TIME ebola

Obama Hugs Nurse Who Survived Ebola

President Barack Obama hugs nurse Nina Pham, who was declared free of the Ebola virus after contracting the disease while caring for a Liberian patient in Texas, during a meeting in the Oval Office in Washington on Oct. 24, 2014.
President Barack Obama hugs nurse Nina Pham, who was declared free of the Ebola virus after contracting the disease while caring for a Liberian patient in Texas, during a meeting in the Oval Office in Washington on Oct. 24, 2014. Saul Loeb—AFP/Getty Images

The nurse was cleared of Ebola Friday morning

A few days ago, Dallas nurse Nina Pham lay in bed in an isolated hospital room at National Institutes of Health (NIH) where her doctors donned hazmat suits to care for her. On Friday, President Barack Obama hugged Pham, now free of Ebola, in the open air of the Oval Office.

“Let’s give a hug for the cameras,” he told Pham.

Health and Human Services Secretary Sylvia Burwell, NIH infectious disease head Anthony Fauci, along with several other doctors and family members, were also present at the Friday meeting.

Pham contracted Ebola while caring for Thomas Eric Duncan, the first person diagnosed with Ebola in the United States, who died Oct. 8 at Texas Health Presbyterian Hospital in Dallas. Pham was subsequently moved to NIH in Maryland to undergo treatment, and was declared Ebola-free Friday morning.

After a patient was diagnosed with Ebola in New York City on Thursday, the hug was a triumphant moment amid continued fear over the potential for Ebola to spread in the U.S. White House Press Secretary Josh Earnest told journalists at press briefing Friday that Pham’s recovery served as “a pretty apt reminder that we do have the best medical infrastructure in the world.”

TIME ebola

Mali Hopes Rapid Response to First Ebola Case Will Limit Spread

Electron micrograph of Ebola virus
NIAID/EPA

Two-year-old girl from Guinea tested positive on Oct. 23

Mali became the sixth country in West Africa to be hit by the regional Ebola outbreak after reporting its first case on Thursday. Health Minister Ousmane Kone told state television that a two-year-old girl had traveled from neighboring Guinea, where more than 900 people have died in an outbreak that has killed nearly 4,900 and infected more than 9,900 others. The girl was admitted to a hospital in the western town of Kayes on Wednesday night, where she tested positive for Ebola.

Health officials told the World Health Organization (WHO), according to a report released Friday, that the child was accompanied to Mali by her grandmother. The girl’s mother was reported to have died a few weeks earlier, but WHO could not yet confirm that the grandmother went to Kissidougou, in southern Guinea, for the funeral. The pair returned to Mali by public transportation and arrived in the capital, Bamako, where they stayed for two hours before moving on to Kayes.

The girl had begun bleeding from the nose before she left Guinea, the report found, “meaning that the child was symptomatic during their travels through Mali” and that “multiple opportunities for exposure occurred when the child was visibly symptomatic.” The initial investigation identified 43 close and unprotected contacts, including 10 health workers.

The Ministry of Health and Public Hygiene said in a statement it had “taken all necessary steps to prevent the spread of the virus” and the government called for calm, claiming it had identified and isolated those who had contact with the child and begun monitoring for symptoms. Tracing this particular case is “a work-in-progress,” Isabelle Nuttall, the WHO’s director of Global Capacities, Alert and Response, tells TIME. WHO had already sent a team of 10 to Mali at the beginning of the week to work on mobilization activities and preparedness operations, and is sending more as part of a rapid response team.

Mali still has its border open to travelers from Guinea, though border checkpoints and health points have been implemented on major roads and crossings. Greg Rose, health advisor to the British Red Cross, says the fact that the child is now “in a more remote location is a good thing” because Kayes is not situated on the main transport routes (unlike larger towns situated on the Niger River) and only has a population of around 127,000, a fraction of Bamako’s 1.8 million. Another positive, Rose says, is that “it doesn’t look like the situation from where this child has come is out of control,” which could reduce the risk of transmission. He adds that Kissidougou, where the child’s mother is believed to have died, has seen relatively few cases since the beginning of the epidemic and is now the site of a treatment center.

Rose believes that being able to isolate people who are asymptomatic will prove a major advantage for Mali. Since the government has reacted very quickly and identified this case early, he adds, it will be able to do much more to contain any spread of Ebola from this sole case. In comparison, “when you have a disseminated outbreak like in Guinea, Liberia or Sierra Leone, where resources are limited, they can only isolate symptomatic people.”

