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Those Touched By Ebola Recount How Their Lives Have Changed

Those Touched By Ebola Recount How Their Lives Have Changed

By Judy Wiley, Fort Worth Star-Telegram (TNS)

FORT WORTH, Texas — Nina Pham came home still suffering from the after-effects of Ebola virus disease and found herself dealing with harsh, new realities — such as reporters hanging around outside her family’s house.

“Of course it was very crazy right after I came home, media camped outside my house and everything,” said Pham, who grew up in Fort Worth, in an interview with the Star-Telegram. “It’s just weird being normal and not seeking the celebrity and just kind of — very weird. It’s not natural to me.”

Pham, 26, was an intensive care nurse at Texas Health Presbyterian Hospital in Dallas when she tested positive after caring for Thomas Eric Duncan, the Liberian man who died of the virus at Presbyterian on Oct. 8.

“Whenever I found out, he had just died three or four days prior,” she said. “I was the first person to contract it in the U.S. I thought, what’s going to happen? There’s no proven treatment, so we have limited resources — it was very scary, not knowing.”

After Duncan’s diagnosis on Sept. 30, Ebola began its burn into the public consciousness, fueled by the 24-hour news cycle and a deluge of stories that ranged from repetitious to useful.

So most people knew about the virus by Oct. 12, when Pham tested positive. In fact, “What is Ebola?” was the top search on Google for 2014.

Well-wishers lined up to waved good-bye to the young nurse as an ambulance carried her to Love Field for the flight to the National Institutes of Health Clinical Center in Bethesda, Md., where she ultimately recovered. Her release from the hospital on Oct. 24 was covered live by the major TV networks and later that day she met with President Barack Obama in the White House before returning to North Texas.

Pham lost most of her belongings in the rush of fear and the abundance of caution that followed her diagnosis. A hazmat crew packed nearly all the contents of her Dallas apartment into blue barrels and took them away to be incinerated. Realizing a dog in Spain had been euthanized after its owner contracted Ebola, she insisted her dog, Bentley, be kept alive.

The Cavaliar King Charles Spaniel was quarantined and tested for Ebola while Pham was being treated.

“I don’t think I could have lived with myself if something happened to Bentley and not me,” she said.

He’s become a little media hound, tweeted around the world and recently part of helping a good cause.

“I’m trying to use my voice for positive things,” Pham said. “The other day Bentley and I presented a check to Dallas Animal Services. They were very instrumental in helping Bentley.”

She plans to attend a veterinary conference next month to speak about Ebola and animals.

Beyond that, Pham is still weighing her options for the future. She said she has good days and bad days physically, and still suffers from fatigue, so she isn’t ready to return to the pressures and 12-hour shifts of the ICU.

“Right now it’s a little too soon, I’m trying to focus on my health,” she said.

And she’s considering other avenues as well. She said whatever she does will probably having to do with involve nursing or with helping people, “perhaps pursuing a graduate degree or something in advocacy. There are a lot of options out there. I want to see what I can do to help people in the biggest way.”

The new ability to help in a larger sense than before also drives Dr. Kent Brantly, the Fort Worth-trained doctor who contracted Ebola while caring for patients on a mission for the Samaritan’s Purse, an international charity.

Like Pham, Brantly, 33, of Fort Worth was wrenched from obscurity onto the cover of Time magazine, which honored “the Ebola fighters” collectively as Person of the Year. Both their stories were included, and Brantly’s portrait was on one of the five covers.

He is not doctoring for now, but instead spreading the message of Ebola’s continued lethal march through West Africa, and helping Samaritan’s Purse chart the course ahead for fighting the disease.

The death toll from Ebola in Guinea, Liberia and Sierra Leone — the West African countries most affected — stood at 7,693, according to the U.S. Centers for Disease Control. Total deaths in the U.S. stood at seven, and eight people had died in Nigeria.

“Right now, I feel like the best role I can play in fighting Ebola is to stand here and be a voice for the people of West Africa who have no voice here,” Brantly said at a Tarrant County Commissioners Court meeting Dec. 9, which was declared “Dr. Kent Brantly Day.”

Amber Vinson, a second young nurse who contracted Ebola virus from Duncan, also survived and the last time she surfaced publicly, said she is happily continuing with her plans to marry.

