One of our sources called last night to tip us off that a cruise ship would be docking in Galveston on the 19th and that on that cruise ship was a lab worker who had worked with the samples from Ebola Patient Zero up in Dallas.
Now that two healthcare workers in the hospital had come down with symptoms, my source told me, there was consideration being given to sending a helicopter out to bring the exposed lab worker back for closer medical scrutiny.
“Our problem, “ said the source who is a government official, “Is that we don’t want to be the ones responsible for letting 2,000 people who have been exposed off the ship in Galveston Sunday morning.”
As a result, look for high-stake government discussions today and into the weekend on how to best deal with the ship.
While we didn’t put this up as a headline last night (pending second sourcing) that came overnight when ABC and the NY Times reported on the case. The Time’s “Health Worker Who May Have Had Contact With Ebola Is on a Cruise Ship.” provides a few additional details.
So does this early morning press release from the State Department:
As part of the Centers for Disease Control and Prevention’s detailed contact trace investigation conducted in response to the first Ebola case in Dallas, it was discovered that an employee of Texas Health Presbyterian Hospital had departed the United States via a commercial cruise ship on October 12 from Galveston, Texas. The employee did not have direct contact with the since deceased Ebola patient, but may have had contact with clinical specimens collected from him. The individual was out of the country before being notified of CDC’s updated requirements for active monitoring. At the time the hospital employee left the country, CDC was requiring only self-monitoring.
The employee has been self-monitoring, including daily temperature checks, since October 6, and has not had a fever or demonstrated any symptoms of illness. It has been 19 days since the passenger may have processed the since deceased patient’s fluid samples. The cruise line has actively supported CDC’s efforts to speak with the individual, whom the cruise ship’s medical doctor has monitored and confirmed was in good health. Following this examination, the hospital employee and traveling partner have voluntarily remained isolated in a cabin. We are working with the cruise line to safely bring them back to the United States out of an abundance of caution
There are only three cruise ships due to dock in Galveston on the 19th and the Washington Post mentions Carnival by name in its headline. USA Today names the Carnival Magic.
So, as of this morning, there are three main aspects of Ebola to be watching as we head into the weekend:
1. Will local government officials move to prevent the cruise ship from unloading on schedule come Sunday morning? As our unnamed government source told me last night “I don’t want to be the [redacted] that turns 2,000 people loose, if they have been exposed…”
Yes, a tough call indeed, although I think it would be totally cool for Carnival to simply lay on double provisions for the Magic and turn the cruise into a 21-day event and let the people onboard log some additional R&R.
2. The next problem to consider is whether the widely promoted 21-day window is enough. There’s a report out this week on the Natural News site – which often has good healthcare content – that the incubation period (in a small percentage of cases, admittedly) may be as long as 41-days.
Medical sources tell us the highest period of communicability is when the host has reached high levels of the virus and is actively “shedding” but if the onset can be so long, we may have other cases still incubating out of the Dallas incident.
3. Last, but not least, keep an eye on economic impacts and lawsuits on this.
For example, does Frontier airlines have any recourse to CDC if they gave the Dallas nurse the OK to fly because she was subcritical? A good lawyer ought to be able to build a 7 or 8-figure argument that CDC actions may have damaged their prospects. Or, might other airline groups be eying a drop in forward revenue and be looking to legal departments?
It would be predictable.
And similarly, what will happen to the poor lab tech? Will we – in coming months as this case shakes out – see lawsuits coming out of the woodwork for lost revenue?
Our back of the envelope math figures about a 60% chance of two more cases coming to light between now and Tuesday morning. But in the meantime, the condition of the lab tech who went on a cruise will be important to watch, as will government response at the local level down in Galveston.
Organizationally, on the federal side, CDC is an Agency under the Director of Health and Human Services. As Wikipedia notes “The President of the United States appoints the director of the CDC and the appointment does not require Senate confirmation.