Ebola in America, 2014
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Humanitarian workers helping to contain the outbreak in West Africa were the first Americans to contract the Ebola virus, at which point most of them were flown back to the U.S. for treatment. The first cases of the Ebola virus diagnosed in the U.S. were in Dallas, Texas and New York City, prompting the Obama administration to establish new guidelines for the treatment of Ebola patients and the handling of contaminated waste materials. President Obama also appointed an Ebola response coordinator, Ron Klain, to coordinate the efforts of federal agencies dealing with containing the virus.
Additionally, the president agreed to send 4,000 military personnel to West Africa and requested $500 million in aid to be sent to the region, where the Ebola virus is devastating populations in the most deadly outbreak in history. Four Americans have been infected by the virus while fighting to control the outbreak and three were brought back to the U.S. for treatment, while one died in Africa serving the Liberian government. As of October 2014, the virus already killed over 4,000 in West Africa and the first case contracted outside of West Africa was diagnosed in Spain on October 6, 2014.
History of the virus[edit]
The Centers for Disease Control and Prevention first began investigating the Ebola virus in 1976 when an outbreak occurred in Sudan and the Democratic Republic of the Congo, formerly Zaire.[1] According to the World Health Organization (WHO), the virus is most common in central and western Africa, near rainforests and is spread to humans by animals, namely the fruit bat. The virus gained it's name due to the site of the first outbreak in Zaire being along the Ebola River. It is transferred through the blood and other bodily fluids of an infected person. The symptoms include severe fever, headache, weakness and muscle pains and the disease has an incubation period, from when one is infected to when symptoms show, between 2 and 21 days. WHO records indicate 24 previous outbreaks in Africa with the highest recorded death toll reaching 280 during the first outbreak in Zaire.[2]
Public health emergency called[edit]
- August 7, 2014
The WHO announced the Ebola virus outbreak met the criteria for a Public Health Emergency of International Concern on August 7, 2014. The criteria are listed on the WHO website as:
| “ |
|
” |
| —World Health Organization[4] | ||
CDC Director Tom Frieden activated the agency's emergency operation center the same day, in an effort to help stop the spread of the virus; however, he expressed concern on September 2, 2014, with the virus' spread, suggesting, "It is the world’s first Ebola epidemic, and it’s spiraling out of control. It’s bad now, and it’s going to get worse in the very near future. There is still a window of opportunity to tamp it down, but that window is closing. We really have to act now."[5][6]
Possible 2016 presidential candidate comments[edit]
- See also: Presidential election, 2016
Rick Perry[edit]
October 1, 2014
Texas Governor Rick Perry (R) issued a statement saying, "There are few places in the world better equipped to meet the challenge that is posed in this case. Texas is one of only 13 states certified by the CDC to conduct diagnostic Ebola testing, and we have the health care professionals and the institutions that are second to none. The public should have every confidence that the highly trained professionals involved here will succeed in this very important mission."[7]
October 6, 2014
Perry called for more screening at customs in order to keep more Ebola infected people from making it into the country, suggesting, "Many of the circumstances that led to this situation can only be addressed at the federal level. Washington needs to take immediate steps to minimize the dangers of Ebola and other infectious diseases."[8] He also announced the creation of a Texas task force to combat the spread of Ebola, stating, "Today, I issued an executive order creating the Texas task force on infectious disease and response."[9]
Rand Paul[edit]
October 2, 2014
Sen. Rand Paul (R-KY) warned the administration to not take the threat of Ebola lightly, arguing, "I think because of political correctness we’re not really making sound, rational, scientific decisions on this. It’s a big mistake to underestimate the potential for problems worldwide." Along the same lines, he questioned the decision to send 3,000 soldiers to West Africa in attempting to contain the virus, stating, "You also have to be concerned about 3,000 soldiers getting back on a ship. Can you imagine if a whole ship full of our soldiers catch Ebola?"[10]
Bobby Jindal[edit]
October 6, 2014
Louisiana Governor Bobby Jindal expressed his support of a ban on flights from West Africa, citing Duncan's entrance to the U.S. while infected. He argued, "We should stop accepting flights from countries that are Ebola stricken. President Obama said it was ‘unlikely’ that Ebola would reach the U.S. Well, it has, and we need to protect our people."[9]
Ted Cruz[edit]
October 15, 2014
Sen. Ted Cruz (R-TX) spoke out in favor of a travel ban from West African countries, suggesting, "Common sense dictates that we should impose a travel ban on commercial airline flights from nations afflicted by Ebola. There’s no reason to allow ongoing commercial air traffic out of those countries." Cruz added, "The risks of epidemic are far too large for us to allow unimpeded commercial flights."[11]
Chris Christie[edit]
October 27, 2014
New Jersey Governor Chris Christie denied he had changed his stance on the mandatory 21-day quarantine after releasing the first nurse subjected to the quarantine after only four days, claiming, "I didn’t reverse any decision. She hadn’t had any symptoms for 24 hours. And she tested negative for Ebola. So there was no reason to keep her. The reason she was put into the hospital in the first place was because she was running a high fever and was symptomatic."[12]
October 28, 2014
When asked about criticisms of his plan and pressure from the Obama administration to ease the restrictions, Christie responded, "This is common sense, and the members of the American public think it is common sense. We are not moving an inch."[13]
Elizabeth Warren[edit]
October 9, 2014
Sen. Elizabeth Warren (D-MA) placed blame for the lack of vaccine progress on spending cuts pushed by Republicans, suggesting, "We knew about this many years ago and started funding research on it. And then, with all the spending cutbacks and all the pressure on the National Institute of Health, much of that research has been shelved." She argued further, "So now, we’re out spending millions, billions of dollars in emergency response. People have lost their lives, we’re all very worried, instead of spending the money in advance to do more of the research to avoid this kind of problem."[14]
Andrew Cuomo[edit]
October 28, 2014
New York Governor Andrew Cuomo explained his decision to ease the state's mandated quarantine period after receiving pressure from the Obama administration. He responded, "I want to make sure that every policy we put in place is supportive of their efforts." He also stated it was important for decisions to be made based on "science" and not "fear."[15]
U.S. efforts to contain[edit]
- September 16, 2014
| President Barack Obama addressed the nation about the Ebola outbreak in West Africa on September 16, 2014. |
Following a briefing by the CDC on September 16, 2014, President Barack Obama announced the assignment of 3,000 military medical and logistical personnel to West Africa in order to prevent any further spreading of the virus. In addition to the military aid, he promised an "air bridge," of open transportation between the affected area and the United States through which supplies could be sent to West Africa.[16] The administration also planned the building of 17 hospitals of 100 beds each to be used to treat more patients and agreed to train more medical care professionals as well as the local populations on what to do with infected patients.[17]
On October 3, 2014, the administration announced an additional 1,000 troops were assigned to Africa to help construct new treatment facilities and testing labs. While the troops were not expected to be in contact with Ebola patients, they were all to be screened upon their return, with any having had contact with the virus being under isolation for 21 days.[18] CDC Director Frieden said all suggestions were being taken into consideration in the containment of Ebola, acknowledging that the risk in the U.S. could not be zero without first dealing with the problem in Africa. He said options were being taken into careful consideration with respect to the impact in both Africa and the U.S., stating, "We don’t want to do something that inadvertently increases our risk by making it harder to stop the outbreak there."[19]
- October 15, 2014
- Reps. Keith Ellison (D-MN), Karen Bass (D-CA), and Barbara Lee (D-CA) spoke out and insisted that the troops that were deployed to Africa deal more directly with containing the virus than was intended by the administration. They wrote in a letter to Obama, "We write to urge you to consider building on the current response to the Ebola epidemic by allowing military medical and technical personnel to provide direct care to and to come into contact with patients in West Africa." The letter continued, "The commitment of 4,000 military personnel, to assist with standing up Ebola Treatment Units (ETU) and logistical response are essential contributions. However, we have heard from those working in West Africa that there is uncertainty about who will staff the ETUs, who will manage them, and whether their level of experience under these conditions is commensurate with the task."[20]
Ebola waste disposal[edit]
The group Healthcare Coalition for Emergency Preparedness accused the U.S. Department of Transportation (DOT) on October 3, 2014, of lowering their safety standards in regard to disposing of Ebola waste. The standards held by DOT specify that the waste not be transported by regular disposal services but must be treated as biohazard material. Ebola waste, the group argued, should be disposed of in a waste sterilizer on-site, or since the Dallas hospital treating Duncan did not have one, he should have been transferred to a hospital with the appropriate resources. The group's director explained, "There is no reason for [the Department of Transportation] to lower safety standards when there are affordable, existing technologies commonly used today that allow hospitals to properly and safely treat substances infected with Ebola on-site. Appropriately disinfecting waste on-site instead of trucking it across the city will help promote confidence in our health system and government agencies' ability to protect the public."[21]
The Department of Transportation, in conjunction with the CDC, issued a special permit on October 3, 2014, to Stericycle, Inc., allowing the Lake Forest, Illinois company to handle the disposal of all Ebola waste in the state of Texas. It also includes the removal of household items, leaving the company in charge of disposing of possibly contaminated items in Duncan's family's apartment. The permit established the required packaging and disinfectant, mandated a written accident response plan and provided transport controls to the company.[22]
Ebola waste is classified as a "Category A infectious substance," which requires items to be transported in double layered leak-proof packaging inside a rigid container.[22][23]
Ebola 'czar'[edit]
Rep. Jack Kingston (R-GA) called for the administration to appoint an Ebola "czar" on October 4, 2014, to coordinate the U.S. efforts to contain the virus. While he acknowledged that each individual agency working on solutions were doing well, he argued that they were each "in their own silo," and could use an overseer who could act as "a command and control general, a strategic guy."[24]
- October 12, 2014
Sen. John McCain (R-AZ) - Sen. John McCain (R-AZ) backed up Kingston's call for a "czar" in handling the overall attempt to contain Ebola, stating, "From spending time here in Arizona, my constituents are not comforted. There has to be more reassurance given to them. I would say that we don't know exactly who's in charge. There has to be some kind of czar. I don't think we're comforted by the fact that we were told there would never be a case of Ebola in the United States. Obviously that's not correct." The comments were criticized by many Democratic commentators after McCain was very critical of the Obama administration's appointment of "czars" in other policy areas. McCain tweeted in 2009, "Obama has more czars than the Romanovs - who ruled Russia for 3 centuries. Romanovs 18, cyberczar makes 20."[25]
On October 17, 2014, President Obama announced the appointment of an Ebola "czar," formally called the Ebola Response Coordinator, to help coordinate multi-agency efforts to contain the spread of the virus. Ron Klain, the former chief of staff for both Vice Presidents Al Gore and Joe Biden, was named to lead the effort. The choice came under fire from Republicans, however, as Klain had no medical training or experience.[26] Klain, whose first official day on the job was October 21, 2014, met with President Obama followed by a series of meetings with other White House staff to discuss strategy and coordination on his first day.