Presbyterian Hospital was not left unscathed. A series of missteps in the way Duncan’s diagnosis was handled left the hospital and its parent company, Texas Health Resources of Fort Worth, with a lot of explaining to do. But the ordeal ultimately ended in a settlement with Duncan’s family designed to help Ebola victims in West Africa.

Other area hospitals benefited from Dallas’s experience.

“Ebola’s arrival in North Texas strengthened and broadened our internal response knowledge for how to protect our employees while also providing care to victims of a possible pandemic,” said Robert Earley, president and CEO of JPS Health Network in Fort Worth.

Another life forever changed by the crisis in North Texas was that of Louise Troh, the woman Duncan came to the U.S. to marry.

One day she was a woman looking forward to starting anew with the man she loved, and a few days later she had become a pariah struggling to find a place to live. Nobody wanted anything to do with people who had been exposed to Ebola, regardless of whether they were symptomatic or diagnosed.

Ultimately, the Catholic Diocese of Dallas took in Troh, her son and two nephews at its Conference and Formation Center in Oak Cliff. She confronted the same problem even after she and other relatives completed a quarantine period at the center, and finally moved into a condo purchased by members of the Wilshire Baptist Church in Dallas.

Troh reportedly has a book deal to write her story — she has said it will be a love story about growing up in Liberia, meeting Duncan at a refugee camp in Ivory Coast and the events that followed.

AFP Photo/Alex Wong

Nurse Nina Pham Is Ebola-free: ‘I Feel Fortunate And Blessed’

Nurse Nina Pham Is Ebola-free: ‘I Feel Fortunate And Blessed’

By Christine Mai-Duc, Los Angeles Times (MCT)

Two weeks after she was hospitalized with a fever, Dallas nurse Nina Pham is now Ebola-free and has been released from the hospital.

“I feel fortunate and blessed to be standing here today,” Pham told reporters at a news conference outside a National Institutes of Health clinic in Bethesda, Md. “Throughout this ordeal, I have put my trust in God and my medical team.”

Pham, dressed in a black suit and light teal top, her nails and makeup done, looked healthy and was smiling as she stood next to her mother, sister and NIH doctors who helped bring her back to health. Many of them were wearing ribbons in the colors of Texas Christian University, a tribute to Pham’s nursing school.

“She as an individual is extraordinary, but she also represents the nurses and health care workers who put themselves on the line…to take care of people who are in such need,” said Dr. Anthony Fauci, head of the NIH’s Institute of Allergy and Infectious Diseases.

Fauci said five consecutive Ebola tests have now shown that Pham’s blood is free of the Ebola virus.

While hospitalized, Pham was cared for by a special team of doctors and researchers, who provided general supportive care, but did not treat Pham with any experimental Ebola drugs, Fauci said.

Pham was able to communicate with family and friends by phone and Facetime.

“She taught me how to use Facetime,” Fauci said, to laughter. “I’m going to miss Nina a lot.”

Dr. Francis Collins, director of the National Institutes of Health, called it a “very special moment” for the institution.

Pham, 26, was the first of two nurses diagnosed with Ebola this month after taking care of Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas.

Duncan, the first Ebola patient diagnosed on U.S. soil, died on Oct. 8.

Two days later, Pham went to the hospital with a fever and was put into isolation. Hospital officials upgraded Pham’s condition Tuesday from “fair” to “good.”

Nurse Amber Vinson, the third person to be diagnosed with Ebola in the U.S., is also free of the disease, Emory University Hospital says.

“We are overjoyed to announce that, as of yesterday evening, officials at Emory University Hospital and the Centers for Disease Control are no longer able to detect virus in her body. She has also been approved for transfer from isolation,” Vinson’s family said in a statement. “Amber remains under treatment within Emory’s Serious Communicable Diseases Unit.”

Although the virus may no longer be in Vinson’s blood, she will still require treatment to regain her strength, her mother, Debra Berry, noted. The family statement did not say when the 29-year-old might be released from the hospital.

News of Pham’s release from the hospital came as New York was dealing with its first diagnosed case.

A doctor who tested positive for Ebola was in stable condition at a New York hospital on Friday, as federal officials face heightening scrutiny over protocols for health care workers who have treated Ebola victims.

The ill doctor, Craig Spencer, 33, became feverish in his Manhattan apartment on Thursday and was diagnosed hours later at Bellevue Hospital. He returned to the United States on Oct. 17 after working with Ebola victims in Guinea, a West African country badly hit by Ebola.

