(UPDATE: Thomas Eric Duncan died from the disease October 8.)
When Ebola came to Texas last week, the panic it caused was understandable: Ebola is a horrific disease that kills people effectively and gruesomely. Current estimates put the number of people who’ve been infected in West Africa at more than 7,000—and infections are by many accounts severely under-reported. Still, the disease is unlikely to spread in an epidemic-like fashion in the US, given the differences (both culturally and economically) between somewhere like Dallas and a place like Sierra Leone or Liberia. Home care, as opposed to hospital care, increases the risk of transmitting the disease significantly, and simple hand-washing can eliminate the disease. Sunlight, bleach, and heat all kill it.
In other words, the most effective way to manage the possibility of an Ebola outbreak in the U.S. is to limit the contact that people who aren’t prepared to deal with the disease have with people who are infected.
Right now, there’s only one person in the U.S. who has Ebola: Thomas Eric Duncan, the 42-year-old Liberian citizen who, after flying to Dallas to marry the mother of his 19-year-old son, sought treatment at Texas Health Presbyterian Hospital for his symptoms.
Duncan, it’s believed, contracted Ebola when he helped a convulsing woman who was 7 months pregnant into a taxi to find a hospital. At the time, she hadn’t been diagnosed with the disease. Neighbors who also helped her reported that they thought her condition was related to her pregnancy; the New York Times reports that she was the first person in the area to be infected. (That woman, Marthalene Williams, died shortly after her encounter with Duncan, and nine of Duncan’s neighbors have since died of the disease.)
In other words, it’s unclear whether Duncan knew that he’d been exposed to Ebola at the time he boarded his flight to Dallas.
The Liberian government is unsympathetic, though. Authorities in Duncan’s home country intend to prosecute him for lying on health forms that everyone leaving the country is required to fill out and which are supposed to disclose exposures to diseases including Ebola.
Binyah Kesselly, chairman of the board of directors of the Liberia Airport Authority, said Duncan had answered “no” to a question asking whether he had cared for an Ebola patient or touched the body of anyone who had died in an Ebola-affected area.
Because of the circumstances of his encounter with Williams, it’s plausible that Duncan didn’t know that he’d cared for an Ebola patient, and at the time he’d touched her body to help her out of the cab, his hometown of Monrovia wasn’t an Ebola-affected area. But if the Liberian government wants to prosecute Duncan, they may have to get in line: Texas Health Presbyterian Hospital officials told reporters last week that Duncan lied to them, as well, when asked if he’d been around anyone who was ill, and Dallas County D.A. Craig Watkins suggested late last week that he might like to get a crack at prosecuting Duncan himself.
Debbie Denman, a spokesoman for Watkins’ office, issued the following statement exploring the issue:
We are looking into whether or not Thomas Eric Duncan knowingly and intentionally exposed the public to a deadly virus – making this a criminal matter for Dallas County. To put this in perspective, we prosecuted defendants who know they are HIV positive and intentionally have sex with others without protection. In those cases, defendants with HIV who exposed the virus to others faced aggravated assault charges. It’s possible the same charge could apply here.
Also, DA Watkins says it would be irresponsible if we didn’t look into this, but we have to tread lightly because we could not place an Ebola virus patient into the county jail and risk infecting others. On a humanitarian note, it would be cruel and inhumane to go after a person on their death bed but at the same time the DA’s office would want to show that there are consequences to entering the country by falsifying documents and then knowingly putting the public at risk.
That’s fine tough-talk, but it’s also risky for reasons that go beyond the possibility of Duncan infecting other people in the county lockup. Watkins might talk about falsifying documents, but the circumstances of Duncan’s exposure are still unclear, and talking prosecution without those facts seems careless when you consider the unintended consequences: Namely, that if you prosecute people who come forward with having been exposed to Ebola, you discourage people from coming forward with having been exposed to Ebola.
Right now, the Ebola risk in the U.S. is essentially limited to “If you don’t touch an Ebola patient’s bodily fluids and then put your hand in your mouth, you’re okay,” and it’s relatively easy to know who’s an Ebola patient in this country: It’s Thomas Eric Duncan—and, potentially, some of the people he spent time with after arriving in the U.S., a group of ten “high risk” family members and medical professionals who are being closely monitored.
For that monitoring to work, though, authorities need the ability to track Ebola exposure, which means tracking anyone who might have symptoms. Creating a disincentive for those with symptoms to report them is how this can go from a threat level of “scary, but not really a risk” to “oh my god, I’m bleeding from the eyes.” That’s not great news for anybody who hopes that this infection remains isolated, contained, and easily monitored.
(AP Photo/LM Otero)