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Health

Someone in the US Has Ebola: Now What?

Yesterday, the CDC confirmed that some unlucky person in Dallas has the Ebola virus. That's not good for the patient or anyone else, but the CDC is a big organization, and we're about to see what it can do.

Screengrab from the CDC press conference. Via FOX 4 News - Dallas-Fort Worth

If you follow Ebola news, you've already heard about the patient in Dallas who had some extremely Ebola-like symptoms, and how the CDC was preparing to take action in the event of a horrifying diagnosis. Well, the diagnosis came in yesterday around 4 PM Eastern time, and there is officially an Ebola case in the United States.

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I contacted Laura Seay, a professor of government at Colby College specializing in African politics, who writes authoritatively about the politics of the Ebola crisis. She told me that, in contrast to what's happening in Africa, "the response [in the US] is rapid and comprehensive. We have hospital facilities here that are well equipped to deal with infectious diseases, and we have health workers who are trained for this and practice for these kinds of incidents on a regular basis."

If you're the patient with the Ebola diagnosis, you have good reason to panic, although, as Seay told me, "hopefully they get the patient back to health. That’s the ultimate hope: With good quality care, he or she can be saved." If, however, you're literally anyone else in America—chill out. What's about to happen will almost definitely not include people all over Dallas wandering the streets vomiting blood. Even though this is a first—and a person with Ebola was out there in the world before going to the hospital—the steps being taken right now by the CDC are more systematic than you may think.

Still, what happens next depends on who you are.

Photo via Flickr user Jason Scragz

The Patient
If you're the patient, you should be pretty unhappy, and pretty scared, but the good news is you're in America. The health care here isn't cheap, but it's pretty good, and you might just live through this. Unlike in Liberia, where doctors are a limited and shrinking resource, you'll be surrounded by more doctors than you'll know what to do with. You'll be in quarantine, so your doctors will be wearing protective clothing, and your environment will be clean and relatively comfortable. Best of all, they'll most likely inject you with ZMapp, the cocktail of antibodies that, in the best of circumstances, seriously brings down the chances of you dying. Typically, the odds are about 50–50 without the serum. We don't have good statistics about the odds with the serum, but in the handful of cases when it's been used, the treatment seems promising. So in other words, there's cause for optimism.

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If you want to prepare for the worst, though, here's what Ebola essentially does, according to VICE News' report on Liberia's Ebola outbreak: It causes your capillaries to separate slightly, and this lets blood leak out. You may get something called conjunctival injection, which means your eyes fill with blood. You might not see the kind of terrifying full-body bleed-outs that became part of the Ebola myth in the 1990s. Often, rather than visible signs of bleeding, you get low blood pressure, which eventually leads to organ failure. Dead and infected tissue inside you can result in sepsis. Any of these possibilities can be deadly.

People the Patient Came in Contact With
Seay told me "the process of what they call 'contact tracing' has already begun." This process, she explained, is when "public health workers track down everybody who came into contact with this individual and start monitoring them for symptoms." So if you came in contact with the mystery patient, you're in for some attention from the CDC. We know that the patient was traveling from Liberia. According to the CDC's press conference yesterday, the patient departed on September 19 and arrived in the US on September 20, so the airport (likely DFW) is probably one place that will be swept for signs of infection, but since it takes some pretty intimate contact to spread Ebola, it's unlikely anything will be found.

Moreover, the person had no symptoms until around the 24th, which is when the disease would have become contagious. Between then and the 28th, when the CDC says the person was admitted to the hospital, people who encountered this patient could have been infected, specifically those who—and this is really important—came in contact with the patient's bodily fluids, which, according to the CDC include, but are not limited to, "urine, saliva, feces, vomit, and semen." As in cinematic quarantine scenarios, it's conceivable that people who may have been exposed could find themselves in quarantine, like the unnamed doctor currently being observed in Bethesda, Maryland. However, Seay told me, "I don’t know to what degree that was voluntary or involuntary."

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One way or another, the CDC will be watching potentially exposed people like a hawk for 21 days. According to VOX's Susannah Locke, officials will "suggest various options for these people, depending on the level of risk, including watching and waiting, isolation at home, and testing for infection."

The City of Dallas
A single patient with Ebola is a localized problem, and precautions should keep it that way. No one wants to use the word "outbreak" unless it's necessary, but the CDC will no doubt take some of the precautions that they would in the event of multiple patients. Residents should expect a public-awareness campaign all around Dallas, instructing people about what they need to do if they think they have Ebola (namely, get the fuck to the hospital). Unfortunately, everyone with flu-like symptoms and every hypochondriac in the Dallas-Fort Worth area will be extremely susceptible to panic. I'm a hypochondriac in Los Angeles, and even I'm about to be on high alert for the next three weeks.

Creative Commons image via Global Panorama, as posted on Flickr

Say what you will about America, but we have a ton of money, and this kind of event is why we've been funding the Center for Disease Control and Prevention for all these years. Professor Seay was clear that this couldn't be more different from what's happening overseas: "The amount of resources that will be mobilized just for this one individual—both to get him or her back to health and to protect the community—that’s going to be a lot of money, and way out of proportion to what the Liberian authorities can spend on a per-patient basis."

Follow Mike Pearl on Twitter.