- October 17, 2014
- House Foreign Affairs Committee Chair Ed Royce (R-CA) questioned Klain's background as for why he was chosen to lead the effort, stating, "Given the mounting failings in the Obama administration’s response to the Ebola outbreak, it is right that the president has sought to task a single individual to coordinate its response. But I have to ask why the president didn’t pick an individual with a noteworthy infectious disease or public health background?"[27]
- White House Press Secretary Josh Earnest claimed the criticisms were merely political games being played by Republicans, suggesting, "That's a shocking development there. Three weeks before an Election Day, and Republicans are seeking to score political points. Stop the presses!"[27]
- Sen. John McCain (R-AZ) argued that the appointment was a partisan effort by the administration, claiming, "Frankly, I don't think Mr. Klain fits the bill, as a partisan Democrat, certainly not in any effort to address this issue in a bipartisan fashion. He has no experience or knowledge or background in medicine."[28]
- October 20, 2014
NIH's Dr. Fauci supported the administration's choice and argued that Republican criticism of the appointment was misguided. He argued, "You don't need to be a health care person, you need to be somebody who's a good organizer. And his experience is extraordinary."[29]
The president gathered with at least a dozen of his top advisers on October 18, 2014, the day following Klain's appointment to the position of Ebola Response Coordinator for a meeting about the administration's response to the virus, but Klain did not attend the meeting.[30]
Travel screenings[edit]
NIH's Anthony Fauci acknowledged that the screening of passengers in U.S. airports was a possibility on October 6, 2014. Screening was already established in airports leaving infected countries, with passengers showing any types of symptoms being turned away, but screening was not established for U.S. airport arrivals.[31]
On October 6, 2014, President Obama announced the development of additional screening measures both pre-flight in foreign countries and post-flight in the United States. He remained confident that the protocols in place would stop an outbreak from happening in the U.S., explaining, "All of these things make me confident that here in the United States, at least, the chances of an outbreak, of an epidemic here are extraordinarily low."[32] The NIH announced the following day that the additional screening may include taking the temperature of passengers twice before boarding for anyone leaving a West African country to come to the United States.[33] A questionnaire would also be provided to the travelers, with answers to a number of questions being flagged as potentially having contact with Ebola.[34]
Minnesota Governor Mark Dayton (D) and Sens. Amy Klobuchar (D-MN) and Al Franken (D-MN) called on the administration on October 13, 2014, to expand the list of airports that provided additional screening of those coming from West Africa to include Minneapolis-St. Paul International, the 16th largest airport in the U.S. The three wrote a letter to President Obama stating, "The Ebola experience in Dallas, Texas has taught us that even one case of Ebola in our state or country can have devastating consequences. Our request is that the CDC conduct heightened screenings of all passengers with Liberia, Sierra Leone, and Guinea in their travel history when they arrive at MSP [Minneapolis-St. Paul]. We hope to work with you to do everything we can to prevent the disease from spreading to Minnesota."[35]
- October 3, 2014
- Assistant to the president on Homeland Security and Counterterrorism Lisa Monaco explained, "It’s very important to remind the American people that U.S. has the most capable healthcare system and the most capable doctors in the world, bar none." She continued, arguing that the administration's screening system was highly effective, claiming, "Dozens and dozens of people have been stopped from getting onto planes. We have now seen tens of thousands of people [arrive in the U.S.] since March to the current day, and we now have this one isolated case."[36]
- October 6, 2014
- Gov. Rick Perry called for more screening questions at customs in order to keep Ebola infected people from making it into the country, suggesting, "Many of the circumstances that led to this situation can only be addressed at the federal level. Washington needs to take immediate steps to minimize the dangers of Ebola and other infectious diseases."[8]
Sen. Mark Udall (D-CO) argued on October 18, 2014, for the restriction of travel for those on the Ebola watch list following Vinson's flight to Ohio while she could have been contagious. While he did not argue for a total travel ban from West Africa, he supported the Transportation Security Administration working with the CDC to stop those on the watch list from flying, stating, "We need to take every step to stop Ebola from spreading. This requires decisive and coordinated action to keep Coloradans safe. If you're being monitored for exposure to Ebola, it's for a reason — and it's the same reason you shouldn't be on an airline flight."[37]
Calls for travel ban[edit]
Some legislators called for a complete travel ban on flights out of West African countries, but CDC Director Tom Frieden claimed on October 4, 2014, a ban would only do more harm, suggesting the ban would not allow critical aid workers to reach the countries and assist in containing the virus.[38]
A group of 27 members of Congress, including three democrats signed a letter on October 9, 2014, to President Obama requesting that he ban flights from the most devastated nations in Africa. The letter argued that the president was heeding the advice of the WHO and "passing the buck" instead of taking independent action. The lawmakers wrote, "[The WHO] has no duty to protect the lives and well-being of Americans, as you do. Furthermore, it has utterly failed to stem the epidemic through its own action. The responsibility for this decision is yours, not theirs." Following is a list of the 27 lawmakers who signed the letter.[39][40]
Alan Grayson (D-FL)
Kyrsten Sinema (D-AZ)
Dave Loebsack (D-IA)
Steve Stivers (R-OH)
Ted Yoho (R-FL)
Robert Pittenger (R-NC)
Dennis Ross (R-FL)
Kenny Marchant (R-TX)
Stephen Fincher (R-TN)
Tom Cole (R-OK)
Steve Stockman (R-TX)
Michael Grimm (R-NY)
Adrian Smith (R-NE)
Bill Posey (R-FL)
Tom Marino (R-PA)
Dave Joyce (R-OH)
Mike Kelly (R-PA)
Roger Williams (R-TX)
Steve Daines (R-MT)
Matt Salmon (R-AZ)
Andy Barr (R-KY)
Gregg Harper (R-MS)
Steven Palazzo (R-MS)
Mike Coffman (Colorado) (R-CO)
Bob Gibbs (R-OH)
Paul Gosar (R-AZ)
- October 6, 2014
- Louisiana Governor Bobby Jindal expressed his support of a ban on flights from West Africa, citing Duncan's entrance to the U.S. while infected. He argued, "We should stop accepting flights from countries that are Ebola stricken. President Obama said it was ‘unlikely’ that Ebola would reach the U.S. Well, it has, and we need to protect our people."[9]
Gov. Bobby Jindal
- David Dausey, an epidemiologist came out as the first expert in pandemics to support the ban on air travel from West African countries. He explained, "Individuals who suspect they have been exposed to Ebola and have the means to travel to the United States have every reason to get on a plane to the United States as soon as possible. There are no direct flights from the three most-affected nations, but passengers can transfer elsewhere, as Duncan did. If they stay in Africa, the probability that they will survive the illness if they have it is quite low. If they make it to the United States, they can expect to receive the best medical care the world can provide, and they will have a much higher probability of survival. So they are motivated to lie about their exposure status (wouldn’t you, in their shoes?) to airlines and public health officials and travel to the United States."[41]
Rep. Keith Ellison (D-MN)
- October 12, 2014
- NIH's Dr. Fauci defended Frieden's opinion against a travel ban, arguing, "You diminish greatly their ability to handle their own epidemic. If that happens, it very likely will spread to other African countries. To isolate them, maybe with good intentions, actually can be counterproductive and make things worse."[42]
- October 15, 2014
- Reps. Keith Ellison (D-MN), Karen Bass (D-CA), and Barbara Lee (D-CA), in a letter to Obama urging the use of U.S. troops to help contain Ebola in West Africa, also came out in opposition of the travel ban, stating, "If the U.S. enacts policies like travel bans, which are not effective and discourage volunteer participation, we increase the chance of worsening the epidemic and the chance that new cases arrive in the U.S. Instead, we should be offering incentives for volunteers and assurances that they will have access to everything they need to be as safe as possible at all times."[20]
- Sen. Ted Cruz (R-TX) spoke out in favor of a travel ban from West African countries, suggesting, "Common sense dictates that we should impose a travel ban on commercial airline flights from nations afflicted by Ebola. There’s no reason to allow ongoing commercial air traffic out of those countries." Cruz added, "The risks of epidemic are far too large for us to allow unimpeded commercial flights."[43]
Sen. Ted Cruz (R-TX)
- Rep. Michele Bachmann (R-MN) suggested that a travel ban would have been effective near the start of the outbreak, she questioned whether the ban would still be effective, stating, "I think a travel ban at the earliest beginnings of this disease would have been the best. I don't know if we're beyond that now." She proceeded to call into question President Obama's credibility in dealing with the crisis, suggesting, "When it comes to something and serious and life-threatening as Ebola, we can't get it wrong. Government needs to wake up, pay attention and handle this like adults in a serious manner."[44]
Democratic Sen. Kay Hagan (NC) joined other party members in calling for a travel ban on October 17, 2014. Hagan, locked in a tight United States Senate in North Carolina, agreeing with her opponent, Thom Tillis, who was the first Senate candidate to call for a ban. Hagan explained, "Although stopping the spread of this virus overseas will require a large, coordinated effort with the international community, a temporary travel ban is a prudent step the President can take to protect the American people, and I believe he should do so immediately." Tillis criticized her delay in calling for a ban, claiming she was waiting for Obama to choose a direction before making her own decision.[45]
The Republican Doctors Caucus came out in support of a travel ban in a letter to the administration written on October 21, 2014. The letter claimed, "Containment is the key to stopping the spread of this highly contagious and deadly disease, and we strongly urge your administration to consider implementing a temporary travel ban for individuals who are citizens of, or traveled to, affected countries in West Africa."[46] According to a list compiled by The Hill on October 21, 2014, a total of 74 members of Congress, including nine democrats, supported the ban.[47]
New CDC recommendations[edit]
October 2, 2014
The CDC released guidelines on October 2, 2014, by which the airlines were permitted to deny access to flights based on Ebola symptoms. The authority was given to the airlines by the U.S. Department of Transportation. Following are the guidelines given by the CDC.
