Outside the Beltway

The Dallas Ebola Outbreak That Began With Timothy Eric Duncan Is Officially Over

Good news that ought to quiet people's concerns significantly, on the Ebola front.

Doug Mataconis · Thursday, November 6, 2014 · 12 comments

An Ebola outbreak that began when Timothy Eric Duncan arrived in Dallas from Liberia and was, by the end of September, diagnosed with Ebola and admitted to Texas Presbyterian Hospital, where he died in early October, then spread when first one nurse then another who treated him were diagnosed with the disease has officially come to an end:

The 21-day monitoring period for the people who may have been exposed to Ebola in Texas is drawing to an end, and no one else has exhibited any symptoms of the virus, health officials announced on Thursday.

The last person who could have come into contact with Ebola after a Dallas hospital treated an Ebola-infected man from Liberia is expected to be officially cleared on Friday. That individual, whose name has not been released, is a hospital worker who handled potentially hazardous medical waste on October 17.

Meanwhile, the two nurses who did contract Ebola from patient Thomas Duncan have both completely recovered and returned home to their families. One of them, Amber Vinson, told the Today Show on Thursday that she has no regrets about being part of the team that treated Duncan. “Nursing is what I do. I could never see a patient that needs help and not do everything I can to help them,” Vinson said.

Dallas Presbyterian Hospital came under considerable fire for the way that it handled Duncan’s case. There were reports that hospital staff initially turned away Duncan despite his symptoms and his travel history, which should have led them to consider Ebola as the likely source of his illness. Vinson and her colleague, Nina Pham, may have been infected as a result of breaches in the protocol that’s supposed to protect health workers against the virus.

Despite those missteps, the conclusion of the monitoring period and the lack of any subsequent cases actually points to the strength of the United States’ hospital system. Unlike in Western Africa, where the deadly disease has spread to thousands of people, there is currently just one Ebola-infected person in the U.S. because the handful of cases here have been effectively contained. Even if the system didn’t work completely perfectly in Dallas, it still worked pretty well.

“We reached this point through teamwork and meticulous monitoring, and we’ll continue to be vigilant to protect Texas from Ebola,” Texas’ Health Commissioner, Dr. David Lakey,said in a statement on Thursday.

The conclusion of the monitoring periods — which have been staggered depending on when individuals had contact with Thomas, Vinson, or Pham — has helped ease fears significantly in Texas, where rampant anxiety about Ebola has led to some irrational behavior. In recent weeks, people have refused to serve Liberian immigrants at restaurants, denied college admission to immigrants from the affected West Africa region, rejected housing applications from Liberian individuals, and even stopped volunteering at an organization that provides after-school tutoring in immigrant neighborhoods.

The fact that, of all the people who treated Mr. Duncan at the hospital in Dallas, only two people actually caught Ebola during this outbreak, nurses Nina Pham and Amber Ray Vinson, and that both of them have been treated, cured, and released should be seen as a significant sign of what it means for a nation like the United States to deal with this disease when it is handled properly. Even amid the apparent mistakes that accompanied the treatment of Mr. Duncan, including the fact that he might have Ebola was apparently missed the first time he visited the Emergency Room, we have learned that it is difficult for this disease to be transmitted. None of the people who spent time with Mr. Duncan in an apartment in Dallas during the time between his initial visit and the time that he reported to the ER a second time when his symptoms were far more severe, displayed even one of the symptoms associated with the disease and none of them merited admission to a hospital during their respective monitoring period. Additionally, again with the exception of Ms. Pham and Ms. Vinson, none of the several dozen people who did treat or come in contract with Mr. Duncan during the time when he was the most contagious showed any signs of the disease, which again ought to emphasize the fears of the disease being easy to transmit have been largely overblown.

At this point, the only Ebola patient known to be in the United States is Dr. Craig Spencer, who was diagnosed with the disease two weeks ago today after first displaying one of the initial symptoms, an elevated fever, and immediately being admitted to Bellevue Hospital where he remains under treatment, although recent reports seem to indicate that his condition is improving. A report yesterday says that there are some 357 people under some form of monitoring in New York City due to actual or potential contact with Dr. Spencer, most of which occurred before he was symptomatic and therefore contagious, but nonetheless being monitored out of what is described as ‘an abundance of caution.’ Those people will begin nearing the end of their twenty-one day incubation/monitoring period, which should end for the people who have not had any contact with him since his admission to Bellvue by the end of next week. Monitoring for the health care workers that have been treating Dr. Spencer will, obviously, continue past that period and likely until twenty-one days have passed until their last contact with Dr. Spencer. In addition, up in Maine, Kaci Hickcox, the nurse who became the focus of a national debate over whether health care workers returning from the Ebola ‘Hot Zone’ in western Africa, will be near the end of her incubation period less than a week from now so presumably her monitoring period will be ending as well. So far, there has been no indication that she is displaying any symptoms and medical experts seem to agree that the longer one goes into the incubation period without displaying symptoms, the less likely it is that you have the disease. Given all of this, the New York “outbreak” in the person of Dr. Spencer, who was a Doctors Without Borders volunteer like Ms. Hickcox, should be over by sometime early in December at the latest depending on if and when he is released from the hospital. So far, while there have been several reports of “possible” Ebola cases showing up around the country, there have been no other people in the United States who have tested positive for Ebola or shown any symptoms of the disease.

None of this means we should let our guard down, of course. The health care system still needs to be prepared to identify potential Ebola patients and to respond properly to their treatment and care if they are positive for the disease. The steps being taken to identify potential patients from the hot zone among arrivals to the United States from the region will need ot continue until the outbreak there is contained and starts to be rolled back. Most importantly, though, the outbreak in west Africa must be confronted and stopped before it becomes a bigger problem. For now at least, though, we can point to the successes in the response to the Dallas and New York City situations as good signs for how the disease is being handled domestically, and these successes ought to stand in some sense as a rebuke to the panic mongering by many pundits and politicians on this issue.