Delay and carelessness in cleaning up Dallas Ebola man's linens and vomit

Thomas Eric Duncan (from a Facebook photo)

Thomas Eric Duncan (from a Facebook photo)


Ebola is a virus that has a 60-90% fatality. There is no cure.
Thomas Eric Duncan, 42, a Liberian national who recently flew from Nigeria on United Airline, arriving in Dallas, Texas (via Washington Dulles) on September 20, 2014, is the first diagnosed case of Ebola in the United States. (See “First case of Ebola in U.S. may have contacted 18, incl. 5 children, while showing symptoms“)
Duncan entered the U.S. on a tourist visa.
Both Liberia and Nigeria are among the West African countries stricken by the terrible epidemic that has a 60-90% fatality rate.
On Sept. 26, four days after he arrived in Dallas, Duncan displayed the flu-like early symptoms of Ebola — of fever, sore throat, headache and muscle pain. He sought treatment at a hospital but, despite having just arrived from Ebola-infested Liberia (via Nigeria), he was sent home.
By Sunday, Sept. 28, he had worsened — sweating profusely, vomiting, and had diarrhea. He finally was hospitalized and is being kept in isolation at Texas Health Presbyterian Hospital of Dallas.
Two days later on Sept. 30, lab results on tests done on Duncan confirmed he has Ebola.
On Sunday, as he was taken away to the hospital in an ambulance, Duncan vomited in the parking lot outside The Ivy, an apartment complex at 7225 Fair Oaks Dr. north of downtown Dallas where he had been staying with his girl friend, also from Liberia. As reported by Yahoo:

His whole family was screaming. He got outside and he was throwing up all over the place,” resident Mesud Osmanovic, 21, said . . . describing the chaotic scene before the man was admitted to Texas Health Presbyterian Hospital on Sunday where he is in serious condition

The New York Times reports that Texas state and local authorities confirmed today (Oct. 2) that a week after Duncan had fallen ill with Ebola in Dallas, and four days after he was placed in isolation at a hospital here, the apartment where he was staying with four other people still had not been sanitized and the sheets and dirty towels he used while sick remained in the home. County officials visited the apartment without protection Wednesday night.
Hospitals say they face a major challenge disposing of waste generated in the care of Ebola patients because two federal agencies have issued conflicting guidance on what they should do. As a result, hospitals say, waste may pile up, and they cannot get rid of it.
The delay in cleaning Duncan’s apartment came amid reports that as many as 100 people could have had contact with him. In a news conference this afternoon, Thomas R. Frieden, the director of the Centers for Disease Control and Prevention, said that health workers were assessing 100 people — including hospital workers and emergency medical technicians — to determine whether they had been exposed. That number does not include secondary contacts — those who had contact with people who had direct contact with Duncan, such as his family members.
Duncan’s four family members are now quarantined inside the apartment. Police cars were stationed at the complex Thursday, to keep reporters out and the family in. Officials said they were arranging to have food and other necessities delivered to the apartment.
Those who are discovered to have had direct contact with Duncan will be monitored for three weeks, receiving twice-a-day visits from health officials who will take their temperature and inquire about other symptoms.
Remember Duncan’s vomit in the parking lot of The Ivy?
Chopper 5 from WFAA Channel 8 in Dallas took aerial footage of two workers cleaning up the vomit. This image from the aerial footage has gone viral on Twitter (source: Twitchy):
Ebola clean up in Dallas
We are told that the Ebola virus is transmitted via direct contact with blood or bodily fluids — vomit, diarrhea, sweat, saliva, semen — from an infected person (including embalming of an infected dead person) or by contact with objects contaminated by the virus, particularly needles and syringes. But a Canadian research study in 2012 had shown that in the laboratory, Ebola was transmitted via air from one animal species (pigs) to another (primates).
The Ebola virus can be eliminated with heat (heating for 30 to 60 minutes at 60 °C or boiling for 5 minutes). On surfaces, some lipid solvents such as some alcohol-based products, detergents, sodium hypochlorite (bleach) or calcium hypochlorite (bleaching powder), and other suitable disinfectants at appropriate concentrations can be used as disinfectants. (Source: Wikipedia)
Notice the workers cleaning up Duncan’s vomit weren’t wearing surgical masks or protective hazmat suits.
Notice the workers appear to be using a power hose to wash off the vomit, which would only blast the vomit into the air in the form of tiny particles and droplets, all the better for aerial transmission.
Nor do we know how long the vomit was on the pavement and whether any dog or other animal had ingested the vomit.
Note that all this inexcusable sloppiness and carelessness is happening in 21st century America, not in backward Third-World Liberia or Sierra Leone in West Africa.
Frightening.

