Doctor who treated Ebola patients rushed to NYC hospital

[magical thyme]

Source: New York Post

A 33-year-old Doctors Without Borders physician who treated Ebola patients in Guinea and returned to New York City 10 days ago was rushed in an ambulance with police escorts from his Harlem home to Bellevue Hospital on Thursday, sources said.

Craig Spencer was suffering from Ebola-like symptoms — a 103-degree fever and nausea, sources said.

Clad in hazmat suits, FDNY hazardous materials specials sealed off his fifth-floor apartment. Cops blocked off West 147th Street between Broadway and Amsterdam after he was taken to the hospital, witness Oscar Nunez said.


Read more: http://nypost.com/2014/10/23/nyc-may-have-its-first-ebola-case/

---

According to CNN, he did not self-quarantine and was out bowling recently, took UBER (public trans?) to get there. They're tracing his contacts now.

[still_one]

1. Sorry but he should have known better

[TwilightGardener]

2. Hope it's just norovirus or something. My husband came down with a nasty GI bug

and fever last week, after a work stint in TX (but not Dallas!). Turned out to be a gas-station bacon egg and cheese sandwich, is our theory.

[LisaL]

4. He came in NYC 10 days ago from West Africa where he was treating Ebola patients.

[still_one]

5. Hope so to, but if the story is accurate it probably is Ebola

[TwilightGardener]

6. Trying to be an optimist. I don't know why this guy wouldn't have

chilled out at home for a few weeks, he should know better.

[still_one]

7. Agreed, the key is he treated Ebola patients, and I am not sure if doctors without borders take

appropriate precautions

[LisaL]

9. Of course doctors without borders take precautions.

But they still lost 9 people to Ebola.

[still_one]

13. Really? Then why didn't he wait 21 days before going into the public

He is a physician and should know better

The Texas hospital also thought they took proper precautions

[LisaL]

15. You would have to ask him.

I don't know. We don't require people returning from West Africa to quarantine.
Maybe we should.
Especially if they had contact with Ebola patients.

[darkangel218]

76. +1000

[Ash_F]

43. No they didn't

http://www.nationalnursesunited.org/blog/entry/statement-by-registered-nurses-at-texas-health-presbyterian-hospital-in-dal/

[Chemisse]

53. He would not be contagious until he began to exhibit symptoms.

I can see why he would avoid practicing medicine for a few weeks, but I can't see the need to be isolated all that time.

[still_one]

61. Because you may become infectious before symptoms are apparent

[truth2power]

72. I read an article today, from what I considered, at the time, as a credible source

that you absolutely are NOT infectious before symptoms are present. something to do with the titre of virus in the blood...

I'm sorry. I'll try to jog my memory and see if I can find the article. I've had limited time to spend at the computer lately.



Found it. It was right here on DU: http://www.democraticunderground.com/10025698921

It was about titers of virus in the blood.

Reality Check: How People Catch Ebola, And How They Don’t (Very Good Interview)

Ebola is transmitted by having very close contact to infected patients. So we know that it is transmitted by bodily fluids, which include blood, first of all — because the amount of virus in the blood is very, very high, especially at late stages of infection — but it’s also spread by vomit, by sputum, by feces, by urine and by other bodily fluids.

The reason for that is that at late stages of infection, the Ebola virus affects almost all our organs — it causes a systemic infection. One main organ targeted by Ebola virus is the liver, and that could be one of the reasons that we see these very high concentrations of viral particles in the blood. But I would like to emphasize that that occurs late in infection.

Early infection is the other way around. The primary targets — the first cells that come in contact with Ebola virus and get infected — are cells that are part of our immune system. And these cells most likely spread the virus throughout our body. But there are not so many cells infected at the very beginning of the infection, which might be the reason why Ebola virus patients do not spread virus at the very beginning of infection. And that’s why it’s safe to have contact with these patients, because the viral titers in their blood are so low that we cannot even detect them with methods like PCR, which is one of the methods we use to diagnose Ebola virus.

[magical thyme]

54. until recently, MSF had the best record on avoiding infection

they take the best precautions. But even so, they've recently had an outbreak among their healthcare workers and have lost 9.

