As a doctor fights Ebola, a nurse beats virus, meets with Obama
By TONY PUGH | McClatchy Washington Bureau (MCT) | Published: October 24, 2014
WASHINGTON — The dangers confronting health care workers who treat Ebola patients took center stage Friday in the nation’s capital and in America’s largest city.
While doctors in New York City closely monitored the condition of Dr. Craig Spencer, the nation’s newest Ebola patient, others in Bethesda, Md., marveled at the rapid recovery of Nina Pham, a Dallas nurse who contracted the deadly virus only weeks earlier.
Pham is the sixth U.S. patient in the current epidemic to fully recover from the virus after treatment in one of the four specialized bio-containment facilities in the United States.
Spencer, 33, became infected while treating patients in Ebola-stricken Guinea, in West Africa, as a volunteer with the humanitarian group Doctors Without Borders. He’s currently in stable condition at Bellevue Hospital Center as health officials try to retrace his travels and find people who he may have infected while he was contagious. The governors of New York and New Jersey announced a mandatory quarantine for all health care workers returning from West Africa who had direct contact with Ebola patients.
Pham, a nurse at Texas Presbyterian Hospital Dallas, became infected on her job while caring for a Liberian Ebola patient, Thomas Eric Duncan. She was one of more than 70 health care workers at the beleaguered Dallas hospital who were monitored for possible infection after they helped treat Duncan, who later died.
On Friday, Pham, 26, looked healthy, happy and emotional as she faced a throng of journalists who cheered her release from the clinical center at the National Institutes of Health in suburban Washington, where a medical team helped her beat the same Ebola virus that’s killing 70 percent of people who become infected in West Africa.
With her mother, Diana, and sister, Catherine, in attendance, Pham thanked her care team, her public supporters and former Ebola patient Dr. Kent Brantly, for his “selfless act” of donating his plasma.
Because he recovered from Ebola, Brantly’s plasma may have developed antibodies against the virus, which may have helped Pham “jump-start” her own immune response, said Jennifer Kanakry, assistant professor of medicine at Johns Hopkins University School of Medicine
“It’s still experimental at this point,” Kanakry said. “It’s been used in a handful of patients with Ebola and it may have some benefits, but it’s not been proven to have a benefit yet.”
Pham didn’t receive any experimental medications during her eight-day stay at NIH, said Dr. Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases. Aside from Pham being young and very healthy and receiving intensive care immediately in Dallas after becoming infected, Fauci said it’s impossible to say what made the difference in Pham’s improvement.
“I can’t pinpoint in one patient what is the turning point,” Fauci said. “The only thing that we’re really happy about (is) that the turning point occurred.”
Pham seemed fully cognizant of her improbable recovery.
“As a nurse, I have a special appreciation for the care I have received from so many people,” she told reporters. “Not just doctors and nurses, but the entire support team.”
“I believe in the power of prayer because I know so many people all over the world have been praying for me,” she added. “I do not know how I can ever thank you, everyone, enough for their prayers and their expressions of concern, hope and love.”
Pham’s colleague at the Dallas hospital, nurse Amber Vinson, 29, also contracted Ebola after treating Duncan. Vinson is hospitalized at the bio-containment unit at Emory University Hospital in Atlanta. Earlier this week, Vinson’s family released a statement saying she, too, was free of the virus. On Friday the hospital and the Centers for Disease Control and Prevention released a statement saying Vinson was making good progress in her treatment.
“Tests no longer detect virus in her blood,” the statement said. “She remains within Emory’s Serious Communicable Diseases Unit for continued supportive care. We do not have a discharge date at this time.”
While Pham’s release was good news, her recovery hasn’t allayed the concerns of nurses nationwide.
As Pham and her family greeted reporters Friday and made their way to the White House for a triumphant meeting with President Barack Obama, another nurse testified before Congress that the federal government should do more to protect members of her profession from Ebola infections as the virus continues to turn up in the U.S.
Deborah Burger, co-president of National Nurses United, which represents more than 185,000 registered nurses, told the House Committee on Oversight and Government Reform that uniform national standards are needed for the use of personal protective equipment and respirators when treating Ebola patients.