AFP Photo/Alex Wong

A Strategic Shift On Ebola Care

A Strategic Shift On Ebola Care

By Noam N. Levey and Michael Muskal, Tribune Washington Bureau (MCT)

WASHINGTON — The federal government effectively began to restrict the care of Ebola patients to hospitals with special bio-containment units Thursday, and the Obama administration labored to reassure jittery Americans and increasingly skeptical lawmakers that public health authorities can prevent a widespread Ebola outbreak here.

The tacit shift in policy came amid growing concerns about mistakes at Texas Health Presbyterian Hospital in Dallas, where two nurses who treated Thomas Eric Duncan of Liberia have since come down with the disease.

One of the nurses is being treated at Emory University Hospital in Atlanta, and the other was being transferred to a specialized treatment center at the National Institutes of Health near Washington.

On Capitol Hill, lawmakers demanded answers from the director of the U.S. Centers for Disease Control and Prevention, Dr. Thomas Frieden, who has acknowledged his agency’s lapses in responding to the disease, including allowing one of the nurses to board a commercial flight after she treated Duncan.

Frieden strenuously defended the CDC’s efforts.

“CDC works 24/7 to protect Americans. There are no shortcuts,” he said. “We have a team of 20 of some of the world’s top disease detectives in Texas now. We were there. We left the first day (Duncan) was diagnosed.”

Despite repeated assurances from Frieden and other top health officials that the risk of a widespread outbreak is extremely low, fear of the deadly disease has led to school closings and a suggested ban on travel from the U.S. to and from West Africa — which President Barack Obama said Thursday evening that he might consider in the future.

Domestic air travel was of more immediate concern in Texas and Ohio, where several public schools closed as a precaution after officials learned that faculty and students had flown on the same plane as Ebola patient Amber Vinson, the second of Duncan’s nurses to be diagnosed with the virus that killed him.

Now hospitalized at Emory, Vinson flew to Cleveland on Friday, returned to Dallas-Fort Worth late Monday and was diagnosed with Ebola on Wednesday.

Eight people who came into contact with Vinson quarantined themselves and are being monitored, according to health officials there.

Officials also are asking anyone who visited an Akron bridal shop that Vinson visited Saturday to contact health officials.

The deadly virus is transmitted by the bodily fluids of a symptomatic person.

In Dallas, where fears about Ebola are highest, local officials signed off on “control orders” Thursday that will restrict those being monitored for Ebola from using public transportation or venturing out to public places such as grocery stores.

Dallas County Judge Clay Jenkins said he expected officials to start serving the orders on 75 health care workers Thursday. During an emergency meeting of county leaders, Jenkins said the addresses of those being monitored would be flagged for first responders but not publicly distributed.

Growing public anxiety has fueled Republican lawmakers’ escalating attacks on the Obama administration.

“People are scared,” House Energy and Commerce Committee chairman Fred Upton, R-Mich., told federal health officials at the Washington hearing. “People’s lives are at stake, and the response so far has been unacceptable.”

GOP lawmakers and some Democrats urged a travel ban on passengers from Liberia, Sierra Leone and Guinea, the three West African countries at the center of the Ebola outbreak.

Many public health experts oppose such a move. And Thursday, Frieden also rejected that call, noting it would likely induce travelers from the heart of the outbreak to go underground.

“Right now, we know who’s coming in,” he said. “If we try to eliminate travel, the possibility that some will travel over land, will come from other places, and we don’t know that they’re coming in, will mean that … when they arrive, we wouldn’t be able to impose quarantine as we now can if they have high-risk contact.”

On Thursday evening, Obama said he might consider imposing a ban on travel to Ebola outbreak areas, but he fears it could encourage the sick to hide their illness and result in “more cases rather than less.” But the president said he “may consider it if experts recommend it.”

Obama emphasized, as have Frieden and others, the need to focus on containing the outbreak in West Africa.

The president signed an executive order Thursday authorizing the Pentagon to call up additional Ready Reserve forces to assist in the ongoing U.S. military effort to combat Ebola in Liberia, Sierra Leone and Guinea.

The order was aimed at calling up personnel with key skills, according to an administration official; so far the Pentagon had identified just eight people for the mission.

