US Ebola patient's waste not cleared from apartment two days after diagnosis
Health officials admit they were unable to find waste management company willing to accept soiled towels and sheets
A company with experience of dealing with medical waste was finally due to clean the apartment on Thursday afternoon, but only after the patient’s girlfriend told CNN that the materials had not been disposed of.
Health officials obtained an order to force the residents of the apartment to stay at home, after admitting they had not complied with a voluntary request to do so on Wednesday. The order applies to four “close” family members, including a woman believed to be the girlfriend of the patient, Thomas Duncan, as well as her child and two nephews in their 20s. Local police have been stationed at the apartment complex to ensure compliance.
State health officials estimate the number of people who came into direct contact with Duncan as being between 12 and 18, including five school-age children. They are being actively monitored, a procedure that includes taking the person’s temperature twice a day. They are also working from a list of 100 potential or possible further contacts.
“Out of an abundance of caution, we’re starting with this very wide net, including people who have had even brief encounters with the patient or the patient’s home,” said Carrie Williams, a spokeswoman with the Texas department of state health services.
Officials in Liberia have threatened to prosecute Duncan for failing to disclose on a health form when he left the country late last month that he had come into contact with someone suffering from Ebola.
Binyah Kesselly, chairman of the Liberia Airport Authority,told the Associated Press that Duncan ticked “no” on a questionnaire that asked if he he had come in contact with anyone who was infected with or had died from Ebola.
The New York Times reported that while in Liberia, Duncan helped his landlords transport their pregnant daughter, who showed symptoms of the disease, to hospital. The young woman later died.
At a rowdy press conference in Dallas, officials were repeatedly pressed by reporters on apparent missteps in their response to the Ebola diagnosis, the first outside Africa, where the disease has caused more than 3,000 deaths since the outbreak began in March. On Wednesday, hospital chiefs admitted they sent Duncan home with a course of antibiotics even though he told a nurse he had travelled from Liberia. The nurse did not share the information more widely with the medical team assessing Duncan.
Jenkins said the sheets and towels, along with Duncan’s belongings, were in sealed plastic bags.
“The house conditions need to be improved,” Dr David Lakey, the Texas health commissioner, acknowledged during a separate conference call with reporters on Thursday.
Lakey said local and county officials had experienced difficulties in securing a contractor to remove the waste from the apartment and clean it. “There has been a little bit of hesitancy for entities to want to do that,” Lakey said.
He added on Twitter later that his agency was arranging for food and groceries to be delivered. He said that Duncan, who is being treated at a hospital less than a mile from the apartment, has a telephone and is able to make calls, and that there is “no intention to put other individuals under a control order”.
Duncan was staying with family in an apartment complex in north-east Dallas, eight miles from downtown. After being sent home from hospital on Friday, he fell seriously ill on Sunday and an ambulance was called to take him from the residence to hospital.
Sally Nuran, the manager of the apartment complex, told reporters gathered outside the front entrance on Thursday that one woman and two children were registered as living at the property.
Nuran said that she is confident that Duncan did not closely interact with anyone outside when he became infectious following his arrival in Dallas from Liberia on 20 September, though a man who lives on the complex said on Wednesday that he had seen him stagger outside and vomit on the ground as the ambulance arrived.
“The person did not get in contact with anyone on the property,” she said. “There is no fear about the common areas, the guy wasn’t here for that long.”
Nuran said that she was notified by health officials from various agencies about the possible diagnosis on Monday night. The information was publicly released on Tuesday afternoon. The family had been expected to move out on 30 September, Nuran said, because their lease was up.
Now they are under a 21-day quarantine by order of Texas state and county health officials, banning them from leaving the flat without approval until at least 19 October, when the incubation period will be over, and mandating them to report any symptoms and submit to health tests if deemed necessary. Failure to comply could result in criminal charges.
Local government officials said that the complex has 300 units and about 25,000 people live in the densely populated, multi-ethnic district known as Vickery Meadow.
At midday on Thursday, a child peeked out from behind a red diamond-pattered curtain in one of the apartments while at ground level a team of three contractors – none wearing any sort of protective clothing – power-washed the front porch. A stroller stood at the bottom of a staircase.
Earlier, a representative of one of the agencies who issued the control order said that arranging clean bedding was the responsibility of the family – despite the ban on them leaving their home. “The individuals, it’s up to them … to care for the household,” Erikka Neroes of Dallas County health and human services told the Guardian. “Our science tells us, according to CDC, that Ebola virus germs can be killed with soap and water … Dallas County has not been involved in a disinfection process.”
Mbusa said he is a night shift worker from South Sudan and has lived in the Dallas area for about 15 years. He said that he woke up this morning to find a one-page general information sheet about the virus on his door and was confused by the police presence in the complex and asked a small boy what was happening.
“I don’t know anything about Ebola,” he said. “This thing is happening in west Africa.” After reporters updated him, he said that he was “upset completely, I’m not sure what’s going on … Me and everybody who lives here should be screened, that hasn’t happened … whoever lives here should stay inside.”
Nuran said that she had arranged for flyers to be posted on every apartment door on Wednesday evening but the variety of different languages spoken by residents made communication difficult and it took time to translate the information. She said that the exterior of the whole property would be cleaned and that representatives from the CDC and other government departments were in regular contact and making visits.
Jennifer Gates, a local council member, said that “eight to 10” CDC officials had visited the complex on Wednesday but acknowledged that some people are “scared” and “confused” and that many Meadow residents speak little or no English.
Several schools are in the area and parents have expressed concern about their children’s safety. “The school is a safe place, please continue to send your kids to school,” she said. Dallas Independent school district said in a statement that its schools are following a normal schedule but nurses are on twice-daily rounds visiting schools attended by five children who may have come into contact with Duncan. The five children are now being schooled at home.
A spokesman for the Dallas Independent School District said attendance was down by 10% across the five affected campuses on Thursday, with higher absences at the elementary schools.
Official reassurances do not seem to be carrying much weight. “Nobody really knows what’s going on,” said Chris Cooper, a local resident who was driving past the complex. “Hell yeah, I’m very worried.”
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