Burger testified that the government should require — through an act of Congress or by presidential executive order — two direct-care nurses to treat Ebola patients. She said the response to Ebola by governmental agencies and U.S. hospitals had been “dangerously inconsistent and inadequate,” by relying on voluntary compliance to safety guidelines that have “left caregivers vulnerable to infection.”
A poll released Friday by a trade group, the Association for Professionals in Infection Control and Epidemiology, found that just 6 percent of U.S. hospitals are well-prepared to take in a patient suffering from Ebola. The association calculated the results from polling 1,039 of its own members who work as infection prevention experts at hospitals across the country.
The survey also found that half of all hospitals had only one full-time infection prevention expert on staff, or none.
“We are your first line of defense,” Burger told the committee. “No nation would ever contemplate sending soldiers into the battlefield without armor and weapons. Give us the tools we need. All we ask from President Obama and Congress is not one more infected nurse.”
Earlier this week, the CDC tightened its recommended safety measures for health care workers treating Ebola patients. The new guidelines require that medical personnel train, practice and show competency in the donning and removal of personal protective equipment before they’re allowed to treat Ebola patients; that supervisors monitor the donning and doffing of protective gear; and that no skin be exposed when protective gear is worn in the presence of Ebola patients.
Also at the hearing, Rep. Mike Turner, R-Ohio, raised concerns about Spencer, the New York Ebola patient, going bowling and not being quarantined after returning from Africa. Turner said the public worries that others being monitored for possible Ebola exposure have “too much contact with the American public and (are) raising the risk to the United States’ citizens.”
On Friday, New Jersey Gov. Chris Christie and New York Gov. Mario Cuomo announced a mandatory quarantine for all health care workers who had direct contact with someone infected with Ebola in Liberia, Sierra Leone or Guinea, the three West African nations where the outbreak is centered.
“The steps New York and New Jersey are taking today will strengthen our safeguards to protect our residents against this disease, and help ensure those that may be infected by Ebola are treated with the highest precautions,” Cuomo said in a statement.
Spencer, who had been purposely limiting his public activities since he returned from Guinea on Oct. 17, isn’t thought to have been contagious during his bowling outing earlier this week because he had no Ebola-like symptoms, only fatigue.
Spencer is helping investigators reconstruct his movements over the past few days. Teams of detectives with the New York City health department are retracing his travels since Tuesday, when the doctor first started feeling sluggish.
That day he visited the Meatball Stop, a restaurant on Greenwich Avenue, and went jogging on the popular High Line elevated park in Manhattan, where he stopped at the Blue Bottle Coffee shop. On Wednesday, Spencer took the subway from Manhattan to Brooklyn and visited a bowling alley.
In his daily briefing, White House press secretary Josh Earnest stressed that Ebola is only transmitted when someone comes in contact with the bodily fluids of an individual who has the symptoms of Ebola.
Earnest said disease protocols are continually being reviewed, but he said the president “would have no qualms about riding the subway in New York or taking a stroll on the High Line . . . or even bowling a few frames at this bowling alley in Brooklyn,” where Spencer visited. “The risk that is facing the average New Yorker, the average person going to those places, remains today exceedingly low.”
As for a mandatory quarantine for people returning from Ebola hot zones, Earnest said those decisions would be “driven by the best scientific advice.”
In a breakfast meeting with reporters on Friday in Washington, Dr. Jim Yong Kim, president of the World Bank, praised Spencer as a “hero,” saying the doctor’s decision to volunteer in West Africa was “exactly what is needed to stop this epidemic.”
Kim, a physician by profession who has taught at the Harvard School of Public Health, has been at the forefront of pushing the global response to the Ebola epidemic. He persuaded the slow-moving World Bank system to approve $400 million to accelerate the medical response in West Africa in just nine days when it was clear that other potential donors weren’t coming forward. Of that, $117 million has been dispersed, he said.
As for Spencer: “I would not be surprised if he goes back,” Kim said.
Lindsay Wise, Lesley Clark, Samantha Ehlinger and Mark Seibel of the Washington Bureau contributed to this report.
©2014 McClatchy Washington Bureau