City officials are rushing to decontaminate the New York building where Spencer was living. Police moved people back around 9:15 am as two officers with the Sanitation Department’s Environmental Police Unit arrived on the scene and entered the building through a side entrance. They were joined by several people in plain clothes who exited a truck belonging to the Bio-Recovery Corporation, a full service crime scene cleanup and bio remediation company.
Seventh district City Council member Mark Levine:
Today we’re expecting a specialized crew [to] come in full protective gear and will clean and sterilize Dr. [Craig] Spencer’s apartment for signs of bodily fluid. [Officials will] confiscate material that might have come into contact with his body such as sheets and pillowcases and bath towels and toothbrushes.
Addressing the crowd:
We’ve had neighbors understandably concerned that live right across the street, maybe they live down the hall, maybe they’ve seen him in the local bodega and they’re worried. But the truth is and the facts they need to understand are they’re really not at risk.
Spencer experiences gastrointestinal symptoms. He is awake and communicating. Bellevue:
In addition to the required supportive therapy, we initiated antiviral therapy within hours of admission. We also administered plasma therapy yesterday. These therapies have been used at Emory and Nebraska.
New York City Mayor De Blasio, his wife his wife Chirlane McCray, and New York City Health Commissioner Mary Bassett dine at The Meatball Shop in West Village, a restaurant visited by Spencer before he was diagnosed with Ebola. The restaurant reopens to a packed house after being closed for a brief time following Spencer’s visit. De Blasio:
We are not only resilient, we are not only tough, we stand by each other. It’s an example of how New Yorkers deal with a challenge.
A high number of staffers Bellevue call in sick after Spencer tests positive, and those who do show up are too terrified to enter the isolation chamber. Source:
The nurses on the floor are miserable with a ‘why me?’ attitude, scared to death and overworked because all their co-workers called out sick.
Crowl describes the scene when hazmat teams arrived at the apartments where he lived next door to Duncan:
People were freaking out. People were looking at them like they were zombies.
Gov. Cuomo says Spencer’s temperature was 100.3 degrees, not 103 degrees as previously reported. When he went out bowling and to a restaurant, he:
obviously felt he wasn’t symptomatic
Cuomo also says Spencer ‘went out in a limited way’.
The health worker is quarantined at University Hospital after recording a high temperature. She doesn’t show Ebola symptoms but is isolated under the mandatory isolation rules after revealing that she has been in Sierra Leone and had contact with Ebola patients. She is the first person to be quarantined under the rules.
The worker had been treating patients in west Africa. Christie:
Her next stop was going to be here in New York. A quarantine order will be issued.
New York and New Jersey have introduced stricter rules under which state officials will establish a risk level by considering the countries that people have visited and their level of possible exposure. Patients with the highest level of possible exposure will be automatically quarantined for 21 days at a government-regulated facility. They include anyone having direct contact with a person infected with Ebola while in Liberia, Guinea, or Sierra Leone. Those with a lower risk will be monitored for temperature and symptoms. City health departments will determine their own specific procedures for hospitalization and quarantine, and will provide a daily recap to state officials on the status of screening. Gov. Cuomo:
We believe it’s appropriate to increase the current screening procedures from people coming from affected countries … We believe it within the State of New York and the State of New Jersey’s legal rights.
The Department of Health and Human Services says public fear is worse than the virus. Testimony to House Oversight and Government Reform Committee:
Ebola is a dangerous disease, but there is hardly a reason for panic. There is an epidemic of fear, but not of Ebola, in the United States.
Bucks is reported to have flown in Thursday night on a Royal Moroccan Airlines flight after treating patients in west Africa. He stayed at the Hilton Garden Inn in Jamaica, Queens, near the airport, where CDC workers also stay, after missing a connecting flight. On Friday, he was cleared to travel home to northern California, where he will be monitored by the CDC. Source:
He is asymptomatic and he’s being allowed to leave the hotel and fly home
United Flight 5732 from Dulles is grounded on the ramp at Columbia Metropolitan after a passenger reports a nosebleed. The chances that the passenger has the virus are ‘very, very low’. Spokeswoman:
Emergency crews are meeting the plane. We are taking precautionary measures.