[rocktivity]

10. He should have quarantined himself

Last edited Thu Oct 23, 2014, 05:18 PM - Edit history (1)

and BEFORE leaving Africa. Now begins a frantic search for everyone he's been in contact with for the past ten days...NOT including he had contact with BEFORE leaving Africa!


rocktivity

[valerief]

49. I think these people have a sense of invincibility. It's what gives them the

will to treat highly infectious people in the first place.

[uppityperson]

55. Not contagious until symptomatic. Did he have symptoms for the last 10 days?

[rocktivity]

57. Keeping contagious people from traveling wins the battle but loses the war

INFECTED people need to be stopped, too. And if he'd been required to wait another ten days or so, he would have been.

Regrettably, we're at least six months away from a way to detect Ebola while you're infected (link). But if a complete travel ban is not an option, delaying travel from Ebola-affected countries is better than doing nothing at all to keep infected people from taking the disease to other countries.


rocktivity

[uppityperson]

59. You said now bengins a frantic search for everyone he's been in contact with the las 10 days.

That is why I am asking if he was contagious for the last 10 days? If not, why do a frantic search?

[rocktivity]

62. Because they'll do one anyway.

In Maine, an elementary school teacher was recently put on paid leave for up to three weeks after parents complained that the teacher had traveled to Dallas, where there have been a few Ebola cases. On Sunday, a similar precaution was taken at a high school in Phenix, Alabama, after an employee flew on the same plane as a person who contracted Ebola -- even though the employee flew a day later, long after the aircraft had been cleaned...(A) New Jersey elementary school reported...that two students from Rwanda -- a country not hit by Ebola -- would stay home for three weeks after parents complained that they may spread the virus...
(Lots) More


rocktivity

[uppityperson]

63. 2 cases of over reaction? huh.

[rocktivity]

73. Mea culpa...

Last edited Sun Jan 18, 2015, 10:38 PM - Edit history (1)

Huffington Post: ...(A) New Jersey elementary school reported...that two students from Rwanda -- a country not hit by Ebola -- would stay home for three weeks after parents complained that they may spread the virus...

NJ.com: The superintendent...apologized Monday after the district posted a letter announcing the arrival of two students from East Africa, a letter which inadvertently sparked Ebola fears among parents...

The...letter...stat(ed) that the students who recently moved to the community and...did not show any symptoms of the disease...The children are from Rwanda, about 2,600 miles away from the region where the outbreak is centered. Their parents agreed to keep the children home “past the 21-day waiting period...”

...Some slam(ed) the district for contributing to an irrational panic...The children are (now) scheduled to start school next week.

FYI, 2600 miles is the approximate distance between Maple Shade and Portland Oregon.

MotherJones.com: The Rwandan Ministry of Health...(now requires) visitors who have been in the United States or Spain during the last 22 days...to report their medical condition -- regardless of whether they are experiencing symptoms of Ebola -- by telephone...between 7:00 a.m. and 8:00 p.m. for the duration of their visit to Rwanda (if less than 21 days), or for the first 21 days of their visit to Rwanda. Rwandan authorities continue to deny entry to visitors who traveled to Guinea, Liberia, Senegal, or Sierra Leone within the past 22 days...

rocktivity

[secondwind]

36. I AGREE!

[closeupready]

12. Not necessarily. Long-distance travel is stressful in itself,

wearing down the immune system. I've gotten sick a number of times after the same experience. Also, the infrastructure in Africa is NOT up to Western standards. I got a bit of 'Delhi belly' in Morocco, despite my attempts to be hypervigilant.

Additionally, while it CAN incubate over 21 days, it typically shows up after 3 days. If it's been 10 days, it's probably something else.

[LisaL]

16. It doesn't typically show up after 3 days.

The typical timeline to show symptoms is 8-10 days in the current outbreak.

[closeupready]

17. Oh, I didn't know that it was taking that long.

Well, even so, I think the likelihood that it is some other illness is better.

[LisaL]

20. How is it better?

He treated Ebola patients in West Africa and now has Ebola like symptoms.

