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Jen147 
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 Topic: Craig SpencerPosted: October 24 2014 at 6:03am |
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New York doctor diagnosed with Ebola; health officials seek out those in contact
October 24, 2014
Health and New York City officials were trying Friday morning to follow the trail of a young emergency room doctor who traveled about the city for three days before being hospitalized for the Ebola virus. The doctor, Craig Spencer, a member of Doctors Without Borders who had been working in Guinea, returned six days ago and reported Thursday morning coming down with a 100.3-degree fever and diarrhea. He was being treated in an isolation ward at Manhattan's Bellevue Hospital, a designated Ebola center. In the days before Spencer fell ill, he went on a 3-mile jog, went to the High Line park, rode the subway and, on Wednesday night, got a taxi to a Brooklyn bowling alley. Bassett said he felt fatigued Wednesday but not feverish until Thursday morning.
The bowling alley was shuttered Thursday night, and issued a statement saying, "We've been in constant contact with the Health Department and they have determined that there was no risk to our customers." Spencer rode the subway in the past five days, traveling on the A, L and 1 lines, a law-enforcement source told The New York Post. Mayor Bill de Blasio and Gov. Andrew Cuomo on Thursday urged residents not to be alarmed by the doctor's Ebola diagnosis, even as they described him riding the subway, taking a cab and bowling. De Blasio said all city officials followed "clear and strong" protocols in their handling and treatment of him. "We want to state at the outset that New Yorkers have no reason to be alarmed," de Blasio said. "New Yorkers who have not been exposed are not at all at risk." Health officials say the chances of the average New Yorker contracting Ebola, which is spread through direct contact with the bodily fluids of an infected person, are slim. Someone can't be infected just by being near someone who is sick with Ebola. Someone isn't contagious unless he is sick. The Centers for Disease Control and Prevention, which will do a further test to confirm the initial results, has dispatched an Ebola response team to New York. President Barack Obama spoke to Cuomo and de Blasio Thursday night and offered the federal government's support. He asked them to stay in close touch with Ron Klain, his "Ebola czar," and public health officials in Washington. The city's disease detectives have been tracing Spencer's contacts to identify anyone who may be at risk. The city's health commissioner, Mary Bassett, said Spencer's fiancee and two friends had been quarantined but showed no symptoms. Bassett said the probability was "close to nil" that Spencer's subway ride would pose a risk. Still, the bowling alley was closed as a precaution, and Spencer's Harlem apartment was cordoned off. The Department of Health was on site across the street from the apartment building Thursday night, giving out information to area residents. The Ebola epidemic in West Africa has killed about 4,800 people. In the United States, the first person diagnosed with the disease was a Liberian man, who fell ill days after arriving in Dallas and later died, becoming the only fatality. None of his relatives who had close contact with him got sick. Two nurses who treated him were infected and are hospitalized. According to a rough timeline provided by city officials, Spencer felt fatigue Wednesday and when he felt worse Thursday he and his fiancee made a joint call to authorities to detail his symptoms and his travels. EMTs in full Ebola gear arrived and took him to Bellevue in an ambulance surrounded by police squad cars. Doctors Without Borders, an international humanitarian organization, said per the guidelines it provides its staff members on their return from Ebola assignments, "the individual engaged in regular health monitoring and reported this development immediately." Travelers from Guinea, Liberia and Sierra Leone must report in with health officials daily and take their temperature twice a day, as Spencer did. Spencer works at NewYork-Presbyterian/Columbia University Medical Center. He had not seen any patients or been to the hospital since his return, the hospital said in a statement, calling him a "dedicated humanitarian" who "went to an area of medical crisis to help a desperately underserved population." Four American aid workers, including three doctors, were infected with Ebola while working in Africa and were transferred to the U.S. for treatment in recent months. All recovered. Health care workers are vulnerable because of close contact with patients when they are their sickest and most contagious. In West Africa this year, more than 440 health workers have contracted Ebola and about half have died. Spencer, 33, is from Michigan and attended Wayne State University School of Medicine and Columbia's University Mailman School of Public Health. According to his Facebook page, he left for West Africa via Brussels in mid-September. A photo shows him in full protective gear. He returned to Brussels Oct. 16. "Off to Guinea with Doctors Without Borders," he wrote. "Please support organizations that are sending support or personnel to West Africa, and help combat one of the worst public health and humanitarian disasters in recent history." |
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Jen147
