Health officials in Dallas and Washington are feeling a bit better now that the 21-day monitoring period has passed for dozens of people who had contact with Thomas Eric Duncan before he was (belatedly) diagnosed with Ebola late last month. As of Monday, 43 of the 48 people on the original watch list had been told that they are no longer at risk of contracting the virus that killed Duncan and infected Nina Pham and Amber Vinson, two nurses who cared for him at a Texas hospital. The rest of the people on the list are expected to be cleared soon. “It’s a significant hurdle for us to get over,” Dallas Mayor Mike Rawlings said. “It brings a little bounce in our step, because we know the science is working.”
It’s not time to declare “mission accomplished” just yet. Texas health officials say they are still keeping tabs on roughly 120 people who may have had contact with Duncan, Pham, or Vinson. Once that surveillance runs its course, it will take an additional 42 days—twice the virus’ incubation period—from the last day anyone in the country had contact with a confirmed or probable Ebola victim before the World Health Organization is ready to declare the United States disease-free, as it recently did Nigeria and Senegal. With Vinson and Pham still in the hospital, that means Ebola fears will likely continue to swirl through the end of the year. And of course, a new case could arrive on U.S. soil, resetting the clock and further testing the public health system’s ability to contain a virus that is ravaging the West African countries of Liberia, Guinea, and Sierra Leone.
But despite the long road ahead—and the mistake-filled one behind—there’s mounting evidence that America’s public health system bent but did not break during its first run-ins with Ebola. The system is also now significantly better-prepared to deal with Ebola cases going forward.
Among the reasons for optimism is that Duncan’s girlfriend, her 13-year-old son, and two other young men who lived in the apartment where Duncan was staying when he became ill have all been cleared. That the foursome remains symptom-free is particularly noteworthy given that they were in close contact with Duncan while he was sick, and were also involuntarily quarantined in Duncan’s apartment—along with soiled linens and sweat-stained sheets—for several days before being moved to another location. That none of them contracted the disease confirms what health officials have long been saying: Ebola is not easily spread through casual contact.
While health officials can’t say for certain exactly when Pham and Vinson contracted the virus, it appears most likely that they were exposed between when Duncan was admitted to the hospital and when he was officially diagnosed with Ebola two days later. Tuesday will mark 21 days since that test result, the point at which the hospital staff first began donning hazmat suits and taking additional protective measures. Tuesday will also mark 13 days since Duncan died. While 21 remains the magic number, the average incubation period for the virus is between eight to 10 days. So each passing day brings with it additional hope that Pham and Vinson were the only workers infected while caring for Duncan.
The two infected nurses, meanwhile, are both in isolation in hospitals equipped with biocontainment units. Both were admitted with low-grade fevers but before their symptoms progressed to diarrhea and vomiting, bodily fluids associated with the spread of the disease. So while it remains mind-boggling that someone at the Centers for Disease Control and Prevention gave Vinson the green light to board a plane to Ohio, there’s little reason to fear she spread the disease across the country. Now that both are in isolation, there’s good reason to believe the virus is contained, particularly given that the two hospitals where they are being treated—Atlanta’s Emory University Hospital and the National Institutes of Health in Bethesda, Maryland—are among the best in the nation.
More generally, the federal government is taking steps to ensure that the initial mistakes at Texas Health Presbyterian Hospital aren’t repeated elsewhere. The CDC is rewriting its safety protocols, which will likely soon require full-body suits, site managers to supervise the putting on and taking off of equipment, and a “buddy system” for nurses and doctors. The government has also announced plans to dispatch a rapid response team of trained experts to any hospital with a confirmed case of Ebola. So while the virus remains a serious domestic concern, it’s clear that the country is significantly better-prepared to contain it today than it was when Duncan arrived in Dallas from Liberia last month.
Of course, that will do little to allay the fears of overprotective parents or opportunistic politicians. Take a quick survey of the country and you’ll find plenty of examples of hysteria masquerading as vigilance:
- In Mississippi a middle school principal was pressured to take a paid vacation after a group of parents learned that the administrator had traveled to a funeral in Zambia—a country that is half a continent away from Nigeria, the closest country to its border with a documented case of Ebola and one that has since been declared Ebola-free.
- In Maine an elementary school teacher was placed on 21-day paid leave as the result of a similar parental freak-out over her trip to Dallas for an educational conference.
- In New Jersey an elementary school announced Sunday that two new students from Rwanda—more than 1,000 miles from the Nigerian border—who were set to begin school on Monday would instead be kept home for the next three weeks.
- In Georgia, school officials are under pressure to make a similar decision when two high school students return from a mission trip to Uganda in the coming days. Fortunately, officials there aren’t giving in to the panic. “In Ringgold, we are closer to the cases in Dallas and Atlanta than these students are in Uganda,” Superintendent Denia Reese reminded parents.
Such hysteria has made it into the realm of higher education as well. Syracuse University last week canceled a talk from a Pulitzer Prize-winning photojournalist who has documented the Ebola crisis in Liberia despite the fact that he had been symptom-free for the past 21 days. The University of Georgia made a similar decision when it canceled a guest lecture by a Liberian journalist who had been set to speak this coming Thursday. And, sadder still, a two-year community college outside Dallas rejected at least two applications from students because they were Nigerian.
These anecdotes might be outliers. As the Atlantic’s Derek Thompson points out, the number of Americans who are terrified about Ebola—Gallup reported that 16 percent of respondents “think they or someone in their family will likely get the virus”—is sizeable but not necessarily significant. “One in six people thinking they’re about to die from Ebola is a serious matter. But you can get about approximately 20 percent of Americans to say all sorts of crazy things in anonymous polls,” Thompson writes, citing a Harris Interactive survey that found more than 40 percent of Americans believe in ghosts and 26 percent in witches.
But the doomsday hype is difficult to dismiss given the current debate in Washington and on the campaign trail. An increasing number of Democrats are joining the Republican chorus calling for a travel ban from West Africa, a proposal that has been repeatedly met with widespread criticism from public health experts. Things are worse still among a certain of subset of ultra-conservatives, whose fears of immigration, terrorism, and Ebola are combining to form a dangerous supercluster of anxiety.
Such scaremongering will likely only grow louder as the November elections draw nearer. But the good news is likely to keep coming as well. On Monday, Emory officials announced that an American doctor who was infected while working in Sierra Leone last month had been released. He was the third Ebola patient to leave the Atlanta hospital after recovering from a disease that typically has a 50 percent fatality rate. That’s a great sign, and it’s not the only one out there for those who are willing to see them.