| “ |
|
” |
| —CDC[48] | ||
An airline lobbyist executive for Airlines for America claimed airlines were "totally safe" in a statement on October 9, 2014, encouraging people not to fear getting on a plane during the Ebola outbreak. The executive argued, "We think that air travel is totally safe, and people should keep getting on airplanes, if you look at the facts of how the disease is communicated." He followed up, stating that the airlines were working with the CDC, ensuring customers that they were taking action, "Our members are working with CDC and the other agencies involved. It’s obviously a difficult problem."[49]
October 12, 2014
The CDC issued new recommendations to hospitals on October 12, 2014, for treating Ebola patients following Pham's diagnosis. Each hospital was to hire a specialist in caring for the victims and maintaining proper protocols among staff. Hospitals were also instructed to keep as small a number of staff working on Ebola cases as possible in order to limit infection risk. Finally, Frieden insisted that caution be used when determining what types of procedures were conducted on victims, as some procedures included a higher risk of infection to medical staff.[50] While Frieden acknowledged that no hospital could afford to "let its guard down," he suggested Ebola patients should be treated by four main hospitals, the National Institutes of Health in Bethesda, Maryland; Emory University Hospital in Atlanta, Georgia; the University of Nebraska Medical Center in Omaha Nebraska and St. Patrick Hospital in Missoula, Montana, the only one of the four that had not yet treated an Ebola patient.[51]
October 20, 2014
A more expansive list of recommendations and guidance was released by the CDC on October 20, 2014. The guidance was aimed at three important points in the use of personal protective equipment: rigorous and repeated training, no skin exposure when worn and the use of a trained monitor to ensure safety. The CDC pointed out that the model was based on and closely resembles the Doctors Without Borders protocols. Additionally, the CDC announced their "Five Pillars of Safety" which are:{{Quote|
- Facility leadership has responsibility to provide resources and support for implementation of effective prevention precautions. Management should maintain a culture of worker safety in which appropriate PPE is available and correctly maintained, and workers are provided with appropriate training.
- Designated onsite Ebola site manager responsible for oversight of implementing precautions for healthcare personnel and patient safety in the healthcare facility.
- Clear, standardized procedures where facilities choose one of two options and have a back-up plan in case supplies are not available.
- Trained healthcare personnel: facilities need to ensure all healthcare providers practice numerous times to make sure they understand how to appropriately use the equipment.
- Oversight of practices are critical to ensuring that implementation protocols are done accurately, and any error in putting on or taking off PPE is identified in real-time, corrected and addressed, in case potential exposure occurred.|author=CDC.gov[52]
CDC SWAT teams[edit]
The administration announced on October 15, 2014, that emergency response teams would be deployed to hospitals with suspected Ebola cases in order to enforce proper protocols waste disposal procedures. President Obama explained, "What I’ve directed the CDC to do is that as soon as somebody is diagnosed with Ebola, we want a Rapid Response Team — a SWAT team, essentially — from the CDC to be on the ground as quickly as possible, hopefully within 24 hours, so that they are taking the local hospital step by step through exactly what needs to be done and making sure that all the protocols are properly observed, that the use of protective equipment is done effectively, the disposal of that protective equipment is done properly." The announcement came after a second nurse that treated Duncan was diagnosed with the virus, but only after she traveled from Texas to Ohio while possibly exhibiting symptoms.[53]
The Pentagon announced the team of 30 medical professionals began a week of training on October 25, 2014. The team consisted of 20 critical care nurses, five infectious disease doctors and five infectious disease protocol experts.[54]
Mandated quarantines ordered[edit]
Following the diagnosis of New York City resident Craig Spencer, New York and New Jersey Governors Andrew Cuomo and Chris Christie ordered mandatory quarantines for those who directly treated Ebola patients in West Africa upon returning to their prospective states. Cuomo explained, "It’s too serious a situation to leave it to the honor system of compliance."[55] Nurse Kaci Hickox was the first humanitarian worker to return during the mandatory quarantine period on October 25, 2014. She expressed her concern over the mandate, worrying for other healthcare workers returning, "I am scared that, like me, they will arrive and see a frenzy of disorganization, fear and, most frightening, quarantine. ... The U.S. must treat returning health care workers with dignity and humanity."[56] Illinois also set in place a mandatory 21-day quarantine, but, along with New York, backed off due to pressure from the administration to allow the quarantines to take place at travelers' homes.[57]
Hickox hired a law firm to represent her civil rights and after four days in quarantine, she was allowed to leave. Christie denied he had changed his stance on the mandatory 21-day quarantine, claiming, "I didn’t reverse any decision. She hadn’t had any symptoms for 24 hours. And she tested negative for Ebola. So there was no reason to keep her. The reason she was put into the hospital in the first place was because she was running a high fever and was symptomatic."[58] When asked about criticisms of his plan on October 28, 2014, Christie responded, "This is common sense, and the members of the American public think it is common sense. We are not moving an inch."[59]
- October 26, 2014
- NIH's Fuaci called the quarantine mandate "draconian," claiming it would lead to unintended consequences. He stated, "The best way to protect us is to stop the epidemic in Africa, and we need those healthcare workers. So we do not want to put them in a position where it makes it very, very uncomfortable for them to even volunteer to go."[60]
- October 27, 2014
- Frieden argued that mandatory quarantines should not be used for those returning from treating patients in West Africa. He explained, "At CDC, we base our decisions on science and experience. We base our decisions on what we know and what we learn. And as the science and experience changes, we adopt and adapt our guidelines and recommendations."[61]
Maryland, Georgia and Virginia also imposed new plans on October 27, 2014, to deal with people coming from West Africa, but their plans relied on asking travelers to voluntarily quarantine themselves in their homes for 21 days.[62] Similarly, the CDC also announced a self-quarantine plan for those at "high risk," returning from treating Ebola patients. Those high risk patients would be asked to check twice daily for any symptoms, including once per day in person with medical professionals.
Calls for Frieden's resignation[edit]
Reps. Pete Sessions (R-TX) and Tom Marino (R-PA) were the first members of Congress to call for the resignation of CDC Director Tom Frieden.[63]
- October 15, 2014
- Rep. Marino (R-PA) explained his call for Frieden's resignation, suggesting, "This Ebola situation is beginning to spiral beyond control. The reports my colleagues and I have received are utterly unacceptable and the information provided to the public has been cryptic and in some cases misleading. This has provided a false sense of security to many of our citizens. That is exactly the opposite of the CDC Director's primary responsibilities—to communicate clearly and honestly. I have no ill will towards him personally but he should resign his position effective immediately."[64]
Prevention cost estimates[edit]
The WHO estimated on September 16, 2014, that the total cost of containing and eliminating the Ebola outbreak in West Africa could total $1 billion, while still only limiting casualty numbers to the tens of thousands. Additionally, that total excluded money spent on researching vaccinations and treatment methods. WHO's assistant director claimed, "Quite frankly, ladies and gentlemen, this health crisis we're facing is unparalleled in modern times. We don't know where the numbers are going on this," after the number of infected people doubled between August and September 2014.[65] Weeks prior to the announcement, on September 3, 2014, the WHO estimated the cost of prevention was $600 million, prompting the WHO director general, Margaret Chan, to say, "It has become a global threat that requires urgent action. ... This is an international issue, a global threat, and it requires a coordinated effort."[66]
U.N. funding behind schedule[edit]
The U.N. Office for the Coordination of Humanitarian Affairs expressed concern on October 3, 2014, over the trickling in of promised funding. According to the office, $988 million of the $1 billion requested was pledged to help contain the virus in West Africa, however, only $256 million had been given to the affected countries. Health officials urged the international community to take action during the unprecedented situation.[67]
Prevention funding[edit]
Private funding[edit]
Paul Allen[edit]
Microsoft co-founder Paul Allen announced a $100 million pledge on October 23, 2014, to help treat and contain the virus. Allen put part of the funding to the website Tackle Ebola in an effort to coordinate the global response to the virus. He was also working to develop two medevac containment units that would be used to evacuate infected doctors and nurses from West Africa in a safe manner.[68] According to The Telegraph, Allen's donation was more than any other country aside from America had donated to that point.[69]
Mark Zuckerberg[edit]
Facebook co-founder Mark Zuckerberg announced a $25 million donation on October 14, 2014, to the CDC's Ebola fund. He argued that the spread of Ebola was at "a critical turning point." He wrote on a Facebook post, "We need to get Ebola under control in the near term so that it doesn't spread further and become a long term global health crisis that we end up fighting for decades at large scale, like HIV or polio."[70]
Gates Foundation[edit]
The Bill and Melinda Gates Foundation donated $50 million on September 10, 2014, to organizations focused on containing and eliminating the Ebola virus. The donations went to the U.S. Centers for Disease Control and Prevention, World Health Organization, United Nations and other international health organizations working on the Ebola outbreak. The foundation's president of global development, Chris Elias, explained the decision to up their donation from an original mark of $10 million, stating, "It became clear to us over the last 7 to 10 days that the pace and scope of the epidemic was increasing significantly." Donations were intended to go toward emergency supplies, diagnostic tools and vaccine development.[71]
Obama's funding request[edit]
The Obama administration requested funding of $500 million in the 2014-2015 fiscal year for the containment and eradication of the Ebola virus. The $500 million, in addition to another $500 million requested for the fight against ISIS in Iraq and Syria, would be drawn from the Overseas Contingency Operation to be used at the discretion of the U.S. Department of Defense. Since they would be coming from the Overseas Contingency Operation, the Defense Department was not obligated to use the full $500 million requested on the ebola outbreak and maintained the ability to shift funding over to operations in Iraq and Syria. The request also did not require congressional approval since it was already budgeted, rather the military-related congressional committees had the ability to debate and stop the budget transfer.[72]