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Posted: October 24 2014 at 6:08am |
Man Down10.23.14
Why New York’s Ebola Case Will Hurt Infected Patients EverywhereCraig Spencer wanted to inspire other doctors to go fight the outbreak in West Africa. Instead, they may be scared away—right when they’re needed most. Just before arriving in the Ebola-torn nation of Guinea, 33-year-old Craig Spencer posted a picture of himself on Facebook smiling in a yellow hazmat suit, face mask, and gloves—his new uniform. In the caption next to his image, after announcing his mission with Doctors Without Borders/Médecins Sans Frontières (MSF), he typed a plea: “Please support organizations that are sending support or personnel to West Africa, and help combat one of the worst public health and humanitarian disasters in recent history.” His brave mission, followed by a devastating diagnosis, complicates an already nightmarish scenario for health-care workers fighting against Ebola: It may be deterring doctors from helping—right when they’re needed most. The news of Spencer’s positive test for the virus, announced Thursday night in New York City, might achieve the exact opposite of his stated goal. Spencer, whose LinkedIn account lists him as an international emergency-medicine fellow at New York-Presbyterian Hospital/Columbia University Medical Center, completed his assignment in Guinea on Oct. 12 and landed at JFK International Airport on Oct. 14. Once back in his Harlem apartment, he closely monitored his condition, taking his temperature twice a day. Feeling healthy, he reportedly went on a 3-mile jog, as well as took the L train to Williamsburg to go bowling at a venue known as Gutter. According to health officials in New York, he did not present a fever until Thursday morning, meaning he was not symptomatic on public transit. Four people have been identified as potential contacts, including Spencer’s fiancée, but all are in stable condition. At a press conference Thursday evening, New York Mayor Bill de Blasio addressed the situation calmly. “We want to state at the outset there is no reason for New Yorkers to be alarmed. Ebola is an extremely hard disease to contract,” he said. “Being on the same subway car or living near a person with Ebola does not in itself put someone at risk.” New York City Health Commissioner Mary Travis Bassett reinforced de Blasio’s statements saying that Spencer followed the self-monitoring guidelines set out by MSF for those returning from West Africa, which includes checking one’s temperature twice a day. In West Africa itself, in the four weeks since Spencer arrived in Guinea, things have gotten worse. Much worse. With close to 10,000 confirmed cases and more than 4,800 deaths in West Africa, humanitarian organizations’ calls for more medical workers have turned to shouts. Around the time that Spencer decided to go to West Africa, it seemed that the world was finally getting involved. In mid-September, the United States, joined by several other countries, pledged more than $175 million to the fight and 3,000 troops. Days after that announcement, the United Nations Security Council unanimously passed an “unprecedented resolution” calling for $1 billion (and an additional $570 million on behalf of WHO) from world leaders in order to send the people and supplies necessary to contain the epidemic. Ten days later, when the dust had settled, MSF President Joanne Liu called their bluff. “Generous pledges of aid and unprecedented UN resolutions are very welcome. But they will mean little, unless they are translated into immediate action,” Liu said. “The reality on the ground today is this: The promised surge has not yet delivered.” As of Oct. 17, over a month after the plans were set, the UN has only collected 38 percent of its goal. MSF, the first humanitarian organization to recognize the epidemic, has been waiting for help to come since March. According to a spokesperson, the organization employs 270 international and around 3,018 locally hired staff in the three affected countries: Liberia, Guinea, and Sierra Leone. Among those nations is a population of 22 million. Some heroic volunteers, like Spencer, have joined the fight—but not enough. “The sick are desperate, their families and caregivers are angry, and aid workers are exhausted,” Liu continued at the meeting. “Maintaining quality of care is an extreme challenge.” Identifying patients with an infection, isolating them, and providing quality care, are the key methods needed to stop Ebola. The “tried and true measures” that CDC Director Thomas Frieden has referred to dozens of times. Those methods require facilities, equipment, and, most importantly, people. Even before Ebola struck in West Africa, all three were in short supply. Humanitarian Paul Farmer and World Bank Leader Jim Yong Kim captured the problem in a Washington Post article last week. “The reality is this: The Ebola crisis today is a reflection of longstanding and growing inequalities of access to basic health care,” it reads. “Guinea, Liberia, and Sierra Leone do not have the staff, stuff and systems required to halt the outbreak on their own.” In other words, if the health-care systems in West Africa are failing, it’s because they never had a chance in the first place. In a May 2013 report, Global Health Africa detailed the problems facing West African health-care systems. Staffing issues were one of the main problems discussed. The World Health Organization’s