Craig Spencer, who worked with Doctors Without Borders in Guinea, tested positive for Ebola on Thursday evening, marking New York City's first case of the virus. Spencer left West Africa, where an outbreak of the disease has killed almost 4,900 people, on October 14. The 33-year-old doctor returned to New York City, via Belgium, on October 17 and is currently being treated in Bellevue Hospital, Manhattan.
Mayor Bill de Blasio reminded the crowd gathered for a Thursday press conference at Bellevue that Ebola is not airborne, can only be transmitted by "intimate contact," and stated that New York City has the "world's strongest public health system." The staff at Bellevue, he said, have been preparing for a possible Ebola case for months, and followed every protocol.
It was also mentioned at the press conference that health workers at the hospital were given the given the choice of whether they wanted to treat Spencer. No one opted out.
Bellevue staffers were allowed to opt out of caring for Ebola patient, but none did so.
— Erin Durkin (@erinmdurkin)October 24, 2014
"Every hospital in the city is prepared in case other patients come forward," de Blasio added. All at-risk contacts Spencer had since his return are currently being traced and his movements are being reassembled via information from his subway card.
The WHO reports that as of October 19 there have been 9,936 confirmed, probable, and suspected cases of Ebola in five countries — Guinea, Liberia, Sierra Leone, Spain, and the US. Today the WHO confirmed that it is sending experts to Mali after a first case of the virus was confirmed there. Authorities in Mali are monitoring 43 people who have come into contact with a two-year-girl who had traveled to Guinea and was admitted to hospital on Tuesday.
At Bellevue, New York State Governor Andrew Cuomo also reassured that the state has been preparing for this. "This is New York. People come through here. People come through our airports." It's not unexpected, he said. "We are as ready as one could be for this circumstance."
"What happened in Dallas was the exact opposite," Cuomo added. "We had the advantage of learning from Dallas." The governor also noted that health workers had conducted drills, training for weeks for potential Ebola cases in the city. He reiterated that fear was far more contagious than the disease itself.
Since his return, Spencer reportedly took his temperature twice a day. On the 21st, he began to feel fatigued but continued to proceed with life as usual, taking a walk on the Highline and going to a handful of unnamed restaurants.
On Wednesday evening, Spencer took the A and the L trains to the Gutter bowling alley in Williamsburg, Brooklyn, where he bowled, and then took an Uber cab home. At around 10am on Thursday, Spencer developed a fever of 103 degrees and began to experience gastrointestinal symptoms, said Dr. Mary Bassett, commissioner of the Department of Health and Mental Hygiene. Spencer immediately contacted the health department, and was taken to Bellevue for surveillance.
As noted elsewhere, Ebola is extremely unlikely to spread through public transportation. Many at Thursday's press conference questioned the safety of Spencer's contacts from the night before. Dr. Bassett responded that since Spencer had no symptoms, no one was endangered. His friends with him at the bowling alley said he seemed perfectly healthy that night.
During his self-quarantine, Spencer did leave his apartment for a three-mile jog and had close contact with his fiancée and with two other friends, all of whom are under surveillance. When questioned as to why Spencer did not self-quarantine more effectively, Bassett answered that they were working with him to ascertain the exact amount of times he left his apartment. He was, they say, very alert to the signs and symptoms associated with the illness, having spent so much time in an area where the disease is rampant. Authorities emphasized that as recently as Wednesday night, Spencer had no fever and was not symptomatic, thus, not contagious.
"He knew the protocol. He took his temperature twice daily. He went for a jog. How sick could he be?" said Cuomo. "We are very clear that people become contagious as they become symptomatic," said Dr. Bassett. "He didn't have a fever until today."
The Gutter in Brooklyn is closed, and CDC staff will investigate the premises this morning. The Uber driver from Wednesday night had no direct contact with Spencer and is not considered to be at risk.
When asked about whether the subway trains Spencer rode would be specially cleaned, de Blasio reiterated that it "takes intimate contact to contract the disease." So, no.
Spencer is staying is the old tuberculosis ward on Bellevue's seventh floor. It was designed with isolation in mind, making it the perfect infrastructure to convert into an Ebola ward. In the words of CDC director Dr. Tom Frieden: "Bellevue has been preparing for this."