- September 16, 2014
- Speaker of the House John Boehner (R-OH) spoke about the virus' spread prior to President Obama's address, saying, "I think this Ebola outbreak in Africa is a serious problem and I'm a bit surprised the administration hasn't acted more quickly to address what is a serious threat, not only to Africans but to others around the world."[73]
- President Barack Obama said during his address to the nation, "If the outbreak is not stopped now, we could be looking at hundreds of thousands of people infected with profound political and economic and security implications for all of us. So, this is an epidemic that is not just a threat to regional security, it’s a potential threat to global security."[74]
The administration's funding request was separate from previous funding requests, including $175 million that was previously dedicated to the outbreak and an additional $88 million requested as part of the continuing resolution aimed at delaying the national budget deadline to December 11, 2014.[72]
On October 10, 2014, Sen. James Inhofe (R-OK) lifted the hold he placed on $750 million in emergency funds to help contain Ebola. As the ranking member of the Senate Armed Services Committee, Inhofe placed the hold to pressure the Obama administration to reveal their plans to fight the spread of the virus. He explained his decision to lift the hold, stating, "After careful consideration, I believe that the outbreak has reached a point that the only organization in the world able to provide the capabilities and speed necessary to respond to this crisis is the U.S. military."[75]
As of October 19, 2014, only $311 million relating to the Ebola response had been disbursed. That number did not include the $750 million allocated by the Pentagon because that would take longer to "get out the door," according to a spokesperson for the U.S. Office of Management and Budget.[76]
Treatment options[edit]
The Food and Drug Administration (FDA) announced the release of an experimental anti-virus drug, brincidofovir, on October 6, 2014, which was developed by Chimerix, a pharmaceutical company based out of North Carolina. Another drug, TKM-Ebola, was also permitted on an emergency basis by the FDA. TKM-Ebola was used on Dr. Kent Brantly during his successful recovery from the virus. The FDA set agency records in the approval of the two experimental drugs, under pressure from Congress and the public, reviewing the records over a period of days as opposed to the years approval often takes. Brincidofovir was still not expected to be approved for widespread use until 2016. It was determined, however, that the experimental drugs would not be used to treat patients in Africa until more was known about the effects.[77] While Frieden acknowledged the drugs would take time to produce in mass quantities on October 5, 2014, he also suggested the high level of medical care in the U.S. was a major key to keeping Ebola from breaking out within the country, saying that even maintaining fluids in the body could save many lives.[78]
- September 17, 2014
Rep. Michael Burgess (R-TX) - Rep. Michael Burgess (R-TX) announced his displeasure that the drug TKM-Ebola was not being permitted on a clinical trial basis due to FDA testing. He argued during a House subcommittee meeting on Africa, "I’m still bewildered as to why TKM-Ebola has this hold. Instead of clinical holds, let’s talk about clinical trials. Let’s talk about making things available."[79]
- Rep. Betty McCollum (D-MN) argued that the FDA testing should not be sped up, insisting that allowing an untested vaccine to be used in Africa could be very damaging if it did not work properly. She stated, "I know there’s a lot of pressure, but I, for one, think we need to follow the science."[79]
Vaccination attempts[edit]
The National Institutes of Health and British pharmaceutical company GlaxoSmithKline developed a vaccine attempt and announced on September 16, 2014, that 10 of 20 volunteers were given the vaccine with "no red flags," though it is still in the early phases of testing.[80]
The Canadian government sent 800 vials of an Ebola vaccine to West Africa on October 20, 2014. It was to be distributed by the WHO throughout the region.[81] A second vaccine developed by the Canadian public health agency began its initial testing phase through the NIH and Walter Reed Army Institute of Research. The drug, called VSV-ZEBOV, needed extensive human testing to be sure it could be distributed in Africa.Cite error: Closing </ref> missing for <ref> tag
- October 3, 2014
- NIH infectious diseases head Dr. Anthony Fauci shared similar thoughts to Collins during Senate testimony in October, suggesting, "[Budget cuts have] both in an acute and a chronic, insidious way eroded our ability to respond in the way that I and my colleagues would like to see us be able to respond to these emerging threats. And in my institute particularly, [proper funds are] responsible for responding on the dime to an emerging infectious disease threat, [so these cuts are] is particularly damaging."[82]
Sen. Elizabeth Warren (D-MA)
- October 9, 2014
- Sen. Elizabeth Warren (D-MA) placed blame for the lack of vaccine progress on spending cuts pushed by Republicans, suggesting, "We knew about this many years ago and started funding research on it. And then, with all the spending cutbacks and all the pressure on the National Institute of Health, much of that research has been shelved." She argued further, "So now, we’re out spending millions, billions of dollars in emergency response. People have lost their lives, we’re all very worried, instead of spending the money in advance to do more of the research to avoid this kind of problem."[14]
- October 15, 2014
| "Republican cuts kill" produced by Agenda Project |
- Sen. Paul criticized statements made by NIH officials about the agency's funding, suggesting, among other things, that spending $2.4 million on "Origami condoms," a radical attempt to redesign condoms to prevent AIDs, the agency often spent money on frivolous research. He explained, "We have people who go blithely on TV and say we don't have enough money to study Ebola. Have you seen what the NIH spends money on? Nine-hundred thirty-nine thousand dollars spent to discover whether or not male fruit flies would like to consort with younger female fruit flies," the senator said to laughter. "One hundred seventeen thousand dollars spent to determine if most monkeys are right handed and like to throw poop with their right hands."[83]
The Democratic group Agenda Project produced a graphic ad targeting Republican budget cuts affecting the CDC, NIH and other agencies trying to combat the spread of Ebola.[84] The ads were expected to air in Kansas, Kentucky, Colorado, Arkansas, Louisiana, West Virginia, Montana and possibly states with other close races.[82]
International efforts[edit]
Britain
- The British government provided a total of $40 million as of September 11, 2014, toward the containment of the virus. Additionally, they agreed to send military personnel and establish a 62-bed hospital in the infected area.[85]
Canada
- The Canadian government announced the deployment of two mobile labs to be used in conjunction with Doctors Without Borders in Sierra Leone on October 4, 2014.[86]
China
- In mid September 2014, the Chinese government expanded its medical team in West Africa to 174 and provided an additional $32 million in relief aid, on top of the $4.8 million already sent.[87][88]
Cuba
- The Cuban government agreed on September 13, 2014, to send 165 doctors and other medical personnel to West Africa.[89]
European Union
- The European Union (EU) provided nearly $200 million since the outbreak, as of September 17, 2014. Mobile labs were also deployed to West African in an attempt to help diagnose patients and train medical personnel.[90]
France
- France agreed to send 20 experts in biological outbreaks on September 4, 2014, to help stop the spread.[91]
India
- India provided $500 thousand to the WHO to assist in their fundraising goal on September 13, 2014, in addition to preparing for an outbreak on Indian soil should one of their nearly 45,000 citizens in West Africa return infected. India also hosts many students from West African countries.[92]
- October 15, 2014
- The Obama administration urged more support from the international community in containing the outbreak with a White House spokesperson stating, "The leaders agreed to work together to enlist greater support from more countries and to coordinate their efforts on the ground. President Obama made clear that the world must marshal the finances as well as the international personnel required to bend the curve of the epidemic, noting that it constitutes a human tragedy as well as a threat to international security." President Obama reinforced the statement claiming that some governments needed to increase their efforts, claiming, "As I've said before, and I'm going to keep on repeating until we start seeing more progress, the world as a whole is not doing enough. There are a number of countries that have capacity that have not yet stepped up."[93]
2014 outbreak[edit]
In March 2014, medical experts announced an outbreak of the virus in Guinea, which killed 78 people between January and April 2014.[94] In the following months, the virus spread to Sierra Leone and Liberia in what the WHO described could result in more than 20,000 deaths.[95][96] By June 2014, the outbreak had become the deadliest Ebola outbreak on record. By the end of July 2014, the virus had spread to Nigeria, Africa's most populous country. At the end of August 2014, the virus spread to Senegal. Both Senegal's and Nigeria's outbreaks were reportedly from people evading medical facilities.[97] Numerous African countries have shut down borders and halted international travel as a precaution against the virus.[98] According to a WHO report on October 10, 2014, the total death toll of the outbreak reached 4,024.[99] The following chart tracks the death toll by the first WHO reports each month.[100]
Americans infected[edit]
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As of October 2, 2014, four American citizens had been infected by the Ebola virus, all while visiting Africa. Patrick Sawyer, a naturalized U.S. citizen working for the Liberian government's ministry of finance, contracted the virus in July 2014, in Liberia before dying in Nigeria on July 25, 2014, his only stop before he planned to return to his family in America.[101] Nancy Writebol and Dr. Kent Brantly, who were serving patients as part of a religious organization, were flown back to the U.S. in August 2014 under quarantine and treated for the virus, both surviving Ebola.[102] Dr. Brantly then testified before Congress regarding the disease, conditions in Africa and the need for action. He also stated his desire to return to help those still infected, "Lord willing."[103]
The fourth case was diagnosed in Liberia on October 2, 2014, in an NBC freelance photographer whose whole team was sent back to the United States for treatment and observation. NBC News President Deborah Turness said the crew, including the organization's chief medical editor, would be quarantined upon their return for 21 days, a conservative time frame for the virus.[104] The photographer, identified as Ashoka Mukpo was admitted to the same Nebraska hospital that treated another Ebola patient in August.[105]
First case diagnosed in the U.S.[edit]
- September 30, 2014