minimum physician-to-patient ratio lists one doctor per 5,000 citizens. In Sierra Leone, the group reported less than 10 physicians per 100,000 inhabitants. Liberia, the epicenter of the epidemic, was relying on just 50 doctors to care for the entire nation before the outbreak occurred. Sebastian Vidal, a field coordinator for MSF, told NPR he was “flabbergasted” at the lack of international response. “We see that Western countries are preparing themselves in case they have one or two cases,” said Vidal. “This is not acceptable. You just cannot let a whole continent become infected and people die by hundreds. People are giving advice, talking and talking, but we don’t need advice. We need people on the ground doing the job like us. Please come.” “There’s just some hysteria surrounding the virus that prevents people from coming,” Craig Kenzie, a logistics manager with MSF told Canadian Breaking News Wednesday after returning from a trip to Kailahun in Sierra Leone. “Of all the missions I have done with MSF, on the ground, this is one of the clearest needs that I’ve ever worked in. You have a huge need that’s just not being met. And it makes no sense.” In other disasters, such as earthquakes or tsunamis, volunteers come running. But in the face of Ebola, they run the other way. While hysteria is unnecessary, fear is understandable. According to the WHO, more than 400 health-care workers in West Africa have been infected with Ebola. More than half have died. With a shortage of supplies, many nurses and doctors are left to treat their patients without even the most basic of protection, such as gloves. In Richard Preston’s gutting piece for The New Yorker, he describes the inside of an isolation ward as if it’s a torture chamber—drenched in human bodily fluids and reeking of feces. These conditions aren’t acceptable, but they also aren’t the whole story. Some isolation wards, such as the one the U.S. Army is constructing in Liberia, will be fully functioning facilities with the best technology that will allow health-care workers to remain virtually risk-free if they follow proper protocol. But until the international community comes together to flood the region with the facilities, doctors, and supplies it needs, it will be Preston’s image that we remember, and Spencer’s story that we tell. |
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Jen147
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Posted: October 24 2014 at 6:12am |
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2nd article contradicts "a little" the degree of his awareness. Says he felt fine until Thursday morning. But several other sources say he felt fatigued before the fever showed up.
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Jen147
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Posted: October 24 2014 at 6:16am |
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New York Doctor Tests Positive for Ebola
Oct. 24, 2014
A doctor who had returned to New York City recently after treating Ebola patients in West Africa tested positive for the virus on Thursday, officials said, setting up a new front in the nation’s attempt to control the spread of the deadly disease. Craig Spencer, a 33-year-old physician who had worked with Doctors Without Borders in Guinea until returning to the U.S. a week ago, is the fourth patient to be diagnosed with Ebola in the U.S. and the ninth to be treated here. Dr. Spencer called the New York City Department of Health and Mental Hygiene at about 11:52 a.m. to report that he had a fever and gastrointestinal problems, and had quarantined himself inside a fifth-floor apartment on West 147th Street in Manhattan, authorities said. A Fire Department of New York hazardous materials team put Dr. Spencer in an exposure suit and transported him to Bellevue Hospital Center, the official said. He tested positive less than three weeks after Liberian Thomas Eric Duncan, the first person diagnosed on U.S. soil, died on Oct. 8. The subsequent Ebola diagnoses of two nurses who treated Mr. Duncan raised concerns that the nation’s medical systems weren’t well-equipped to stop the spread of a virus that has killed nearly 4,900 people. In New York, Mayor Bill de Blasio said authorities had been preparing for an Ebola case for weeks and followed new protocols “very precisely.” Bellevue is one of eight hospitals that New York state officials have designated to handle suspected cases of Ebola. “There is no reason for New Yorkers to be alarmed,” Mr. de Blasio said at a news conference at the hospital Thursday night. “We have clear and strong protocols which are being scrupulously followed.” Mr. de Blasio said Dr. Spencer was “in good shape” and able to discuss his condition and with whom he came into contact. Detectives were tracing Dr. Spencer’s contacts to determine whether anyone else is at risk of becoming ill, city officials said. Detectives were using Dr. Spencer’s credit card and MetroCard and interviewing his contacts to determine whether anyone else is at risk of becoming ill, city officials said. Dr. Spencer had come into close contact with only four people since he returned from Africa on Oct. 17 through John F. Kennedy International Airport, authorities said. All four—two friends, a cabdriver and his fiancée—are healthy, officials said, but the friends and fiancee are being quarantined though they showed no symptoms. Dr. Spencer hadn’t been back to his job as a staff physician at New York-Presbyterian/Columbia