[closeupready]

23. He has fever and nausea - that's symptomatic of just about everything.

[LisaL]

70. In his case he has Ebola.

[closeupready]

71. Yes, I just heard that on the news. Hoping

he comes out of this okay.

[Yo_Mama]

66. WHO gives the mean incubation time of 11.4 days in this outbreak

Your info is wrong.

The mean is always shifted up from the median due to the higher numbers, so 8-10 median is about right.

[magical thyme]

19. it could be malaria or one of the other endemic diseases there with similar early symptoms

but it is worrisome.

And why he did not quarantine himself for 21 days is beyond belief. Young and invincible? I would expect an MSF doctor in particular to know better.

Samaritan's Purse have set up a quarantine camp for their returnees...

[LisaL]

22. US doesn't require quarantine and MSF doesn't either.

So he was following self-monitoring protocol.

[magical thyme]

24. just because it's not legally required doesn't mean it shouldn't be followed

by somebody who was treating patients.

Samaritan's Purse quarantines their returning health care workers because it's good practice.

[LisaL]

25. I am not saying it shouldn't be.

But we all know a lot of people are not going to do something unless required (and even then some try to go around requirements).

[magical thyme]

28. frankly, it should be a requirement for returning medical workers. nt

[noiretextatique]

35. seems like common sense eom

[Elmer S. E. Dump]

3. Not again!

[In_The_Wind]

8. What was he thinking!

[leftynyc]

11. Uber is a car service

Bellvue is ready for this kind of thing - pretty much all NY hospitals are. He had no business being out and about but if his symptoms just started they may just get lucky.

[seabeyond]

14. they just say nausea, not vomitting. probably just getting to contagious.

if this plays out like the others, then people around him should be ok. though he waited about as long as duncan. maybe duncan had 24 hours or more on him.

[magical thyme]

26. fever, nausea, pain and fatigue, per CNN

The 33-year-old physician, employed at Columbia Presbyterian Hospital, developed a fever, nausea, pain and fatigue Wednesday night, the official said. On Thursday morning he was taken to Bellevue Hospital in Manhattan for testing.
http://www.cnn.com/2014/10/23/health/new-york-possible-ebola-case/index.html?hpt=he_c2

Duncan waited 2 days. The physician one overnight, plus he's being tested and will be treated immediately.

[seabeyond]

50. yes. but the thing in duncan timeline that i think is important. if i read correctly, the first

hospital visit was a late night visit. and then he was home the next day, and in the hospital the next morning. so it was not a full two days. more 36 hourish. and still, so far into it, he infected no one, until later in the disease, he got two nurses.

and i was looking at it more, him giving it to others, not his recovery ability. but... i think it has a lot to do with individual immunity, and stopping the dehydration, allowing the body a fighting chance. one other thing, i forgot.

but ya.

[karynnj]

78. Duncan likely waited longer before the FIRST time he went to the hospital

The doctor called as soon as he developed a temperature and was immediately handled as a potential ebola patient. Duncan was not and was sent home to return 2 days later.

STILL all 48 people Duncan had contact with - including his financee were NOT infected.

The risk seems to be in the much more infectious later times - which for both are the time when they were in the hospital. All US hospitals have learned from Dallas -- and in NYC, they chose this specific hospital to send him to because it was set up to handle this. -- In fact, the hospital the doctor worked at is MUCH closer than Bellevue. He was in the upper west side of Manhattan; Bellevue is in the lower East side (Note I am referring to geography not the neighborhoods' names) Even with the police escort the fire department vehicle took about a half hour to get there.

[seabeyond]

79. All US hospitals have learned from Dallas

i totally agree with the approach you look at the situation. totally. thanks.

[karynnj]

80. Thank you

Let's hope that, though like the nurses, he was unlucky in having been infected, he will be virus negative as quickly as they and the people he was with all stay negative.

It seems that he did wait over a week before since being in Africa to leave home. It is pretty unfair that many are attacking him for going out when he did. However, even assuming that the moment that he was infected occurred on the LAST day he was in Africa, which was likely not a day he saw patients. he was nearing the end of the period after which he could conclude that he had not been infected.