The first case in the United States was diagnosed in Thomas Allen Duncan, who flew in from Liberia on September 20, 2014. He did not show symptoms of the virus for four to five days, after which he was placed in quarantine in Dallas, Texas. Director of the Centers for Disease Control and Prevention, Tom Frieden said Duncan was not showing symptoms until four or five days after he entered the country. While he did have contact with multiple people in the U.S. prior to his isolation, Frieden stated, "I have no doubt that we'll stop this in its tracks in the U.S. But I also have no doubt that as long as the outbreak continues in Africa, we need to be on our guard."[106] Family members said he visited the hospital before his diagnosis, but he was sent home with only medication, even after acknowledging he had visited Liberia.[107]
On October 1, 2014, state and local health officials in Dallas issued an order for the family members he visited and others he came in contact with to remain in isolation for monitoring for 21 days. Between 12 and 18 people were given the orders, along with the need for them to submit to blood testing.[108] The following day, the total number of people in isolation raised to nearly 100, covering those who came in brief contact with Duncan or the house his family lived in. At the time of their isolation none showed symptoms of Ebola.[109]
Duncan's four family members were placed under armed isolation on the evening of October 2, 2014, after it was discovered they had broken the agreement to remain in their apartment. The family was to be relocated prior to a hazardous material crew arriving to decontaminate the area, according to the Associated Press. When asked why an armed guard was ordered, Texas State Health Commissioner David Lakey stated, "We didn't have the confidence we would have been able to monitor them the way that we needed to."[110] Duncan's condition dropped to critical on October 4, 2014.[111]
Duncan died from the virus on October 8, 2014.[112]
- October 1, 2014
- Texas Governor Rick Perry (R) issued a statement "There are few places in the world better equipped to meet the challenge that is posed in this case. Texas is one of only 13 states certified by the CDC to conduct diagnostic Ebola testing, and we have the health care professionals and the institutions that are second to none. The public should have every confidence that the highly trained professionals involved here will succeed in this very important mission."[113]
- October 2, 2014
- Sen. Rand Paul (R-KY) warned the administration to not take the threat of Ebola lightly, arguing, "I think because of political correctness we’re not really making sound, rational, scientific decisions on this. It’s a big mistake to underestimate the potential for problems worldwide." Along the same lines, he questioned the decision to send 3,000 soldiers to West Africa in attempting to contain the virus, stating, "You also have to be concerned about 3,000 soldiers getting back on a ship. Can you imagine if a whole ship full of our soldiers catch Ebola?"[10]
- Former Texas Rep. Ron Paul (R) gave a different warning than his son, Rand Paul, urging "common sense" while dealing with the virus in the U.S. He stated during an interview, "I know there's a lot of reason to be concerned. It is a serious problem, but in my lifetime, when we have been frightened by this so-called coming epidemic — most of it has never materialized."[114]
Sen. Rand Paul (R-KY)
- October 5, 2014
- NIH's director of infectious diseases, Anthony Fauci, disputed Rand Paul's claim that the virus was more easily transmitted than was initially let on. Fauci argued, "I don't think that there's data to tell us that that's a correct statement, with all due respect. We have had experience since 1976 with how Ebola is transmitted. And it is clear that it's transmitted by direct contact with body fluids, blood, diarrhea, vomit, or what have you. And there's no indication that there is another insidious way that it's transmitted that we're missing because of the experience that we've had. So, we've really gotta go with the evidence base. There's always hypothesis and surmising about that, but there's no scientific evidence."[115]
Duncan's initial release from hospital[edit]
The director of National Institutes of Health branch covering infectious diseases, Anthony Fauci, claimed Duncan's release from the hospital after disclosing his travel to Liberia was inexcusable. He stated on October 2, 2014, "It's just an unfortunate misstep. Things like that happen. Unfortunately, to happen under as dramatic circumstances as this is the obvious reason why people are paying such attention to this. It should not have happened. It's not excusable. But ... it's understandable in a busy emergency room how something like that can happen." However, Fauci did point out that due to the public nature of the scare, similar missteps would be much less likely in the future.[116]
After Duncan's death, part of the large Liberian community in Dallas began to question the level of care he received at hospital. Every American who was brought back to the U.S. was treated and survived to that point. The Liberian community in Dallas feared that due to Duncan's skin color and lack of health insurance, he did not receive the same care that Americans with the virus did, however, community leaders urged everyone to wait until the fate of Duncan's family was determined before getting trying to take action. CDC's Frieden also made the statement that the earlier the virus is diagnosed, the better the chance of survival. Duncan's condition was poor enough when he went to the hospital for the second time that an ambulance had to take him in.[117]
Cases contracted in the U.S.[edit]
- October 12, 2014
A Dallas nurse, Nina Pham, who treated Duncan in Texas was the first American to contract the virus on U.S. soil when she showed symptoms October 10, 2014, and was officially diagnosed two days later.[118] Officials were not sure how she might have been exposed, but Frieden did acknowledge that the most at-risk activity was removing the protective suit after having contact with an Ebola patient, saying, "It’s not easy to do right." It was believed that Pham only had contact with one person before entering isolated care, but health officials were investigating protocols to determine if other hospital workers were at risk. She and other hospital workers who treated Duncan were part of the self-monitoring group, who were to take their temperatures twice daily to minimize the amount of time they would be contagious in public if showing symptoms.[50]
National Nurses United, the largest nursing union in the U.S., came out against what it perceived as Frieden claiming that Pham broke protocol on October 12, 2014, leading her to be infected. The union claimed that 80 percent of nurses did not receive full training, 36 percent of nurses polled claimed their hospital did not have the necessary supplies to handle an Ebola case and 76 percent say their hospitals' administrations had not issued suitable plans for Ebola cases. A spokesperson for the union argued, "That is woefully insufficient. We have to continue to sound the alarm. There is the potential for many more Dallases if hospitals are not mandated and do not commit to more vigorous standards. We see potential gaping holes for this to spread."[119]
- October 12, 2014
- NIH's Anthony Fauci said the inadvertent breaching of protocols when dealing with Ebola patients was likely what led to the nurse's infection, stating, "People are human, they have inadvertent breaches, and that’s likely what happened here. Someone is…fatigued, they’ve been working for a long time and when they take [the protection suit] off, they do something inadvertent."[42]
- October 13, 2014
- CDC Director Frieden responded to accusations from the National Nurses United union that he was using Pham as a "scapegoat" by suggesting she broke protocol. He stated, "Some interpreted that as finding fault with the hospital or the healthcare worker. I'm sorry if that was the impression given. That was certainly not my intention." He also noted that the administration would be looking to re-examine the government response to Ebola to look for better ways of handling and containing the situation. Frieden commented, "We have to rethink the way we address Ebola infection control because even a single infection is unacceptable."[120]
Second Dallas patient[edit]
A second Dallas healthcare worker, Amber Vinson, was diagnosed with Ebola on October 15, 2014. Authorities immediately began decontamination procedures at her residence. Vinson lived alone with no pets. Potential contacts were investigated by the Texas state health department. She, like Pham, worked for Dallas' Texas Health Presbyterian hospital where Duncan was first treated for the virus. The CDC released a statement claiming, "An additional healthcare worker testing positive for Ebola is a serious concern, and the CDC has already taken active steps to minimise the risk to healthcare workers and the patient."[121] Vinson was transferred to Emory University Hospital on October 15, 2014.[122]
- October 15, 2014
- Frieden announced there would likely be more cases following the diagnosis of Vinson. He said, "We are planning for the possibility of further cases in the coming days. The investigation is identifying additional healthcare workers who will be very closely [monitored]."[122]
It was determined on October 28, 2014, that Vinson no longer had the Ebola virus.[123]
Vinson's Ohio flight[edit]
It was revealed on October 15, 2014, that days before she was diagnosed with Ebola, Vinson traveled via Frontier Airlines to Akron, Ohio. The CDC announced that all 132 passengers on the flight were being reached out to in order to make them aware of the situation.[124] While CDC Director Frieden insisted she "should not have been allowed to travel" in the first place, he insisted, "We will, from this moment forward, ensure that no other individual who’s being monitored for exposure undergoes travel in any way other than in 'controlled movement." White House Press Secretary Earnest was unaware of the proper protocols that should have taken effect to stop her from traveling, stating, "It’s not clear exactly what protocols were in place and how those protocols were implemented."[63]
Another report from October 15 claimed the CDC approved of Vinson's flight even though she registered a temperature of 99.5 degrees, below the CDC threshold of 100.3 degrees. The agency released a statement that at-risk people would no longer be permitted to use public transportation, instead opting for "controlled movement." Frieden's statement read, "The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement."[125] The CEO of Frontier Airlines also announced the CDC contacted him about the possibility that Vinson was showing symptoms and therefore, contagious on the plane. The plane made an additional five flights after Vinson's before being shut down for cleaning.[126]
Texas hospital treatment conditions[edit]
Nurses at the Texas Health Presbyterian hospital claimed on October 15, 2014, that hospital protocols were constantly changing and their equipment did not match the standards for Ebola care. Following is a list of complaints made by nurses at the facility.
- Medical samples were transferred through the hospital's pneumatic transport system, which could have resulted in the contamination of other samples using the system.
- Hazardous waste was allowed to be piled up to unsafe levels inside the hospital before being disposed of.
- Duncan was located in a non-isolated area of the emergency department for hours, potentially exposing more patients.
- Nurses were given patients in addition to Duncan, leading to the possibility of more contamination.
- Potentially exposed patients were moved from isolation after one day, back in with other patients.
- An optional staff meeting was the only preparation provided by the hospital in regard to Ebola.
- Strict protocols were not enforced across all staff because protocols were constantly changing.