Pham makes a statement after her release, thanking her doctors, family and friends. Pham also asks for privacy so she can could get back to normal life and reunite with Bentley.
I feel fortunate and blessed to be standing here today. I would first and foremost like to thank God, my family, and friends.
The National Institutes of Health says in a statement that Nina Pham is being released Friday from its hospital near Washington. Pham will make a brief statement during a news conference late this morning.
The CDC says its Ebola response team is arriving in the city to offer support. It adds that Spencer cleared enhanced screening on Oct. 17 at JFK. He wasn’t showing symptoms at the time.
AP reports that a Liberian analysis of bed space at Ebola treatment units concludes that of 742 spaces, 351 were occupied and 391 were vacant. It cites Assistant Health Minister Tolbert Nyenswah, who heads the government’s Ebola response. The main problem is the traditional practice of honoring the dead with burial ceremonies. Nyenswah:
For fear of cremation, do not stay home to die… We know cremation is not our culture in our country. But now we have disease, so we have to change the way we used to do business.
Aid groups in west Africa say they have enough money to fight the virus but need more people. The WHO estimates that 1,000 foreign medical workers and 20,000 locals are needed to man the 50 Ebola treatment units due to be rolled out across the three worst effected nations, but so far there are firm commitments from foreign teams for only 30 of the units. Manuel Fontaine, head of UNICEF in west Africa:
The big gap is still in human resources. Money is necessary. It is an expensive operation. But we need people.
A two-year-old girl brought into Mali from Guinea is taken to the hospital in Kayes after showing symptoms, and tests positive. Her father had died of the virus. Health Ministry spokeswoman:
The girl is still in the hospital in Kayes together with members of her family who might have been exposed to the virus
Seattle Seahawks owner Allen donates 100 million to the effort to fight Ebola. Allen sets up a website, TackleEbola.com, where people can make donations.
Everybody feels called sometimes to really pursue a certain thing that resonates with them, and this has resonated with me. The exponential nature of the growth of this disease is really a challenge — we’ve already seen in the U.S. where one case quickly became two.
Health and New York City officials are tracing the steps of Spencer, who travelled the city for three days before being diagnosed with the Ebola virus. They determine Spencer rode the subway, rode in a taxi and visited ‘The Gutter’, a Williamsburg bowling alley. The Gutter, shuttered after hearing the news, issues the statement:
We’ve been in constant contact with the Health Department and they have determined that there was no risk to our customers.
Mayor Bill de Blasio:
Being on the same subway car or living near someone with Ebola does not in itself put someone at risk.
Spencer follows guidelines set by Médecins Sans Frontières/Doctors Without Borders that say he does not need to self-quarantine upon returning from Guinea. MSF guidelines ask that those returning from Ebola infected areas self-monitor their health for 21 days. MSF statement:
‘Our colleague in New York followed the MSF protocols and guidelines since returning from West Africa.
Twitter users post angry tweets after learning Spencer travelled around New York City for three days while at risk for Ebola. Many tweets revolve around his visit to the Williamsbug bowling alley, The Gutter.
Spencer’s live in fiancée, Morgan Dixon, is quarantined at Bellevue Hospital. Two of Spencer’s friends voluntarily quarantine themselves in their homes. New York Governor Andrew Cuomo:
We are as ready as one can be for this circumstance.
Spencer’s family defends him against the critics who are upset that he did not quarantine himself upon his return to the United States. Arnie Spencer, Spencer’s uncle to Mail Online:
‘As far as I’m concerned he did nothing wrong. I’m angry that he is getting trashed. I don’t like what’s being said at all. ‘He’s a hero to me,’ said his uncle. He’s a fantastic humanitarian and that is how people should think of him. He wanted to be a doctor without borders from when he was a kid. It’s all he wanted to do.