University Medical Center since his return from Africa and hadn’t seen any patients, the hospital said. “He limited his contact with people,” said Mary Travis Bassett, the New York City health commissioner, though she noted he occasionally went out during the past week. On Wednesday night, he rode three different subway lines, going bowling at a Brooklyn alley called the Gutter and summoning a cab through the e-hailing app, Uber, Dr. Bassett said. That day he went for a three-mile run, walked through the High Line park and ate at a Manhattan restaurant called the Meatball Shop, city officials said. The Gutter was closed Thursday as a precaution and owners didn’t return calls seeking comment. A Meatball Shop employee declined to comment. Authorities stressed that Dr. Spencer appeared in fine health until Thursday morning. He left Guinea on Oct. 14 and flew to Europe, where he stayed for three days before flying out of Brussels, city officials said. On Oct. 17, he made it through multiple levels of screening at Kennedy Airport and showed no signs of illness, the Centers for Disease Control and Prevention said Thursday night. Dr. Bassett said Dr. Spencer knew he was at risk for Ebola and took his temperature twice a day. He didn’t begin to feel ill until Thursday morning between 10 a.m. and 11 a.m., she said, when he experienced a high fever. He contacted authorities who rushed him to the hospital. Dr. Spencer was being treated with fluids—standard treatment for Ebola virus—and “he’s lucid and communicating,” said a city official. The CDC deployed a team of experts to New York City Thursday before test results came in, signaling its level of concern about Dr. Spencer’s case. The agency has received more than 400 reports of possible Ebola cases during the past several weeks, and deployed only once previously: to Dallas, where Mr. Duncan was a patient at Texas Health Presbyterian Hospital Dallas. Doctors Without Borders confirmed that one of its workers in West Africa recently had been hospitalized in New York but offered no details. The organization trains its staff rigorously and has a strong record of safety in its Ebola treatment units. But at least two other workers have been infected during the course of this epidemic, a testament to the challenges faced as cases mount in crowded wards. While Dr. Spencer had been out and around the city since his return from Guinea, public-health officials say the risk that Dr. Spencer infected anyone is low. Ebola is known to spread only through contact with bodily fluids, such as blood, vomit, and diarrhea. The epidemic has taken a heavy toll on health workers overall, many of whom died in the early months because they lacked protective gear. According to the World Health Organization, 443 health workers have been infected during the outbreak, of whom 244 have died. Overall, at least 9,936 people have been infected with Ebola due to the West African outbreak, according to the World Health Organization. Dr. Spencer’s apartment in a diverse, immigrant neighborhood in upper Manhattan was sealed off pending diagnosis, law-enforcement officials said. City Health Department workers were outside the six-story, 36-unit building Thursday, handing out Ebola information brochures and reassuring residents. “We’re just reminding people that we’re on top of it and that they’re safe,” said Sam Miller, an associate city health commissioner at the scene. “We’re telling them the facts,” he added, noting that Ebola can’t be spread by air or in water. The area’s city councilman, Mark Levine, turned up and urged residents to remain calm. “There’s no cause for panic here,” he said. In addition, Ebola patients tend not to be very infectious when they first become ill and are having only mild symptoms. Levels of virus increase as the disease progresses and a patient’s condition worsens; those near death or recently deceased are most infectious. Mr. Duncan was ill for several days in a small apartment, but didn’t infect anyone living in close quarters with him there. The two nurses who did become infected treated him when he already was severely ill and having copious amount of vomit and diarrhea, officials said. New York Gov. Andrew Cuomo said the state’s hospitals had been preparing for this for weeks. “We had the advantage of learning from the Dallas experience,” the governor said. Of the eight people previously treated for Ebola in the U.S. seven, including five evacuated from Africa, have been treated in special biocontainment units built to handle patients with serious infectious diseases, with staff specially trained in use of protective gear. Dr. Spencer’s situation is the latest scare related to the deadly disease in the past two weeks in the Greater New York area, where two of the nation’s five airports receiving passengers from Ebola-affected countries are located. A passenger stopped at Newark Liberty International Airport with fever tested negative for the disease, and a Yale University student returning from Liberia was hospitalized with Ebola-like symptoms last week before testing negative. President Barack Obama on Thursday night talked to Messrs. Cuomo and de Blasio in separate phone calls about the diagnosis of the Ebola case in New York City, the White House said. Mr. Obama noted the extensive preparations that the city and in particular Bellevue Hospital Center had taken for Ebola and offered additional federal support. |
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