A spokesperson for the hospital responded to the accusations, stating, "Patient and employee safety is our greatest priority and we take compliance very seriously. We have numerous measures in place to provide a safe working environment, including mandatory annual training and a 24/7 hotline and other mechanisms that allow for anonymous reporting."[127]
- October 15, 2014
- White House Press Secretary Josh Earnest admitted there were "shortcomings" in the administration's actions dealing with the virus, indicating that President Obama canceled a campaign trip to New Jersey and Connecticut in order to convene a cabinet meeting on the Ebola situation following the release of information that the second nurse diagnosed in Texas had flown to Ohio and back in the days before her diagnosis.[128][124]
New York City Ebola doctor[edit]
On October 23, 2014, New York resident and doctor with the humanitarian group Doctors Without Borders, Craig Spencer, began showing symptoms of the virus he treated in West Africa 10 days after he returned from the region. Spencer shared an apartment with his girlfriend, who was placed under isolation while they determined if she contracted the disease from Spencer. He was transported to the hospital by a HAZ TAC specialist team with full protective gear.[129]
Causes for rapid spread in Africa[edit]
Data produced by Save the Children showed that, due in part to the country's very poor health system, the virus was spreading to five new people every hour during research conducted in the last week of September 2014. The report found that while 765 were found to be infected during that week, the country only had 327 hospital beds available. Anthony Banbury, charged with leading the U.N. Mission for Ebola Emergency Response, said Sierra Leone was not alone in the rapid inflation of infected people, stating, "It is fairly similar in Liberia. The disease is spreading very rapidly – cases doubling every 20 days."[130] In response to the increase in cases, the airline Gambia Bird re-opened flights from London to Sierra Leone in order to help transport aid workers and medical supplies.[131]
Firestone rubber farm[edit]
The Firestone rubber farm, located in Harbel, Liberia, is a private community of about 80,000 people complete with schools, encountered its first case of Ebola in March 2014, when a woman returned to the plantation after caring for a sick family member. The Firestone managers understood the dangers of the virus spreading throughout the community and immediately began creating makeshift facilities out of whatever material they had available and reassigned jobs, such as teachers, to begin educating the community about Ebola. Upon discovering that local hospitals were full, an isolated treatment center was formed out of shipping containers, and the managers informed the custodial staff on how to properly handle the waste and deceased victims of the virus.[132] Isolation procedures were established with the woman's family, and while she died from the disease, the plantation did not have another case for months.[133]
When Ebola hit the nearby capital city of Liberia and the city's treatment centers filled up in August 2014, people began going to the Firestone facilities, causing the company to focus once again on the containment of the virus. Facilities were expanded to meet the new needs for treatment and quarantine areas were nearly filled in mid-September, but by October, the virus was once again contained with only three victims being treated, all from outside the community.[133]
Cases diagnosed abroad[edit]
Spain[edit]
The known case of the virus being transmitted to a person outside of West African came when a nurse in Madrid, Spain, tested positive for the virus on October 6, 2014. More than 50 people were being monitored for symptoms following her positive test, including a fellow nurse and her husband, who was placed in isolation. The nurses were treating two patients with the disease who later died. Following the death of the second missionary, the nurse took time off, but it was reported that she did not leave Madrid.[134]
Hospital workers claimed the gear they were using while treating the infected men was not up to WHO standards.[135] It was also discovered that the disposal of the waste from the victims was taken out of the building using an elevator accessible to any staff, but hospital officials denied that WHO protocols were not followed.[136]
- October 7, 2014
- WHO European Director Zsuzsanna Jakab insisted, "The most important thing in our view is that Europe is still at low risk and that the western part of the European region particularly is the best prepared in the world to respond to viral hemorrhagic fevers including Ebola." Jakab did acknowledge however, that there would continue to be imported cases throughout Europe until the outbreak is completely stopped.[137]
No official numbers were released, but some staff at the hospital refused to return to work and others would not treat certain patients out of fear that the hospital's Ebola protocols were not up to WHO standards. In addition to fears of contracting the disease, staffers claim they have been stigmatized by friends and neighbors due to their proximity to Ebola patients at the hospital. A nurses' union member explained, "They’ve become known as the Ebola nurses. And it’s not fair."[138]
After treatment and further testing, the Spanish nurse, Teresa Romero Ramos, tested negative for the virus in her system on October 21, 2014.[139]
Possible outbreak ramifications[edit]
Probe into Pentagon response[edit]
Sen. John McCain (R-AZ) called for a probe into the U.S. Department of Defense's involvement in Ebola in Africa. McCain argued that since President Obama did not ask congressional permission for the disbursal of troops to the affected regions. He claimed, "I want to have hearings as soon as we get back as to whether our military personnel should go there."[140]
Ebola lobbying efforts[edit]
Lobbying efforts increased as the administration took more actions against the spread of the virus in the U.S. and abroad. Some lobbyists have called for the training of more medical professionals to be sent to Africa, pharmaceutical companies began ramping up development and research into vaccines and treatments, increasing awareness of their products to politicians and others pushed for increased public funding. One pharmaceutical CEO explained, "We have been communicating to all of the government agencies, the World Health Organization. ... We’ve had people at the table at every substantive discussion around how to manage this Ebola outbreak and have educated everybody who’s interested in learning about our technology and the drug we have available."[141]
Weaponized Ebola virus[edit]
Anthony Fauci, National Institute of Allergy and Infectious Diseases director, claimed that while a difficult and expensive task, weaponizing the virus was a possibility as similar viruses were built by the Soviet Union during the Cold War. He explained, "Theoretically, you can manipulate almost any virus to change it in any way you want," said Fauci, whose agency is part of the National Institutes of Health. The only trouble is, it wouldn't be easy for somebody to do that in their backyard laboratory. They would probably kill themselves doing it. It would take a state-type [actor]." He also warned that even though the United States was well-equipped to handle a virus outbreak, if the virus mutated to become airborne, it would be more dangerous.[142]
Spread to U.S.[edit]
In a joint hearing on September 16, 2014, with the Senate Health, Education, Labor and Pensions Committee and Appropriations subcommittee on health spending four U.S health officials testified that an outbreak in the United States was highly unlikely, even if an infected person were to enter the country without authorities realizing. The officials cited the successful handling of Ebola patients coming from the impacted area of West Africa as well as the treatments of other similar hemorrhagic fevers. A CDC representative also stated that hospital protocols have been established to safely contain and treat any patients suspected of having the Ebola virus.[143]
- September 17, 2014
- Sen. Dick Durbin (D-IL) voiced his concern that Americans could be at risk, stating, "I am worried because many people, who — I’m told — have the symptoms are afraid to say anything. Their local governments will quarantine them and not treat them, so they’ll just die. Some of them, in desperation, get on airplanes to get out of the country to save their lives."[74]
Further spread of Ebola in Africa[edit]
An Oxford University study released September 8, 2014, showed the likelihood of Ebola spreading to different countries throughout Africa by using migratory patterns of fruit bats, which carry the disease and can spread it to other animals that African people were likely to hunt and prepare for meals. Using the current and past outbreaks, the study noted that up to 15 countries would be at risk of the virus continuing to spread from animal-to-human interaction. The countries listed were Nigeria, Cameroon, Central African Republic, Ghana, Liberia, Sierra Leone, Angola, Togo, United Republic of Tanzania, Ethiopia, Mozambique, Burundi, Equatorial Guinea, Madagascar and Malawi.[144]
Economic impact[edit]
Africa[edit]
The World Bank estimated the Ebola outbreak could cost the economies of Africa billions over the next year if the virus is not contained. The September 17, 2014 estimates showed Liberia would likely be the hardest hit with an 11.7 percent decline in economic growth. Sierra Leone's decline was estimated to be 8.9 percent, while Guinea's could decline by 2.3 percent. The outbreak also triggered a rise in inflation in the areas.[145] The International Monetary Fund warned on September 11, 2014, that the mining, agriculture and service sectors of the economies in Sierra Leone and Liberia, the two countries' largest economic sectors, were being hit the hardest by the Ebola outbreak, and though there is little risk that the countries themselves would crumble, some believe regimes may fall due to the devastation, particularly in Liberia.[146][147]
An estimate by the World Bank Group claimed the total economic impact of Ebola on the economies of West Africa could total as much as $32.5 billion by the end of 2015 if the virus were to spread beyond the borders of countries already affected.[148]
Cocoa industry[edit]