Microsoft co-founder Allen quadruples an earlier donation pledge of $26 million to non-profits and government organizations including the CDC. Allen:
Everybody feels called sometimes to really pursue a certain thing that resonates with them, and this has resonated with me
Canadian and U.S. scientists developed a vaccine almost 10 years that was 100% effective in protecting monkeys against the virus, publishing their results in Nature and saying a product could be ready for licensing by 2010 or 2011, but the vaccine was shelved due to the lack of market opportunities. It is now undergoing basic safety tests in humans after falling into what an expert calls a ‘biotech valley of death’, where no drug company would help bring it to production. One of the vaccine developers:
There’s never been a big market for Ebola vaccines. So big pharma, who are they going to sell it to? It takes a crisis sometimes to get people talking. ‘O.K. We’ve got to do something here.’
A study in Lancet Infectious Diseases warns of 171,000 cases of the virus in Montserrado county by Dec. 15, 12% of the country’s population, with over 90,000 fatalities. The study depends on the assumptions that every person with Ebola will infect 2.49 other people, and that health measures in Montserrado will remain unchanged. It says that if 4,800 beds are installed at treatment centres in November and health workers speed up fivefold the detection rate of Ebola cases, 77,312 cases could be averted. Health experts say the situation on the ground is changing. Doctor:
It’s too early to say whether the ongoing and intense control efforts in Monrovia have yet achieved control or merely slowed the epidemic, but what is being seen on the ground is clearly incompatible with the results in this paper.
Spencer tests positive for the virus at Bellevue Hospital. Spencer recently returned from treating Ebola patients in West Africa. He is the fourth confirmed case in the U.S. and the first in the city. He is being treated in a special isolation ward. City officials say the doctor’s symptoms developed Wednesday, prompting him to isolate himself in his apartment.
The CDC has dispatched an Ebola response team to New York, and the city’s disease detectives have been tracing the doctor’s contacts to identify anyone who may be at risk. His Harlem apartment has been cordoned off, and his fiance, who is not showing symptoms, is being watched in a quarantine ward at Bellevue.
Mayor Bill de Blasio said proper protocols were followed every step of the way and it didn’t appear the doctor had been showing symptoms for very long.
The patient is in good shape and has gone into a great deal of detail with our personnel as to his actions the last few days so we have a lot to work with. We have a patient who has been very communicative and precise and who has only been back a very short time and has been quite clear about individuals he had close contact with.
The slum, which is Liberia’s biggest and is home to 50,000 people, introduces measures like avoiding contact with the sick and hand-washing using a bleach solution, and avoiding eating ‘bush meat,’ meat from monkeys and rodents. Aid worker Mechie Seih tells charcoal seller Mamie Kollie how to lower infection risk if a family member falls ill:
You put clean plastic bags on your hands. You wear a thick jacket with long trousers. You put shoes and socks on your feet.
Pharmacist Doris Nyenkan says she now tells customers complaining of fever to get tested for Ebola. She also sells hand sanitizer, and uses it herself:
People clean their homes every day now. Now they are washing their hands, buying this gel. Before Ebola you didn’t see people doing such things.
Schools in states states such as Louisiana, Maryland and Georgia are taking precautions that include rules allowing superintendents to close schools, Ebola risk assessments for all children registering for school, and measures to ensure quarantined students are provided homework and instruction. In one instance, DeKalb County School District in Georgia notified principals and administrators that no new students from Liberia, Sierra Leone or Guinea—as well as affected areas in the U.S.—would be enrolled or allowed to attend classes without medical documentation and approval. University of California public health professor:
I can understand wanting to be prepared. But most of these school districts will never encounter a student with contact with the three countries. It’s a legitimate concern but an overreaction.
The workers at University of Texas Southwestern Medical Center use the sauce to practice taking hazmat gear on and off. If the sauce touches their skin, they have been ‘contaminated’. Capsicum frutescens, the peppers used in Tabasco, contain capsaicin, which has previously been used in medical settings including dermatology and neurology for pain and itch relief. Dr. Bruce Meyer:
In a way, it gives feedback immediately
Forty-three Liberians in quarantine after four people died of Ebola in Jenewonda, a town in an impoverished corner of Grand Cape Mount County near the Sierra Leone border, threaten to break out of isolation as they have no food. The World Food Program has not previously been supplying the area but will begin doing so. The WFP’s logistics unit is delivering the food Thursday, but it must be driven in from Monrovia as there are no trucks in the area. WFP spokesman:
WFP in Liberia heard about this community being isolated only two days ago via the radio and staff immediately began organizing a mission to bring food to the quarantined people.
