"Dallas, we have a problem"

Patient infected with Ebola made it to Texas and out of an E.R. due to series of administrative failures

Just a few weeks ago, The Spectrum called upon the United States to do more to combat Ebola in Africa. Now, America is failing to get the job done on home soil.

All it took was a single “no” instead of an affirmative on a form at a Liberian airport, and Thomas Duncan made it into the United States, bringing with him the Ebola virus. Duncan, who arrived in Dallas on Sept. 20, had accompanied a pregnant woman with Ebola to a hospital in Liberia and ended up helping to carry her back home after she was turned away and became too weak to walk.

Though a lack of understanding about incubation periods (Ebola’s maximum is 21 days) has been attributed to Duncan’s reticence on the questionnaire, it seems equally likely that he chose to answer untruthfully. The question, which asks whether or not he’d been in contact anyone who may have been infected with Ebola in the past three weeks, seems difficult to misinterpret.

While discussions of prosecuting Duncan have been raised – the chairman of the Liberia Airport authority said that he would pursue prosecution – the very existence of such a possibility points to the far more pressing matter – that intentionally or not, it is all too easy for infected individuals to slip through the screening process. Because Duncan passed a visual assessment and did not have a fever, only honesty on his part could have kept him from boarding his plane.

There should be no room for error, and no dependence on something as tenuous as honesty in a system tasked with something as important as preventing the spread of a deadly epidemic.

Right now, it appears that there is plenty of space for individuals like Duncan, who is currently hospitalized in critical condition, to slide through and into previously unexposed populations like that of the United States.

The list of people who had contact with Duncan in Dallas continues to grow. A second individual may now be infected, 12 to 18 have possibly been exposed and at least 80 people have had indirect or direct contact with him.

The problem of Duncan’s arrival in the United States was exacerbated by a second failure – that of health officials in Dallas, both in diagnosing Duncan and containing him and the family members with whom he’d been living.

In an unbelievable demonstration of incompetence, doctors at a Dallas hospital actually sent Duncan home with antibiotics after the crucial detail that he’d traveled to Liberia was not communicated to medical staff. Three days passed until Duncan was admitted once again and finally placed in isolation – three days in which the potential for exposure increased and the vital process of clean up and containment was delayed.

The series of mistakes, astonishingly, did not end there. Four more days passed before the apartment in which Duncan had been living, and where four other people – a woman and three children – were ordered by health official to remain, had not been sanitized.

Duncan had been vomiting and suffering from diarrhea. Dirty towels and sheets were left behind in the still-occupied apartment. According to Texas’ health commissioner, officials had struggled to find a contractor who was willing to enter the apartment. And despite the lack of sanitation, county officials had visited the apartment without protective gear.

In a situation where vigilance, efficiency and procedural discipline should have been on display, sheer incompetence took center stage instead.

As this case develops and mortality rates continue to rise, it’s increasingly difficult not to worry about Ebola – not to let some anxiety or fear creep in. But even worse is the fear of incompetence, the looming anxiety that if an outbreak were to occur, this country isn’t prepared to handle it.

email: editorial@ubspectrum.com