Apparently not satisfied with inflicting havoc in Texas for two weeks and causing a major panic, the publicity-hungry Ebola virus set its sights on the media capital of the world on Thursday.
The latest Ebola case is a New York City Doctor. A specialist in international medicine at New York Presbyterian Hospital, Dr. Craig Spencer had been working with Ebola patients for the French relief agency Doctors Without Borders.
New York City health officials are conducting contact tracing to find people who may have had contact with Dr. Spencer.
The bad news?
New York City being New York City, Spencer took the the subway from his apartment on West 143th street in Harlem to a Brooklyn bowling alley the night before his fever spiked. That’s led to speculation that he may have inadvertently exposed a lot of people. Public health health officials are now tracing Spencer’s contacts to find potential “high risk” cases.
Our talking points:
Is It Possible to Catch Ebola on the Subway?
No. Yes. Maybe.
Unfortunately, in reality we don’t know, although we’re pretty sure we do. Current CDC guidelines are based on the assumption that Ebola only becomes contagious when symptoms present and the patient enters the high fever stage.
Via Controversies at Hospital Infection Prevention:
Those at risk for Ebola are healthcare workers who have cared for Ebola patients (whether here or in West Africa). Not mall-goers, bowlers, subway riders, or those who might have been in an airport terminal on the same day as an asymptomatic Ebola patient. The greatest transmission risk is borne by those who provide direct care for Ebola patients during severe illness, when viral shedding is very high.
There’s a lot of evidence to support this argument. There have been cases of symptomatic Ebola patients traveling by airplane, bus and other modes of transportation without spreading the disease. That’s somewhat reassuring.
On the other hand, it is not exactly compelling statistical evidence of anything other than that some people travelled with an Ebola patient and did not develop Ebola.
We need to work with much larger numbers before we know for sure. The good news?
Now that Ebola has arrived in a city of eight million people, we’re now going to have them.
Is it Possible to Catch Ebola from a Bowling Ball?
It has come to this, has it?
Expect Nate Silver and the guys at fivethirtyeight.com to helpfully do a three thousand word quantitative analysis on the probability of catching Ebola from a bowling ball. The truth may be that it is possible to catch Ebola from a bowling ball if you lick it or exchange bodily fluids with it, as several clever wags have helpfully pointed out.
Suffice to say the odds are low.
Is It Possible to Catch Ebola from the Media?
At this point, the greatest danger of transmission may be from the news media. The World Health Organization has documented cases where people have developed Ebola-like symptoms, a sort of “reverse placebo” effect after prolonged exposure to media coverage after the epidemic. There have been numerous cases of people developing headache, nausea, vomiting and other symptoms that suggest to the sufferer that death is imminent.
The only known cure? Doctors Without Borders Recommends a strict 21-day media quarantine. Turn off your television set. Take a walk. Write the Great American Novel. Do something else. Do anything else.
Travel Ban: Expect the Spencer case to lead to further public calls for a ban on flights from Africa.
Also likely to be challenged: the fundamental assumptions behind the new guidelines. That’s not really fair. Had Spencer been required to follow the new self-monitoring guidelines released by the CDC on Tuesday, the case would probably have been caught when Spencer reported that he was feeling unwell on Tuesday and Wednesday.
Are we doing enough to protect people? Again, we’re about to find out.
The issue of how Spencer contacted the disease in the first place is likely to be a major focus. In Guinea, the physician worked closely with Ebola patients using infection control procedures developed by Doctors without Borders. It just so happens that these are the very same guidelines health care workers will be relying on in the fight against Ebola from now on. Expect more debate and understandable fear about as healthcare workers question that enough is being done to protect them.
We’ll learn more Spencer’s story plays out and we see how effective the measures are as doctors, nurses and other healthcare workers handle his case. The reality? No system is likely to be 100% effective.
John Irvine is the executive editor of THCB.