Monday,” Glick said.
On his trip to Sierra Leone, Glick made it a point to not treat any patients there – regardless of their symptoms. In past visits to the region, he and other health care workers would head out to remote villages with a couple of suitcases and take care of as many people as they could in whatever facility was available.
But with Ebola, that isn’t safe anymore.
This time, the doctor went to Sierra Leone to help Phebian Abdulai, the nurse who had worked at Jericho Road. She had fled Sierra Leone during the civil war there and resettled in Buffalo. Last year, she returned to her home country to start a health clinic, with the backing of Jericho Road.
As Ebola spread through Sierra Leone, she decided to stay and Glick wanted to show his support for the health center. The clinic won’t be an Ebola treatment center, but as a primary care facility, the staff is likely to see patients infected with the deadly virus. Dr. Glick went to help Abdulai set up a strict and safe protocol to screen for possible Ebola cases and also to network with other nongovernmental agencies and medical providers.
“Our team was very worried about me going over there,” Glick said of his fellow health care workers at Jericho Road. “The biggest reason was they didn’t think Dr. Glick could say no,” he said.
It was hard for him not to give medical care. But he knew he needed to refrain from any health care work, he said, “first of all to model it to our team – that they needed to be safe – and also just because I wanted to come back and be available to see patients here and be here for my family.”
Just days after a New York City doctor was diagnosed with Ebola after treating people with Ebola in Guinea, Glick shared his firsthand observations about the Ebola outbreak’s devastating impact in Sierra Leone to encourage people in the U.S. to stop being afraid about what could happen here and pay more attention to what’s happening in West Africa.
Changes in lifestyle
Set to open in January, the Adama Martha Memorial Health Center sponsored by Jericho Road is located in the Kono district, near the border with Liberia, which is also dealing with Ebola. Glick said 34 cases of Ebola have been documented in the district, and there are probably many more that have not been reported.
Glick was struck by the changes he noticed in Sierra Leone since the outbreak began in May.
“Just by face value,” he said, “life looks pretty normal.”
But it’s anything but. The country is operating under martial law and a strict curfew is in place. Public gatherings of any sort are discouraged. All schools – from primary school to universities – have been closed.
“No one is allowed to play soccer,” he said, a wildly popular sport across West Africa.
People are no longer allowed to bury their dead on their own and families must wait at least two days before bodies are checked for Ebola to lay their loved ones to rest.
The price of food has skyrocketed and people won’t go to the doctor, afraid they’ll be exposed to Ebola.
There’s only one airline – Brussels Airline – that still flies into the airport at Freetown. The others dropped their routes to Sierra Leone amid the growing Ebola crisis.
In previous visits, Glick enjoyed the warm, welcoming hugs he got from people he met. Now, no one touches each other. They either put their hands together or cross their hands in front of themselves.
“Or bump elbows,” he said.
There were also “Ebola checkpoints” throughout the country, set up to try to prevent people with Ebola from traveling to different parts of the country.
On his 10-hour drive from Freetown, Sierra Leone’s capital, to Kono, he was stopped eight times.
At the checkpoints, soldiers asked Glick to get out of the car.
“They want to see you walk,” he said.
The soldiers asked about where he was going and then took his temperature by waving a touch-free thermometer by his forehead.
“As long as you don’t have a fever, you’re fine,” he said. “God forbid you had a fever, for any reason.”
Inadequate health care
Even before Ebola emerged, health care was already woefully inadequate in Kono, much like the rest of Sierra Leone and West Africa.
In the district of 540,000 people, there is just one hospital.
“There are health centers,” Glick said. But just three doctors. Total.
“In Buffalo, we probably have a thousand doctors,” he said. “At Jericho Road, I have six doctors and nurse practitioners.
The hospitals don’t even have rudimentary medical supplies. There are no X-rays or sonograms.
“If you want a C-section, the family has to go out and buy fuel for the generator [to run the operating room],” he said.
“These doctors are already horribly overwhelmed and now you go bring Ebola into the system,” he said.
Jericho Road is part of a coalition of health care and faith-based groups working in the Buffalo area called the Sierra Leone Alliance of WNY. During his visit, Glick met with the “in-country” director of the alliance to find out what needs they’ve identified: burial teams, ambulances (including fuel for ambulances), hospital gowns, even food.
Unlike in the U.S., where hospitals have food services and laundry, patients in Sierra Leone can only expect to get medical care from doctors and nurses. It’s up to their families to feed and clothe them and change their bedding.
With Ebola, patients are isolated, sometimes abandoned, in Ebola holding centers, and their families are quarantined inside their houses with armed guards at their doors.
“People are escaping holding centers because they’re hungry,” he said.
Glick said the alliance is looking to raise $190,000 over the next few weeks to start a food program to help Ebola patients and their victims. The money would fund the program for a year. “Your money goes far there,” he said.