[Ms. Toad]

18. Fantastic.

Another medical provider who puts his medical knowledge on hold. Now we can add another hundred or so people to the quarantine lists. (Vinson resulted in more than 150 being added to one of 4 watch/quarantine levels).

UBER is a private arrangement equivalent to a taxi service.

[magical thyme]

21. so I wonder how many other people rode in the UBER vehicle after him, aside from the driver with him

who will now have to be monitored?

Hopefully his test will be negative.

[Ms. Toad]

37. Can't tell from the article.

The UBER I'm familiar with is a private car service - you have a car & want to make money using it, you can sign up to be an UBER driver. The central app connects you with people who want rides. They should have pretty good records.

From the description, the exposure and the significant number of Doctors without Borders team members who have contracted Ebola recently), I would expect the doctor to be positive. Not much chance of transmission if his first fever was this morning, But (broken record here) not non-zero - so everyone in contact with him needs to be monitored. If NYC hasn't already implemented the strict categories and restrictions that Summit and Cuyahoga Counties in Ohio have, they need to.

Had the doctor been following that protocol, he would have been in tier 1 or 2, and not even in the US.

Tier No. 1 is the group that is in quarantine. According to the ODH, this tier has enforced restrictions on movement and travel, their temperature is taken twice daily, they're in communication with a public health contact and they are not allowed to do any commercial traveling. This group had direct skin contact with an Ebola patient.

Tier No. 2A is experiencing active monitoring. Their temperature is taken twice daily; once in person by a public health official. They're not allowed to do commercial traveling and other travel restrictions are possible. This group didn't have direct contact, but they were within three feet of an Ebola patient for more than one hour.

Read more: http://www.wlwt.com/news/odh-daily-report-142-ohioans-being-monitored-for-ebola/29238078#ixzz3H0TZ6scQ

[LisaL]

56. Apparently he went to the bowling alley using a subway.

How do you even find people that took a subway with him?

"Mr. Spencer went to a bowling alley in Brooklyn on Wednesday evening, according to a city official briefed on the contact tracing efforts. He took the subway to Brooklyn and a taxi home".

http://www.nytimes.com/2014/10/24/nyregion/craig-spencer-is-tested-for-ebola-virus-at-bellevue-hospital-in-new-york-city.html?_r=0

[A Simple Game]

27. I hope the Doctor is OK. But besides the personal tragedy we don't need

any new cases popping up just before the election. This made up epidemic needs to go away or it will hurt Democrats on election day.

[magical thyme]

29. With nearly 5,000 dead, this epidemic is hardly "made up."

Just because the countries involved happen to be African does not mean it is "made up."

It is not an epidemic here in the US, but since it is growing exponentially and out of control, it has the potential to become a pandemic.

[LisaL]

32. Yes, the epidemic starts with one case.

If we are not careful it could happen here.

[A Simple Game]

38. I should have been clearer, of course it is an epidemic in certain African countries, but in America

so far it is an epidemic only in the minds of the Republicans the media and those easily fooled. Unless I missed a case we have only had two cases of people catching the disease in the United States so far and they were both in care giving positions for a person that contacted the disease elsewhere. Poor protocols, lack of personal protective equipment, or not following protocol seems to have been the major factors in both cases.

To put your statement into perspective, if we only have 5000 deaths in the US from the flu this winter it will be a good year. I can't see Ebola becoming a major problem in the US.

[magical thyme]

39. comparing a, incurable disease that is spreading exponentially with a doubling time of 21 days,

and a 70% fatality rate with one that is relatively stable in numbers, has a reliable vaccine with less than a 1% fatality rate, killing those who are immunocompromised is a false comparison.

[lancer78]

41. Ebola fatality rate when treated in the US

is now 1 in 6? nowhere near 70%

[LisaL]

45. The six who survived were treated in special hospitals.

There is limited number (very limited) of beds available in those special hospitals.

[magical thyme]

46. that does not change the fact that it currently has an overall fatality rate of 70%.

If there were to be an outbreak here, we have limited capacity to treat it. We are now increasing that capability as quickly as possible. However to date, our cures were limited to 2 facilities that were set up specifically to treat this sort of disease and the staff were specifically trained and prepared for this.