Nuttall believes it is still too premature to assess the effectiveness of Mali’s public health response. But “so far, it looks good,” Rose says. “If you look back to Guinea when the outbreak first began in January of this year, nothing was being done because everybody was taken by surprise,” he adds. “Experience of Ebola in other contexts had shown that Ebola outbreaks tend to burn out so Guinea was neglected, which is why this got out of hand.”

While experts believe Mali’s health system is stronger than some of its neighbors, it is still quite weak. “In this part of Africa, as a general rule, the health system needs to be strengthened,” Nuttall says. Maternal mortality ratio, which Rose says is a solid indicator of public health infrastructure because it depends so much on the provision of health services and skilled attendants, is at 550 deaths per 100,000 live births in Mali. That figure isn’t as high as other countries affected by Ebola — Liberia stands at 640, Guinea at 650 and Sierra Leone at 1,100 — but is still remarkably high when compared with the U.S. (28 per 100,000) and the U.K., at just eight.

As the situations in Nigeria and Senegal have shown — both were recently declared Ebola-free — it is possible to contain the virus and control the epidemic. But as more cases pop up in the three hardest-hit countries and with the first Ebola diagnosis in New York City, controlling anxiety and fear alongside any actual spread could be a feat.

TIME ebola

Hazmat Suit Maker’s Stock Prices Surge on Ebola News

Lakeland Industries stock surged nearly 25% Thursday

Shares in hazmat suit manufacturer Lakeland Industries surged nearly 25% Thursday following news of New York City’s first Ebola patient. While a Friday decline subsequently cut those gains in half, that still left the company worth more than twice as much as it had been worth at the beginning of the year.

The protective equipment industry is just one of many that has been affected by this year’s Ebola outbreak. Airlines and manufacturers of other Ebola-related products, including experimental treatments, have experienced enormous market volatility as the path of the disease continues to evolve.

Shares in Tekmira Pharmaceuticals, which is developing an experimental Ebola drug, are up nearly 140% this year, but the gains have not been consistent and have at times met with dramatic declines.

Other stocks to watch include Amgen and Johnson & Johnson. Both pharmaceutical companies announced recently that they would work on treatments for the disease.

TIME ebola

NYC Officials Trace Ebola Patient’s Steps as Mayor Urges Calm

Three others have been quarantined

As health officials work to clear anyone who may have come into contact with New York City’s first Ebola patient, Mayor Bill DeBlasio reassured residents that the city is prepared to treat Ebola patients and is not at risk of a widespread Ebola outbreak.

“New Yorkers who have not been exposed to an infected person’s bodily fluids are simply not at risk,” said DeBlasio at a Friday press conference. “We’ve had clear and strong protocols from the beginning, and they have been followed to the letter.”

Health officials are currently contacting everyone Ebola patient Craig Spencer may have come into contact with since Tuesday morning “in an abundance of caution,” according to New York City Health Commissioner Mary Travis Bassett. Spencer, a doctor who returned from Guinea on Oct. 17, was diagnosed with Ebola Thursday.

Spencer’s fiancee, along with two friends, has been quarantined and restricted from public spaces. Gutter and Blue Bottle, a bowling alley and coffee shop visited by the patient, have been cleared and reopened, and a third establishment, the Meatball Shop, is closed temporarily but is expected to be cleared.


A Metropolitan Transportation Authority official told TIME that the city’s subway system is safe to ride, but noted that protocols had been updated to ensure safe handling of any potentially infectious waste. Spencer reportedly rode the subway from his home in Harlem to Brooklyn Wednesday.

Spencer is being treated in an isolation unit at New York’s Bellevue Hospital. He is in stable condition and communicating with friends via cell phone, officials said.

–additional reporting by Alice Park

TIME ebola

How to Talk to Your Kids About Ebola

Electron micrograph of Ebola virus
NIAID/EPA

Here's the best way to calm kids' fear and anxiety over Ebola

Even Centers for Disease Control and Prevention director Dr. Tom Frieden admits it: “Ebola is scary.” But for kids seeing alarming headlines without understanding the context of the disease, Ebola can seem like a looming and personal threat.

TIME spoke to Dawn Huebner, a clinical child psychologist and author of the book What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety about the best way to talk about Ebola with your kids—without scaring them silly.