He said the terrible conditions, sadly typical throughout West Africa, explain why Ebola has spread so widely there. The World Health Organization announced Saturday that there are now more than 10,000 cases associated with the outbreak. Just shy of half of those cases have been fatal.
“It gets to the critical difference between the U.S. and West Africa,” he said. “Ebola is never going to be more than episodic here, a few cases here and there. It’s not a health threat to this country. It is a huge threat to West Africa.”
Hard to contract Ebola
That a U.S. physician with Doctors Without Borders came down with the virus after working in an Ebola treatment center in Guinea and is now being treated at a New York City hospital should not cause public alarm, Glick said.
“The people that are at risk are not the guys who rode the subway with Dr. [Craig] Spencer,” Glick said. “The people that are at risk are the doctors and nurses taking care of him. ... So they have to be extremely careful with regards to how they handle everything about Dr. Spencer.”
He pointed out that in the Dallas case, in which a Liberian man came down with Ebola and died, the only two people who were sickened with – and have since been cured of – Ebola were nurses. “None of his close contacts got infected,” Glick said.
Glick is saddened that Spencer, now fighting for his life at Bellevue Hospital, has been criticized in the media.
“I believe that people like Dr. Spencer are heroes,” he said. “The guy put his life on the line to go over and work in an Ebola treatment center. He ran into the house that was burning, you know. To me, it reminds me of those firefighters that ran into the twin towers.”
He believes that Govs. Andrew M. Cuomo and Chris Christie’s announcement Friday of a mandatory quarantine of anyone who had direct contact with someone infected with the Ebola virus is overkill and is sure to discourage any doctors or nurses from volunteering in West Africa, where their help is desperately needed. Doing so will only allow Ebola to spread more and lead to more cases that end up in the U.S., he said.
“I really think we should let the CDC and our health departments make these decisions,” he said. “Not the politicians.”
CDC protocols supported
Glick supports the protocols of the Centers for Disease Control and Prevention for containing Ebola in the U.S.
He has encountered them firsthand.
Even before he returned to the U.S., he was in touch by email with the Erie County Health Department to alert them that he was in Sierra Leone, but not treating patients.
Upon arriving at the Freetown airport, he had his temperature checked and he filled out a detailed questionnaire.
He flew to Belgium and as he got to the top of the escalator at the arrival area, he again had his temperature taken and was asked to fill out a form. From there, he flew to Newark International Airport.
While in customs, a special sticker on his passport and the Sierra Leone stamp inside it alerted customs officials that he had been flagged for extra screening.
“I was basically pulled out of the line by some guys in masks,” he said. His temperature, once again, was taken and he was asked a series of questions. When they learned he was a doctor, he was taken to another room full of CDC workers in gowns and masks. He had his temperature taken, was asked more questions and then was cleared.
“Dr. Glick, you’re fine,” they said.
They handed him a kit that included a symptom log and a thermometer. He was instructed to take his temperature twice a day, write it down, and report it and any symptoms to his local health department.
Erie County health officials have arranged for him to email them with those results twice a day.
Should he come down with any kind of symptom, like a fever or diarrhea, he is expected to immediately call a pager number for the Erie County Health Department that is staffed 24 hours a day.
He would be transported directly to an isolation unit at a hospital. County health officials on Saturday confirmed these steps were authorized.
Glick believes this protocol is appropriate. “The local Health Department has been amazing,” he said. “They’ve been really helpful.”
The doctor is confident he was not exposed to Ebola. He and his wife, Joyce, are more concerned about public reaction to his recent visit to Sierra Leone.
Even before he left, his West Side clinic got calls from people afraid they could catch Ebola by seeking medical care there, said Joyce Glick, who runs the front office.
She understands that people are afraid of the unknown. She initially tried to keep her husband from going. “I fought him until about five days before he left,” she said. But once she accepted that he would not be performing any health care while there and read up on the science behind Ebola, she felt better about it.
It didn’t help that while he was there, the nurses in Texas were diagnosed with Ebola. “I was sitting here watching [the TV coverage] knowing my husband was there,” she said.
Then three days after he left, she opened the door to get the newspaper and found a giant orange cone sitting on the porch.
“I don’t think it was coincidental,” she said. “I think someone was trying to make a statement.”
She was naturally relieved when he came home and she knew he had not had any known exposure to the virus.
“I’m living with him,” she said. “I’m comfortable. I’m more afraid of the people and their fear. ... I hope they can turn the amount of energy in their fears and just turn it into a more positive direction and try to help where it’s really needed, where the people are suffering,” Joyce Glick said.
Glick knows he has taken a risk in going public with his story about going to Sierra Leone, but he wants people to stop worrying about whether you can catch Ebola while going about everyday activities and start thinking about the people of West Africa.
“We really feel that we need to refocus people on the suffering in West Africa,” he said, “and try to encourage people to put the facts and their faith before their fear.”