Update (Oct. 3, 2014):

Five days after Duncan was away by ambulance, a hazmat team is finally cleaning the apartment.
[youtube=https://www.youtube.com/watch?v=-hGGAmGsWpc]
H/t FOTM’s DCG and Anon
~Eowyn

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Northerngirl
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Northerngirl

I was horrified looking at the picture of that man cleaning up the vomit from the Ebola patient. I worked around body fluids and I can tell you I would not clean that without a hazmat suit on, at the very least, surgical gloves, mask, and gown. I am wondering if high temperatures kill the virus why incineration hasn’t been decided on as a waste treatment plan.

Auntie Lulu
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Auntie Lulu

Dr Eowyn, thank you for this timely blog on such a critical situation. The haphazard manner of cleaning up the parking lot outside the apartment building he was staying in–is just inexcusable! That on top of the fact that the hospital sent him home the first time he presented himself! Could they not tell from his speech, and accent that he was a person that was foreign born? After all the news about Ebola, and judging from the fact that he was a citizen of Liberia–wouldn’t you just kinda, sorta think . . . Wow! This guy comes from that… Read more »

cg
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Reblogged this on Catholic Glasses.

Dave
Editor
Dave

As I noted elsewhere a little while ago, if this is any indication of the incompetence of the CDC, we’re screwed.
-Dave

Dave
Editor
Dave

My guess is Duncan will ultimately come to be known as Patient Zero.
-Dave

Jane
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Jane

How conducive will the humid weather in TX be to spreading a virus like this that travels in air droplets?!?!

MomofIV
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MomofIV

25 years ago ebola (strain called Reston) came to the US from monkeys imported from the Philippines. Even WAAAAY back then they understood the importance of isolation and wore biohazard suits and used highest containment level. https://www.usatoday.com/story/news/nation/2014/08/10/ebola-1989-outbreak/13860929/ What in the world is going on today? All of a sudden ebola is not a big deal to our government? Why is it that I keep hearing he tested positive for “a particular strain” yet no one has mentioned the name of the strain?…since there are quite a few. This government seems laid back in their efforts to contain this. The CDC… Read more »

truckjunkie
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truckjunkie

When word of the ebola problem first came out,the alleged president had the opportunity to prevent it from getting to the US,by ordering NO more flights to or from ANY of the Countries known to have ebola present. He COULD have mandated that ANY planes,even private planes,entering US airspace must have a verified flight plan with their Country of departure clearly listed and filed with ,and specific approval to land here. I’m not sure who could do this stuff best,I’m hesitant to let CDC handle it,with their recent track record…The point is,this could/SHOULD have been stopped before it started here,but… Read more »

PMB
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PMB

So they’re having an ebola epidemic in Liberia and it was that easy for him to just purchase a plane ticket, leave the country, and come to the U.S.? Uh-huh, right.

DCG
Editor

What a cluster…time to stock up on disinfectants and food.

joandarc
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joandarc

Thank you Dr. Eowyn for this important post. The way this matter has been handled will insure that this sickness will spread far and wide in our nation. What idiocy, indiscretion and stupidity!