What should I say to my child who is really scared about Ebola?
Let them know that it’s important to think about proximity—how close they themselves are to the virus. Which is to say: not very. “It’s really important to underline that we are safe in the United States, and that people who have contracted Ebola have been in West Africa or were treating patients with Ebola,” says Huebner. “Not only should parents underline how rare Ebola is, and how far away the epidemic is occurring, but also how hard the disease is to contract.” Huebner says parents can tell their older children that direct contact with an infected person’s bodily fluids like vomit or diarrhea is necessary to spread Ebola. “This has been reassuring to the children I see, as they know they are not going to be touching that,” she says.

By ages 7 and up, kids begin to grasp that their worries and fears aren’t always rational. “Parents can talk to kids about how one of the ways worries and anxiety get their power is by making us think about things that are very unlikely,” says Huebner.

Should I keep my child away from the news?
Your kids can watch the news to stay informed, but media overload is not always a good thing. “The news is often sensationalized and gives kids the idea that they are at an imminent risk,” says Huebner. When kids see endless stories about Ebola on the news, they don’t always realize they’re hearing the same thing on loop. “I’ve had kids come into my office who are under the impression that there are hundreds of people in the U.S. with Ebola.”

How do I know if my child is reacting appropriately to the news?
“An appropriate reaction would be to feel nervous and ask some questions, but to be reassured by the parents’ answers,” says Huebner. Psychologists distinguish between questions that are information-gathering, and questions that are reassurance-seeking. If a child asks reassurance-seeking questions—like “Are we going to be ok?”—once or twice, that’s normal. But asking the same questions over and over signifies that a child is really dealing with anxiety and that their concern is not being curbed. At that point, parents may need to sit their children down for a longer conversation to address their fears and concerns.

My kids don’t want to fly on an airplane over the holidays. How do I convince them they are safe?
It’s important to emphasize that the vacation destination is one that is safe, and not at great risk for Ebola. Parents can also stress that no one in the United States has yet contracted Ebola from a plane ride. However, parents should avoid making comparisons, like “It’s more likely to get in a car crash than to get Ebola.” That will only stress a child out more.

Ebola freaks me out too, and I accidentally overreacted in front of my child. How do I fix this?
“One of the wonderful things about children is that you really can revisit things that didn’t go so well the first time,” says Huebner. If parents slip up with an overreaction, they should have a conversation with their children and reference the moment. She suggests a conversation opener like this one: “I was thinking about when you overheard me on the phone with my friend. I was really overreacting. I got nervous when I heard about Ebola, and you saw me when I was nervous. Now I’ve gotten information and I’ve calmed down, and I’ve realized this is a very sad thing that’s happening far away. It’s sad, but it doesn’t have to be scary for us.” Rational, calm conversations will help ease a child’s fears about Ebola.

TIME ebola

Ebola: World Bank Chief Calls for Health Workers in West Africa

World Bank President Dr. Jim Kim speaks to reporters in Washington about Ebola on Oct. 24 Michael Bonfigli—The Christian Science Monitor

Says thousands needed to stop the spread of Ebola

The global health community needs “thousands” more health-care workers in West Africa to tame the Ebola virus epidemic that has so far killed nearly 5,000 people, the president of the World Bank told reporters Friday.

Dr. Jim Yong Kim, chief of the international financial institution, said a lack of trained medical personnel in Guinea, Liberia and Sierra Leone is one of the main challenges hampering the international effort to control an outbreak that has ravaged three West African countries and risks spreading to its neighbors.

Kim said the global community has stepped up its response to Ebola, but conceded that the World Bank, like other international organizations, was late to recognize the severity of the epidemic. The spread of the virus in the three stricken nations at the heart of the epidemic has left healthcare workers in triage mode. As a result, they are often unable to use “the ideal techniques” for combating an epidemic, such as contact tracing—the process of identifying and isolating the contacts of infected patients.

“We are now on a war footing,” Kim said, “but it took us a long time to get there.”

Kim said that international organizations have ratcheted up levels of support to West Africa after a sluggish start, but said more must be done. “We’ve got to get beyond these sort of nihilists notions that nothing can be done,” he said. The World Bank has pumped $400 million into West Africa to fight Ebola.

Kim praised Dr. Craig Spencer, the physician who was diagnosed with Ebola Thursday night in New York City. Spencer contracted the virus while treating Ebola patients in Guinea as a volunteer for the international organization Doctors Without Borders, or Medicins Sans Frontieres.

“Dr. Spencer is a hero,” Kim said, urging more doctors to follow his lead and fight the epidemic at its source. He added that both the patient and city officials executed a textbook response to Spencer’s symptoms.