New York state officials are monitoring four people who had contact with Spencer. His fiancee and two friends are healthy but have been quarantined. The fourth person is who is in contact with the state is the driver of an Uber car that Spencer took when he bowling Wednesday night in Williamsburg. The driver had no direct contact with Spencer, and is not believed to be in any danger.
Sources say Morrison is suggesting implementing mandatory quarantine for anyone arriving in Australia from Ebola-affected west Africa. He has said that a hard-line quarantine approach could be best run by being absorbed under his immigration portfolio and handled by the Operation Sovereign Borders team, which is in place to stop people smuggling into the country. A minister tells ABC radio:
[Morrison is] annoying everyone on the National Security Committee because he’s not across all the facts on Ebola. He doesn’t have access to what the chief medical officer is advising the Health Minister.
Cybercriminals are using an email that appears to be an informative message from the World Health Organization to hack computers. Cybersecurity firm Trustwave says it appears that several hundred organizations have been targeted. Karl Sigler, threat intelligence manager at Trustwave:
It follows the standard, successful formula for most phishing campaigns.
Spencer tests positive for the Ebola virus at Bellevue Hospital in New York City. Spencer is the only diagnosed case in New York City, the fourth case diagnosed in the United States. New York City Mayor Bill de Blasio:
There is no reason for New Yorkers to be alarmed. New Yorkers who have not been exposed to an infected person’s bodily fluids are not at all at risk.
Mukpo returns home to Providence, RI on a chartered jet after being declared free of the Ebola virus. Mukpo is now requesting privacy. Dr. Mitchell Levy, Mukpo’s father:
He has said he will begin to write and speak about his ordeal, including with the press, but he wants to do it on his own time.
Spencer is rushed to Bellevue Hospital in New York City with Ebola-like symptoms. Spencer tells authorities he began to feel sluggish on Tuesday but did not develop a fever until this morning. At 11 a.m., the doctor found that he had a 103-degree temperature and alerts the staff of Doctors Without Borders, who calls the New York health department, which in turn called the Fire Department. Emergency medical workers, wearing full personal protective gear, rush to Spencer’s apartment, on West 147th Street, and he is transported to Bellevue and arrived shortly after 1 p.m. He is placed in a special isolation unit and is being seen by the pre-designated medical critical care team. They are in personal protective equipment with undergarment air ventilation systems. Health Department:
After consulting with the hospital and the CDC, DOHMH has decided to conduct a test for the Ebola virus because of this patient’s recent travel history, pattern of symptoms, and past work.
Schaffner tells PBS that other illnesses are a bigger risk than Ebola. Questioned about the 600 measles cases this year:
Yes. Can you imagine that? And that’s because there’s still measles out in the world, but our parents, many of them, are withholding their children from vaccination. And so when someone from — with measles comes into this country, it can spread among our own children, causing a whole lot of illness, illness that we thought was long gone.
He says whooping cough, antibiotic-resistant bacteria, and flu are also more dangerous.
Ebola is new, mysterious, fierce. It has a very high mortality rate. And people feel a lack of control. There’s nothing they can do about it. They can get vaccinated against flu, but they feel put upon. I have even spoken to some people who seem indignant that something like Ebola could even come to the United States in the 21st century.
Officials from at least three hospital systems interviewed by Reuters say they are considering whether to withhold individual procedures or leave it up to individual doctors to determine whether interventions will be performed, while ethics experts are fielding calls from doctors asking what their professional obligations are to patients if healthcare workers could be at risk. One issue is that there are no data on whether an Ebola patient is beyond help, or whether procedures like dialysis or CPR can be performed safely and effectively. Medical historian Dr. Howard Markel:
This is another example of how this 21st century viral threat has pulled us back into the 19th century
Vinson’s mother says that she has tested negative for the disease.