Obama also met at the White House for the second day in a row with senior officials coordinating the federal Ebola response.

Administration officials have insisted for months that a wider Ebola outbreak in the U.S. is unlikely because American hospitals can effectively isolate and care for infected patients, a key capacity missing in West Africa.

But the apparent breakdown at Texas Health Presbyterian in Dallas that led to the infection of Duncan’s nurses has prompted growing calls for a new system to concentrate care in designed facilities.

The U.S. has four specialized facilities, including Emory, the NIH in Bethesda, Md., the Nebraska Medical Center in Omaha and St. Patrick’s Hospital in Missoula, Mont.

Officials at Texas Presbyterian have acknowledged that they erred in sending Duncan home when he initially came to the hospital with flu-like symptoms and reported he had recently been in West Africa.

On Thursday, Dr. Daniel Varga, chief clinical officer of Texas Health Resources, which owns the hospital, testified at the congressional hearing that the hospital had not trained the medical staff to deal with Ebola, even after the CDC alerted U.S. hospitals to watch for possible cases.

Nevertheless, Nina Pham, the first nurse to be infected, had remained at Texas Presbyterian since her diagnosis over the weekend.

The hospital said in a statement Thursday that officials decided to transfer her because so many of the hospital’s staff are being monitored for Ebola.

Pham was in good condition, according to health officials.

(Levey of the Tribune Washington Bureau reported from Washington and Muskal of the Los Angeles Times from Los Angeles. Times staff writers Molly Hennessy-Fiske and Geoffrey Mohan in Dallas, Kathleen Hennessey and Christi A. Parsons of the Tribune Washington Bureau in Washington and Christine Mai-Duc of the Times in Los Angeles contributed to this report.)

AFP Photo/Nicholas Kamm

Lawmakers Criticize Dallas Medical Officials For Errors In Handling Ebola

Lawmakers Criticize Dallas Medical Officials For Errors In Handling Ebola

By Todd J. Gillman, Matthew Watkins and Michael E. Young, The Dallas Morning News (MCT)

WASHINGTON — Members of a U.S. House subcommittee sharply criticized national and Dallas medical officials Thursday for errors in the Ebola crisis that they say have eroded public trust in the hospital system.

Fumbles by the Centers for Disease Control and Prevention and by Texas Health Resources Presbyterian Hospital Dallas have demolished CDC assurances that any hospital in America could effectively deal with an Ebola case, said Rep. Tim Murphy (R-PA), the subcommittee chairman.

“CDC and our public health system are in the middle of a fire. Job One is to put it out completely,” Murphy said.

The subcommittee’s top Democrat, Rep. Diana DeGette of Colorado, echoed the concerns.

“It would be an understatement to say that the response to the first U.S.-based patient with Ebola has been mismanaged, causing risk to scores of additional people,” she said.

The questions on Capitol Hill about Presbyterian — and about U.S. hospitals in general — arose as Nina Pham, a Presbyterian nurse infected with the Ebola virus, was moved from Presbyterian to a National Institutes of Health clinic in Bethesda, Md. Pham, 26, was among those who cared for Thomas Eric Duncan of Liberia, who died of Ebola in the Dallas hospital on Oct. 8.

Amber Vinson, 29, a second Presbyterian nurse diagnosed with the disease, was moved earlier to Emory University Hospital in Atlanta, which has special isolation units and has treated three Americans who contracted Ebola in Africa while on aid missions.

The fact that two nurses at Presbyterian contracted the disease while treating an Ebola victim proves that “the frightening truth is that we cannot guarantee the safety of our health care workers on the front lines,” said Rep. Michael Burgess (R-TX), a physician.

Dr. Tom Frieden, director of the CDC, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, a part of the NIH, testified before the committee in Washington. Dr. Daniel Varga, chief clinical officer at Presbyterian, spoke from Texas. Frieden faced some of the toughest questions.

He was pressed him to explain whether Vinson should have been allowed to travel by commercial airliner to visit family in Ohio after she was identified as having been one of Duncan’s caregivers.

That would have been fine, Frieden said, had she worn proper protective gear while treating Duncan. If she hadn’t, she shouldn’t have traveled, he said.

Frieden acknowledged that Vinson called the CDC before her return flight to Dallas, said she had a minor fever, and asked whether she could travel.

“My understanding is she reported no symptoms to us,” he told the committee.