The World Cocoa Foundation (WCF) began fundraising activities in October 2014 from large candy producers that use cocoa from the Ivory Coast and Ghana, producers of more than 40 percent of the world's cocoa combined. While Ebola had not yet reached the countries, the strain it put on neighboring countries limited the cocoa plantations' abilities to hire laborers, raising prices in the international cocoa market. The WCF began fundraising efforts in order to help curb the spread of the virus in order to help stabilize the region and the cocoa producing economies. Prices of cocoa rose from the average trading price of $2,000 per ton to over $3,000 per ton over concerns for the safety of the region.[149]
The WCF sought donations from its 115 member companies, including companies like Nestle and Mars. Mars pledged help, as did international cocoa supplier Transmar Group with a donation of $100,000. Swiss company Barry Callebaut included Ebola safety education in their efforts to educate remote farmers on high yield crops in Ivory Coast. A Nestle spokesperson discussed the importance of supporting the region, stating, "We have taken measures to educate all our staff in Central and West Africa on the virus and the best ways to prevent against it whilst encouraging them to share this information with their families and communities. We are closely monitoring the situation in conjunction with the relevant authorities and following their recommendations with regards to the movement and regrouping of people. We are supporting the needy in some affected zones due to the lack of food and potable water."[149]
U.S.[edit]
The chairman of the Council of Economic Advisers, Jason Furman, claimed the administration did not believe the Ebola virus would have a significant economic impact in the United States. Furman explained on October 3, 2014, "It certainly comes up, it's something that my colleagues are extremely focused on and have been from the president on down. In terms of the U.S. economy, I don't see it having a meaningful impact. I think it's a real public health issue for the world, for the United States, but not an economic problem that we face."[150]
Spread to U.S.[edit]
In a joint hearing on September 16, 2014, with the Senate Health, Education, Labor and Pensions Committee and Appropriations subcommittee on health spending four U.S health officials testified that an outbreak in the United States was highly unlikely, even if an infected person were to enter the country without authorities realizing. The officials cited the successful handling of Ebola patients coming from the impacted area of West Africa as well as the treatments of other similar hemorrhagic fevers. A CDC representative also stated that hospital protocols have been established to safely contain and treat any patients suspected of having the Ebola virus.[151]
- September 17, 2014
- Sen. Dick Durbin (D-IL) voiced his concern that Americans could be at risk, stating, "I am worried because many people, who — I’m told — have the symptoms are afraid to say anything. Their local governments will quarantine them and not treat them, so they’ll just die. Some of them, in desperation, get on airplanes to get out of the country to save their lives."[74]
Further spread of Ebola in Africa[edit]
An Oxford University study released September 8, 2014, showed the likelihood of Ebola spreading to different countries throughout Africa by using migratory patterns of fruit bats, which carry the disease and can spread it to other animals that African people were likely to hunt and prepare for meals. Using the current and past outbreaks, the study noted that up to 15 countries would be at risk of the virus continuing to spread from animal-to-human interaction. The countries listed were Nigeria, Cameroon, Central African Republic, Ghana, Liberia, Sierra Leone, Angola, Togo, United Republic of Tanzania, Ethiopia, Mozambique, Burundi, Equatorial Guinea, Madagascar and Malawi.[152]
Economic impact[edit]
Africa[edit]
The World Bank estimated the Ebola outbreak could cost the economies of Africa billions over the next year if the virus is not contained. The September 17, 2014 estimates showed Liberia would likely be the hardest hit with an 11.7 percent decline in economic growth. Sierra Leone's decline was estimated to be 8.9 percent, while Guinea's could decline by 2.3 percent. The outbreak also triggered a rise in inflation in the areas.[153] The International Monetary Fund warned on September 11, 2014, that the mining, agriculture and service sectors of the economies in Sierra Leone and Liberia, the two countries' largest economic sectors, were being hit the hardest by the Ebola outbreak, and though there is little risk that the countries themselves would crumble, some believe regimes may fall due to the devastation, particularly in Liberia.[154][155]
An estimate by the World Bank Group claimed the total economic impact of Ebola on the economies of West Africa could total as much as $32.5 billion by the end of 2015 if the virus were to spread beyond the borders of countries already affected.[148]
Cocoa industry[edit]
The World Cocoa Foundation (WCF) began fundraising activities in October 2014 from large candy producers that use cocoa from the Ivory Coast and Ghana, producers of more than 40 percent of the world's cocoa combined. While Ebola had not yet reached the countries, the strain it put on neighboring countries limited the cocoa plantations' abilities to hire laborers, raising prices in the international cocoa market. The WCF began fundraising efforts in order to help curb the spread of the virus in order to help stabilize the region and the cocoa producing economies. Prices of cocoa rose from the average trading price of $2,000 per ton to over $3,000 per ton over concerns for the safety of the region.[149]
The WCF sought donations from its 115 member companies, including companies like Nestle and Mars. Mars pledged help, as did international cocoa supplier Transmar Group with a donation of $100,000. Swiss company Barry Callebaut included Ebola safety education in their efforts to educate remote farmers on high yield crops in Ivory Coast. A Nestle spokesperson discussed the importance of supporting the region, stating, "We have taken measures to educate all our staff in Central and West Africa on the virus and the best ways to prevent against it whilst encouraging them to share this information with their families and communities. We are closely monitoring the situation in conjunction with the relevant authorities and following their recommendations with regards to the movement and regrouping of people. We are supporting the needy in some affected zones due to the lack of food and potable water."[149]
U.S.[edit]
The chairman of the Council of Economic Advisers, Jason Furman, claimed the administration did not believe the Ebola virus would have a significant economic impact in the United States. Furman explained on October 3, 2014, "It certainly comes up, it's something that my colleagues are extremely focused on and have been from the president on down. In terms of the U.S. economy, I don't see it having a meaningful impact. I think it's a real public health issue for the world, for the United States, but not an economic problem that we face."[156]
Recent news[edit]
This section links to a Google news search for the term Ebola + Outbreak + West + Africa
See also[edit]
External links[edit]
Footnotes[edit]
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedCDChist - ↑ World Health Organization, "Ebola virus disease fact sheet," accessed September 17, 2014
- ↑ 3.0 3.1 Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
- ↑ Global Alert and Response (GAR), "Ebola virus disease update - West Africa," August 8, 2014
- ↑ The Hill, "Ebola epidemic 'spiraling out of control,' CDC director says," September 2, 2014
- ↑ The Guardian, "Ebola outbreak: CDC director activates US emergency operation center," August 7, 2014
- ↑ Politico, "Video: Rick Perry's statement on Ebola," October 1, 2014
- ↑ 8.0 8.1 The Hill, "Rick Perry: Feds must act now to stop Ebola," October 6, 2014
- ↑ 9.0 9.1 9.2 MSNBC, "Rick Perry announces Ebola task force," October 6, 2014
- ↑ 10.0 10.1 Politico, "Rand Paul stokes Ebola fears," October 2, 2014
- ↑ The Hill, "Cruz: Ebola travel ban is 'common sense'," October 15, 2014
- ↑ New York Times, "Unapologetic, Christie Frees Nurse From Ebola Quarantine," October 27, 2014
- ↑ The Hill, "Christie: 'We are not moving an inch'," October 28, 2014
- ↑ 14.0 14.1 The Hill, "Warren blames Congress for cutting Ebola research funding," October 9, 2014
- ↑ New York Times, "Cuomo Softens Tone in Outline of Ebola Plan Amid Criticism," October 28, 2014
- ↑ The Hill, "Obama at CDC warns Ebola outbreak ‘spiraling out of control’," September 16, 2014
- ↑ The Guardian, "Obama to announce Ebola force of 3,000 US military personnel," September 16, 2014
- ↑ The Hill, "US sending 1,000 more troops to fight Ebola," October 3, 2014
- ↑ The Hill, "CDC open to any suggestions on Ebola," October 5, 2014
- ↑ 20.0 20.1 The Hill, "House Dems call for US troops in Africa to give direct Ebola care," October 15, 2014
- ↑ The Hill, "Feds lowering safety standards for Ebola waste, group charges," October 3, 2014
- ↑ 22.0 22.1 Department of Transportation, "U.S. Department of Transportation Approves Special Permit for the Safe Transport of Ebola Infected Medical Waste for Disposal," October 3, 2014
- ↑ Government Printing Office, "Category A infectious substances," accessed October 7, 2014
- ↑ Washington Examiner, "GOP congressman: Obama needs an Ebola 'czar'," October 4, 2014
- ↑ Huffington Post, "John McCain, Czar Hater, Calls For Ebola Czar," October 12, 2014
- ↑ CNN, "First on CNN: Obama will name Ron Klain as Ebola czar," October 19, 2014
- ↑ 27.0 27.1 The Hill, "GOP blasts Ebola czar pick," October 17, 2014
- ↑ The Hill, "McCain: Ebola czar does not 'fit the bill'," October 17, 2014
- ↑ CBS News, "The uphill battle for Obama's new "Ebola czar"," October 20, 2014
- ↑ The Hill, "Ebola czar missing from Obama briefing," October 18, 2014
- ↑ The Hill, "NIH: Ebola screenings at US airports ‘on the table’," October 6, 2014
- ↑ The Hill, "Obama: We're boosting Ebola screenings," October 6, 2014
- ↑ The Hill, "NIH: Ebola response might include 'entry screenings' at airports," October 7, 2014
- ↑ BBC, "US Ebola patient Thomas Duncan dies in hospital," October 8, 2014
- ↑ The Hill, "Minn. Dems call to expand Ebola screening," October 13, 2014
- ↑ The Hill, "WH says it has Ebola virus under control," October 3, 2014
- ↑ The Hill, "Dem in tough Senate race calls for Ebola travel restrictions," October 18, 2014
- ↑ The Hill, "CDC director: Travel ban could make Ebola outbreak worse," October 4, 2014
- ↑ The Hill, "Dems call for Ebola flight ban," October 9, 2014
- ↑ Scribd, "Ebola Virus Letter to President Obama 10 8 2014," October 8, 2014