Now that they are setting up regional hospitals to act as Ebola centers, I'm sure we'll do a better job than Texas Presb. But there is still a lot to learn about treating it.

And statistically, 6 is not a valid dataset. You need a minimum of 30 data points to gain statistically valid data, and really the numbers don't get reliable until you have a couple thousand data points.

[tblue37]

47. It does seem that when they start supportive treatment very early,

before the patient's viral load has exploded, they have good results. Maybe with high quality and very early treatment, a patent's chance of surviving is much better than we have assumed.

[LisaL]

51. Dallas hospital had one patient (mr. Duncan). Now it's said to be a ghost town.

People don't want to go there. Lets face it, if we were to get a lot of patients, we are in big trouble.

[A Simple Game]

48. Should I have used malaria as a comparison? n/t

[LisaL]

52. Humans with malaria are not going to inect other humans through contact.

[A Simple Game]

60. I didn't want to do this but this is my last chance or I strike out, Aids? n/t

[Yo_Mama]

67. Isn't this an odd perspective? A violently infectious disease that kills 50% of victims, at least

and you're worrying about the political ramifications?

This is not a made-up epidemic. It's a very real epidemic, which is not yet established in our country. But it will be 42 days from last potentially infectious disease before WHO will declare us Ebola free. We are now one of five officially "affected countries". As of the next WHO update we'll be one of six, because of the Mali detection.

WHO is not doing what it is doing to affect the US election:
http://apps.who.int/iris/bitstream/10665/137091/1/roadmapsitrep22Oct2014_eng.pdf?ua=1

[A Simple Game]

69. Do you think that the Republicans are using the "epidemic in the US" to bash the Democrats?

I do, if there are no more cases before the elections it will help Democrats, if there are more cases it will help the Republicans. That is how I feel, disagree if you want to. I wouldn't be surprised if the Republicans accuse Democrats of carrying Ebola across the border in pails. The Republicans want to exploit this tragedy not help alleviate it. Please don't help the Republicans set the tone for this.

But no I don't think there is an Ebola epidemic in the US. Tragically there is in a few countries in Africa but not here nor do I think there will be an epidemic in the US.

[morningfog]

30. Calm down everyone. First symptoms were last night.

He was isolated this morning. It is early, the risk of infection to others was very low, if indeed it is Ebola.

[Renew Deal]

31. Uber is basically a taxi service

At it's most basic level.

[Quackers]

33. I'm sick right now with a high fever

Don't worry, just the flu, but after reading the headline, this is what I pictured:

[d_r]

58. i thought it also nt

[secondwind]

34. Holy crap, what was he THINKING?

[TM99]

40. Hey lay off the guy!

Just like the nurses in TX who went on cruise ships and to wedding plannings several states away, I am sure this MD got permission from someone in authority to go bowling after he came back from working with Ebola patients in Africa. It is not his fault whatsoever. He was following all of the proscribed protocols and procedures. He can't possibly have infected anyone because he wasn't infectious until, well, he was infectious.

[Louisiana1976]

42. If he does turn out to have Ebola it will be scary. Think of all the people he could have exposed.

[hamsterjill]

77. Exactly. "It's not rocket science".

Have you heard about the two guys who were sitting within three feet of Amber Vinson and are self-quarantining?

http://www.nydailynews.com/news/national/male-strippers-quarantine-flying-ebola-stricken-nurse-article-1.1977644

I mean, if a male model is cognizant enough to know to self-quarantine, one might think a doctor would be willing to consider the same protocol.

[cloudythescribbler]

64. the point is that the RULES OF QUARANTINE should be stricter, and there should be close monitoring

and Yes this could hurt Democrats in the midterms

maybe it's me but this obvious point doesn't seem to have been made

[ashling]

65. I thought this was about Dr. Who treating Ebola patients

[flamingdem]

68. Nyt says he's positive

Something tells me they need to stay in self imposed quarentine after working with patients with ebola.

[RussBLib]

74. Great, now we'll get hours and days more of media hysteria

I'll have to try to watch a lot less TV over the next week or so.

[magical thyme]

75. sorry for the inconvenience.

I never watch teevee, myself. Gave it up when it went digital.