Amber and our family are ecstatic to receive this latest report on her condition. We all know that further treatment will be necessary as Amber continues to regain strength, but these latest developments have truly answered prayers and bring our family one step closer to reuniting with her at home.
U.S. and British insurers are writing exclusions into standard policies to cover hospitals, event organizers and other businesses vulnerable to local disruptions. That means new policies and renewals will become costlier for companies that insure business travel to west Africa or to cover the risk of losses from quarantine shutdowns at home. Gary Flynn, an event cancellation broker at Jardine Lloyd Thompson Group Plc in London:
What underwriters are doing at the moment is they’re generally providing quotes either excluding or including Ebola – and it’s much more expensive if Ebola is included
The official WHO death toll from the virus stands at 4,877 as of Oct. 19, while at least 9,936 cases of the disease had been recorded, but the organization says the real figures may be three times as high. The real numbers are higher by a factor of 1.5 in Guinea, 2 in Sierra Leone and 2.5 in Liberia, while the death rate is thought to be about 70 percent of all cases. WHO on why so many have caught the disease:
Early indications are that a substantial proportion of infections occurred outside the context of Ebola treatment and care
The CDC announces that it will monitor all passengers from west Africa – even Americans – for a mandatory 21 days. The screenings will begin Monday in New York, Pennsylvania, Maryland, Virginia, and Georgia. Travelers will be given information cards and a thermometer and be required to make daily checkins with state or local health officials in person, by phone, Skype or Facetime, or through employers. CDC director Frieden:
The bottom line is that we have to keep our guard against Ebola.
Mukpo discusses the effects of his battle with Ebola and his travels to Liberia in an interview with NBC News after being declared free of the virus.
I mean, there’s definitely some physical effects of this that I think are gonna last a while. But I can feel my strength coming back every day. And, I mean, there was a period of time that I was quite sick. And, you know, I was laying in a hospital bed and had no strength. Had various pains. And — and just all kinds of fun stuff going on in my body. I mean, I think it’s important in life to take risks for things that you believe in. But it’s also important to keep yourself safe. So, I mean, it’s hard to call Ebola a learning experience. But I think that I’m gonna walk away from this with some important lessons for the future.
The World Health Organization announces the true Ebola death toll may be three times more. Higher numbers place Guinea with a factor of 1.5, Sierra Leone at 2.0 and Liberia at 2.5. This suggests a true total of approximately 15,000 deaths versus a minimum of 4,877. At least 9,936 cases report infection. Of the thousands of cases, 443 health workers contract the disease resulting in 244 deaths. Official:
Early indications are that a substantial proportion of infections occurred outside the context of Ebola treatment and care.
Klain meets with Obama and senior White House staff members to discuss strategies for preparedness and containment on his first day as “Ebola czar”. White House official:
He will attend meetings with other senior White House staff, as well as with the White House teams that are coordinating and operationalising the comprehensive strategy to enhance our domestic preparedness and contain the epidemic in West Africa.
The DHS says that four passengers were taken from Dulles to a local hospital after enhanced screening raised alarms. DHS and the CDC don’t give further details. The two Northern Virginia hospitals closest to Dulles say they didn’t receive the patients. DHS and CDC aren’t able to explain the discrepancy. A person familiar with the screenings says a 13-year-old boy and his mother were taken to a hospital last Thursday after the CDC became concerned about their symptoms, and two other passengers were taken to a hospital over the weekend. The person was unable to name the hospital, and said that all four passengers apparently were released after further testing.
Klain is reported to be excused from a Republican-led congressional panel on Ebola due Friday. He will officially start work on Wednesday. A White House official confirms that he did not attend two previous meetings in the 48 hours after he was appointed as response coordinator:
It is not that long of a lapse
Friends and relatives of Ebola patients say many people have vanished after being admitted to Liberia’s hospital system. Some people passed through the health system without a paper trail, others were transferred between clinics without notice, and hundreds have been cremated before their families are informed that they have died. A hygienist who says he has reassured people that patients are okay, although he wasn’t sure himself:
I don’t want to be the one to tell them that bad news