- ↑ The Washington Post, "Epidemiologist: Stop the flights now," October 6, 2014
- ↑ 42.0 42.1 The Hill, "Health official: Ebola travel bans would be 'counterproductive'," October 12, 2014
- ↑ The Hill, "Cruz: Ebola travel ban is 'common sense'," October 15, 2014
- ↑ The Hill, "Ebola travel plan may be too little, too late," October 15, 2014
- ↑ The Hill, "Hagan joins challenger calling for travel ban," October 17, 2014
- ↑ The Hill, "GOP doctors back Ebola travel ban," October 21, 2014
- ↑ The Hill, "List: Lawmakers backing travel ban," October 21, 2014
- ↑ CDC, "Interim Guidance about Ebola Infection for Airline Crews, Cleaning Personnel, and Cargo Personnel," October 2, 2014
- ↑ The Hill, "Top airline lobbyist: Flying is 'totally safe'," October 9, 2014
- ↑ 50.0 50.1 The Washington Post, "Second Ebola case confirmed. Texas health worker wore ‘full’ protective gear.," October 12, 2014
- ↑ The Washington Post, "Health worker who treated Dallas patient tests positive for Ebola," October 12, 2014
- ↑ Centers for Disease Control and Prevention, "Tightened Guidance for U.S. Healthcare Workers on Personal Protective Equipment for Ebola," October 20, 2014
- ↑ The Hill, "Obama promises ‘much more aggressive’ response to Ebola," October 15, 2014
- ↑ The Hill, "Military starts training Ebola response team," October 25, 2014
- ↑ Leader-Telegram, "N.Y., N.J. mandate quarantine of medical workers, others who were possibly exposed to Ebola," October 24, 2014
- ↑ NBC Philadelphia, "Health Care Worker Quarantined Under Ebola Watch at NJ Hospital Criticizes Process," October 25, 2014
- ↑ The Hill, "McCain wants probe of military’s Ebola response," October 28, 2014
- ↑ New York Times, "Unapologetic, Christie Frees Nurse From Ebola Quarantine," October 27, 2014
- ↑ The Hill, "Christie: 'We are not moving an inch'," October 28, 2014
- ↑ The Hill, "Fauci calls Ebola quarantines 'draconian'," October 26, 2014
- ↑ Chicago Tribune, "CDC says returning Ebola medical workers should not be quarantined," October 27, 2014
- ↑ The Hill, "Three more states set Ebola restrictions," October 27, 2014
- ↑ 63.0 63.1 The Hill, "CDC: Second Ebola-infected nurse 'should not have' traveled," October 15, 2014
- ↑ Bloomberg, "CDC Director Should Resign, GOP Lawmakers Say," October 15, 2014
- ↑ Reuters, "Ebola cases may be kept within tens of thousands, WHO says," September 16, 2014
- ↑ The Hill, "WHO declares Ebola epidemic a 'global threat'," September 3, 2014
- ↑ UN News Centre, "Ebola outbreak ‘running’ ahead of world’s response, UN warns as funding lags," October 3, 2014
- ↑ The Hill, "Microsoft co-founder pledges $100 million to fight Ebola outbreak," October 23, 2014
- ↑ The Telegraph, "What countries have pledged to fight Ebola... and how much they've paid into the fund," October 22, 2014
- ↑ The Hill, "Zuckerberg gives $25M to CDC Ebola fund," October 14, 2014
- ↑ The Hill, "Gates Foundation charity to spend $50m on fighting Ebola in west Africa," September 10, 2014
- ↑ 72.0 72.1 The Hill, "White House to request $500M to fight Ebola," September 16, 2014
- ↑ The Hill, "Boehner surprised Obama hasn't acted faster on Ebola," September 16, 2014
- ↑ 74.0 74.1 74.2 The Hill, "Congress worries Ebola could hit US, become more contagious," September 17, 2014
- ↑ The Hill, "Inhofe gives approval for $750M in Ebola funds," October 10, 2014
- ↑ The Hill, "Ebola by the numbers," October 19, 2014
- ↑ The Hill, "FDA approves use of experimental Ebola drug," October 6, 2014
- ↑ The Hill, "CDC director: 'Hard to keep up' with Ebola outbreak in Africa," October 5, 2014
- ↑ 79.0 79.1 The Hill, "Ebola fuels debate over speeding up trials for experimental drugs," September 17, 2014
- ↑ The Washington Post, "An Ebola vaccine was given to 10 volunteers, and there are ‘no red flags’ yet," September 16, 2014
- ↑ The Hill, "Canada to send experimental Ebola vaccine to WHO," October 18, 2014
- ↑ 82.0 82.1 McClatchy DC, "Ads target Republicans on Ebola funding," October 13, 2014
- ↑ The Hill, "Rand Paul mocks the NIH for 'Origami condom'," October 15, 2014
- ↑ The Hill, "Ad blames GOP for Ebola deaths," October 13, 2014
- ↑ Gov.UK, "UK treatment centre to tackle Ebola in Sierra Leone," September 11, 2014
- ↑ CBC, "Ebola outbreak: Canada sends 2nd mobile lab to Sierra Leone," October 4, 2014
- ↑ Yahoo News, "China ups its medics in Ebola-hit Sierra Leone to 174," September 16, 2014
- ↑ Xinhuanet, "China offers new aid for combating Ebola," September 12, 2014
- ↑ Yahoo News, "Cuba's Ebola aid latest example of 'medical diplomacy'," September 13, 2014
- ↑ EurActiv.com, "EU calls for wider response to the Ebola epidemic," September 17, 2014
- ↑ Reuters, "France sends experts to West Africa help fight Ebola spread," September 4, 2014
- ↑ Reuters, "Gaps remain in India's Ebola preparedness, says WHO," August 22, 2014
- ↑ The Hill, "Obama to allies: 'Robust' effort needed on Ebola," October 15, 2014
- ↑ The Guardian, "Guinea's Ebola outbreak: what is the virus and what's being done?" April 1, 2014
- ↑ The Guardian, "First Ebola case in Senegal confirmed," August 29, 2014
- ↑ The Guardian, "Ebola cases in west Africa could rise to 20,000 says WHO," August 28, 2014
- ↑ The Washington Post, "Tracing the rise of Ebola in West Africa," September 16, 2014
- ↑ The Guardian, "West Africa in quarantine: Ebola, closed borders and travel bans," August 22, 2014
- ↑ The Hill, "Ebola death toll tops 4,000," October 10, 2014
- ↑ World Health Organization, "Global Alert and Response - Ebola virus disease," accessed October 14, 2014
- ↑ NBC 2, "American citizen dies from Ebola virus," July 29, 2014
- ↑ WJLA, "Nancy Writebol and Kent Brantly, U.S. aid workers with Ebola, released from Atlanta hospital," August 21, 2014
- ↑ L.A. Times, "Ebola survivor Kent Brantly hopes to return to Africa, 'Lord willing'," September 17, 2014
- ↑ The Hill, "NBC freelancer contracts Ebola in Liberia," October 2, 2014
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedNBCphotohospitalized - ↑ CNN, "First diagnosed case of Ebola in the U.S.," September 30, 2014
- ↑ CNN, "Hospital 'dropped the ball' with Ebola patient's travel history, NIH official says," October 1, 2014
- ↑ Politico, "Dallas Ebola patient’s family ordered to stay isolated at home," October 2, 2014
- ↑ The Hill, "100 people now monitored for Ebola," October 2, 2014
- ↑ Associated Press, "Family that hosted Ebola patient confined to home," October 2, 2014
- ↑ The Hill, "US Ebola patient turns critical," October 4, 2014
- ↑ BBC, "US Ebola patient Thomas Duncan dies in hospital," October 8, 2014
- ↑ Politico, "Video: Rick Perry's statement on Ebola," October 1, 2014
- ↑ The Hill, "Ron Paul warns of Ebola ‘overreaction’," October 2, 2014
- ↑ The Hill, "NIH official dismisses Paul's Ebola concerns," October 5, 2014
- ↑ The Hill, "NIH official: Ignoring Ebola patient’s travel history ‘not excusable’," October 2, 2014
- ↑ The Guardian, "Texas Ebola cases expose troubling contrasts and spark fears of race divide," October 9, 2014
- ↑ ABC News, "Dallas Nurse With Ebola Identified," October 13, 2014
- ↑ The Washington Post, "National Nurses United says most hospitals are not prepared for Ebola," October 12, 2014
- ↑ The Hill, "CDC rethinking Ebola strategy after infection of Dallas nurse," October 13, 2014
- ↑ The Guardian, "Second Texas healthcare worker diagnosed with Ebola virus," October 15, 2014
- ↑ 122.0 122.1 The Hill, "CDC planning for more Ebola cases," October 15, 2014
- ↑ The Hill, "Second Ebola nurse free of virus," October 28, 2014
- ↑ 124.0 124.1 The Hill, "Obama scraps schedule to convene Ebola meeting with Cabinet," October 15, 2014
- ↑ The Hill, "Reports: CDC approved Ebola-infected nurse's air travel," October 15, 2014
- ↑ The Hill, "CDC: Ebola patient may have had symptoms aboard flight," October 16, 2014
- ↑ The Guardian, "Dallas nurses accuse hospital of lax safety protocol in Ebola case," October 15, 2014
- ↑ The Hill, "WH: 'Shortcomings' in Ebola response," October 15, 2014
- ↑ The Hill, "Doc who treated Ebola hospitalized in NYC," October 23, 2014
- ↑ The Guardian, "Ebola infecting five new people every hour in Sierra Leone, figures show," October 2, 2014
- ↑ The Guardian, "Ebola: flights from London to Sierra Leone to open humanitarian corridor," October 2, 2014
- ↑ Wall Street Journal, "Liberian Rubber Farm Becomes Sanctuary Against Ebola," October 6, 2014
- ↑ 133.0 133.1 NPR, "Firestone Did What Governments Have Not: Stopped Ebola In Its Tracks," October 6, 2014
- ↑ Yahoo News, "Four hospitalized in Spain after first Ebola transmission outside Africa," October 7, 2014
- ↑ The Washington Post, "A vexing mystery in Spain: How did a nurse contract Ebola?" October 7, 2014
- ↑ The Guardian, "Spanish nurse’s Ebola infection blamed on substandard equipment," October 7, 2014
- ↑ The Hill, "WHO: Spread of Ebola in Europe ‘unavoidable’," October 7, 2014
- ↑ The Guardian, "Madrid hospital staff quit over Ebola fears," October 10, 2014
- ↑ CNN, "Testing shows Spanish nurse's aide free of Ebola, Madrid hospital says," October 21, 2014
- ↑ The Hill, "McCain wants probe of military’s Ebola response," October 28, 2014
- ↑ The Hill, "Lobbyists mobilize on Ebola virus," October 22, 2014
- ↑ The Hill, "Official: Rogue state could weaponize Ebola," September 16, 2014
- ↑ The Hill, "Officials: No risk of Ebola outbreak in US," September 16, 2014
- ↑ The Washington Post, "Oxford study predicts 15 more countries are at risk of Ebola exposure," September 9, 2014
- ↑ Reuters, "Ebola could drain blns of dollars from African economies: World Bank," September 17, 2014
- ↑ Yahoo News, "IMF says Ebola hits economic growth in West Africa," September 11, 2014
- ↑ The Washington Post, "Ebola is ‘devouring everything in its path.’ Could it lead to Liberia’s collapse?" September 11, 2014
- ↑ 148.0 148.1 Cite error: Invalid
<ref>tag; no text was provided for refs namedebolanumbers - ↑ 149.0 149.1 149.2 149.3 Politico, "Ebola threatens chocolate," October 13, 2014
- ↑ The Hill, "WH official sees no 'meaningful impact' of Ebola on economy," October 3, 2014
- ↑ The Hill, "Officials: No risk of Ebola outbreak in US," September 16, 2014
- ↑ The Washington Post, "Oxford study predicts 15 more countries are at risk of Ebola exposure," September 9, 2014
- ↑ Reuters, "Ebola could drain blns of dollars from African economies: World Bank," September 17, 2014
- ↑ Yahoo News, "IMF says Ebola hits economic growth in West Africa," September 11, 2014
- ↑ The Washington Post, "Ebola is ‘devouring everything in its path.’ Could it lead to Liberia’s collapse?" September 11, 2014
- ↑ The Hill, "WH official sees no 'meaningful impact' of Ebola on economy," October 3, 2014
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