But a day earlier, Frieden said that since Vinson had a fever, she shouldn’t have flown.

A series of bad decisions, beginning with Presbyterian’s failure to admit Duncan when he showed up at the emergency room with a high fever and severe pain, has left hundreds of people with potential exposure to the deadly virus.

More than 70 are Presbyterian health care workers who had contact with Duncan, sometimes without proper protective clothing, according to nurses at the hospital. (Varga disputed the nurses’ claim about inadequate protective gear.)

Many more were either on the Frontier Airlines flight that Vinson took from Cleveland to Dallas or were on subsequent flights before the aircraft was taken out of service.

Concerns about passengers’ exposure have spread nationwide, including in North Texas.

On Thursday, Rockwall County announced that four residents who were on Monday’s flight were being monitored by the state health department and the CDC. Another county resident, a Presbyterian health care worker, is also being monitored.

Despite her slight fever, health officials said, the chance that Vinson spread Ebola to other passengers was very small.

Still, school districts in Ohio and Texas contacted parents after learning that some of their students had been passengers on the plane or were the children of passengers. Some schools were closed so they could be disinfected.

And officials in both states were eager to speak with Vinson’s mother, who left Ohio on Tuesday and traveled to Dallas.

Donna Skoda, assistant health commissioner for Summit County Public Health in Ohio, said the mother contacted Dallas public health officials before going to an undisclosed hotel.

“We have no idea where she is at,” Skoda said. “She has elected, even though her daughter was transported to Atlanta, to self-quarantine in the hotel.”

An uncle of Vinson’s, Lawrence Vinson, released a statement thanking people for their good wishes and requesting privacy for the family. He said his niece was stable.

He praised her as “a respected professional” who was passionate about nursing and said, “She’s trusting in her doctors and nurses, as she is now the patient.”

The decision to move Pham on Thursday to the NIH clinic in Bethesda was made in consultation with the nurse and her family, officials said.

In a statement released by Presbyterian, Pham said: “I’m so thankful for the outpouring of love and support from friends and family, my co-workers and complete strangers. I feel very blessed and have gained strength from their support.”

Later Thursday, the hospital released a video of Pham talking and joking with her physician before she departed for the NIH clinic.

In the video, Dr. Gary Weinstein thanked Pham for being part of the team that volunteered to care for Duncan.

As he told her the hospital staff was proud of her, Pham started to cry. “I love you guys,” she said. “We love you, Nina,” Weinstein responded.

Weinstein, chief of pulmonary and critical care medicine at Presbyterian, said it was “a difficult decision to transfer Nina, a member of our own family and someone who is greatly loved and respected.”

He said her condition continued to improve. “She’ll be in wonderful hands at NIH,” he said.

In Dallas County, officials worried that health care workers who had contact with Duncan needed to limit their own contact with others.

After initially considering passage of a declaration that would have given County Judge Clay Jenkins authority to control their movements, the Commissioners Court instead decided to obtain from those potentially exposed signed “voluntary agreements” to avoid public transit and other public places. Those who don’t sign would be subject to court orders restricting their movement.

The commissioners heard from Dallas Mayor Mike Rawlings, who said they should not declare an emergency.

“We should ask them to voluntarily restrict their travel,” Rawlings said. The workers will monitor themselves and submit to visits from health department employees twice a day, he said.

“They can walk their dog,” Rawlings said. “But they can’t go to church. They can’t go to schools. They can’t go to shopping centers.

“If we focus on doing that, we believe that is the appropriate measure. If, on the other hand, we dial this up to another level, we might accomplish that as well but we might also have other people suffer in the process.”

Signing agreements with health care workers means the county will have control of all local residents potentially exposed to Ebola. The county health department had been responsible for tracking 48 people who came into contact with Duncan before he was hospitalized. But they weren’t in charge of the health care workers. That was handled by Presbyterian and the CDC.

The health care workers hadn’t been notified of the agreements before Thursday’s meeting. Rawlings was asked how he thought they’d respond.

“I don’t care,” he said. “Sorry, I’m not trying to be flippant. But this is the right measure. We have to focus on these individuals.”

Jenkins said he had no worries about compliance.

“These are not criminals,” he said. “These are not risks to the community. They are not disease carriers. They are disease contacts.”

Photo: Olivier Douliery/Abaca Press/MCT