The Day Ebola Came to Town

On the evening of October 22nd 2014, I went to the Broadway show “On the Town” here in New York City where I live. I left the theater with joyous lyrics replaying in my mind, especially the iconic “New York, New York, it’s a helluva town!”

I rode the IRT subway home, crushed in next to the typical mass of riders who cling to the poles and can’t help but touch one another during the trip. The next morning, like the rest of the over 8 million residents of NYC and the scores of commuters who come here daily from the tri-state area, I woke up to the decidedly unjoyous news that Ebola had come to this helluva town. Dr. Craig Spencer had returned from West Africa where he treated Ebola patients and then traveled around NYC by subway, including the IRT, on Wednesday even though he had been “feeling sluggish” on Tuesday.

Elected officials and health authorities rushed to reassure us that Ebola is hard to contract and that disinfecting the subway cars was not necessary. The virus, we learned, can only be transmitted via “bodily fluids” and it can only live on hard surfaces for about four hours. New Yorkers are a hardy bunch so for the most part we didn’t panic, but plenty of people found those announcements to be far from reassuring. After all, sweat is a “bodily fluid” and the citizens of Liberia have therefore taken to bumping elbows rather than shaking possibly sweaty hands. I can guarantee you that I came back to my apartment on Wednesday with other people’s sweat on my person. Yes, I avoided touching my eyes and mouth as I always do and I showered the minute I got home, again as I always do after a subway ride, but still . . .

Although Doctors Without Borders and the health department said Dr. Spencer followed protocols, no less an authority than Vanderbilt University’s infectious disease specialist Dr. William Schaffner told reporter Marc Santora of The New York Times that Dr. Spencer probably should have stayed home beginning on Tuesday. “At that point I would have locked myself in, and I would have started checking my temperature hourly,” he said.

In spite of the fact that the city’s health commissioner, Dr. Mary T. Bassett, told a reporter from The New York Times that Dr. Spencer had “handled himself really well” and added “I don’t want anyone portraying him as reckless”, I’m with Dr. Schaffner. Dr. Spencer lives on 145th Street in Harlem. His decision to leave his apartment on Wednesday to go to a bowling alley in Brooklyn seems “reckless” to me in light of the fact that he was already not feeling well. For those of you not familiar with subway routes here in NYC, he had to take three trains – the A, the #1, and the L – in order to get to the bowling alley. Then he took a cab home. Couldn’t he think of anything to do that didn’t involve public transportation and a sweaty activity that night? Oh, and he also went jogging (more sweat) and ate at a restaurant where he must have wiped his mouth on napkins that the waitstaff later touched.

That said, I most certainly wish Dr. Spencer a speedy and complete recovery. I also commend him for volunteering to battle the Ebola outbreak in West Africa. Yet I believe the lesson we’ve learned from his saga and from those of the Dallas nurses is that Personal Protective Equipment – even the type used by Doctors Without Borders – isn’t protective enough and that more training is required for PPE use by healthcare workers. Yesterday here on ThirdAge, we posted an article from JAMA, (https://thirdage.com/article/ebola-and-need-new-personal-protective-equipment) in which three physicians outlined a strategy for improving PPE and its use, not only regarding Ebola but also MRSA and other hospital-acquired infections. May those clear-headed and well-researched recommendations prevail even as headline-grabbing events such as mandatory quarantines and purported “lies” told by Dr. Spencer captivate readers. If that happens, we will all actually have benefitted from Dr. Spencer’s adventures in this “helluva town” where “people ride in a hole in the ground”.

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