Kim said he hoped that the cases in Dallas and New York would help open the eyes of the world to a disease gutting large swaths of West Africa and prompt the global community to spring into action more quickly in the future. “I think this is a wakeup call,” he said, pausing slightly. “I hope this is a wakeup call.”

TIME ebola

Doctors Without Borders Responds to New York Ebola Case

Doctor Quarantined At NYC's Bellevue Hospital After Showing Symptoms Of Ebola
A New York City Police officer stands at the entrance to Bellevue Hospital October 23, 2014 in New York City. Bryan Thomas—Getty Images

"Extremely strict procedures are in place"

Doctors Without Borders/Medecins Sans Frontieres (MSF) confirmed Friday that one its staff members tested positive for Ebola in New York City this week. While the patient’s identity, Dr. Craig Spencer, has been made public, MSF declined to provide further details about his him, citing privacy reasons.

Spencer had recently returned from Guinea, where he was part of the humanitarian aid group’s efforts to treat the Ebola epidemic there. MSF had strict procedures requiring members returning from Ebola-stricken areas to monitor themselves by taking their temperature twice a day for potential signs of a fever, an early sign of the virus. When Spencer found his temperature was high on Thursday morning, he immediately called MSF, which then contacted the New York City Department of Health & Mental Hygiene.

MORE: Ebola in New York: How Worried Should the City Be?

“Extremely strict procedures are in place for staff dispatched to Ebola affected countries before, during, and after their assignments,” Sophie Delaunay, executive director of MSF said in a statement. “Despite the strict protocols, risk cannot be completely eliminated. However, close post-assignment monitoring allows for early detection of cases and for swift isolation and medical management.”

According to the group, three MSF members and 21 locally employed staff have been infected with Ebola; thirteen have died. MSF has 3,000 employees working in West Africa to treat Ebola patients; more than 700 international staff from around the world have spent varying amounts of time in the region battling the epidemic.

TIME ebola

Does Insurance Cover Ebola Care?

Your chances of getting Ebola in the U.S. are very slim. But if you do, who's footing the bill?

Ebola care is pricey, with estimates ranging from $5,000 to $25,000 per day, according to several health care analysts and experts who spoke to TIME. Some patients will end up spending weeks at a hospital, racking up a bill of $500,000 or more. That includes everything from paying the medical staff to disposing of waste, to the cost of resources like protective gear.

“The cost of treating a patient is going to vary vastly from hospital to hospital, [starting with] length of stay,” says Andrew Fitch, a health-care pricing expert at NerdWallet. “A patient treated in Dallas was only hospitalized for two weeks while another was treated for six weeks. The cost of dialysis and IV fluids is going to add up pretty fast and that is going to be compounded by the cost of isolation.”

So who foots the bill?

If you have insurance in the U.S., your insurer is likely going to cover the costs under emergency and/or inpatient care coverage. Even though patients with Ebola often first present in the emergency room, the disease is typically intensive and can last for several weeks. Major insurance providers TIME spoke to said they would cover Ebola treatment—but bear in mind that coverage starts after a person has met his or her deductible, which can be upwards of $13,000 for some family plans and $6,000 for an individual plan, says Jeffrey Rice, CEO
of Healthcare BlueBook, a Tennessee company that calculates health-care prices for consumers.

Dr. Craig Spencer, the Ebola patient in New York City, has health insurance coverage through Doctors Without Borders. Missionaries like Dr. Kent Brantly, Dr. Richard Sacra and Nancy Writebol have insurance through their missionary groups. Nebraska Medical Center, which has treated two patients with Ebola, including Sacra and NBC freelancer Ashoka Mukpo, says all of its patients’ care has so far been covered by their insurance providers.

But what if you don’t have health insurance?

Despite numerous requests from TIME to Texas Health Presbyterian Hospital in Dallas, the hospital did not confirmed how the uninsured Liberian patient Thomas Eric Duncan’s care was paid for. Analysts believe it’s unlikely that Duncan’s family will be dealt a hefty bill given how high-profile the case was and the mistakes made by the hospital.

Nebraska Medical Center says it would go about treating an uninsured patient with Ebola the same way that it would treat any patient who comes into their emergency room without insurance. They are federally obligated to treat the patient, and then the patients who cannot pay for their care can apply for financial aid and become part of the hospital’s charitable care program. “We provide millions of dollars worth of this kind of care yearly,” a Nebraska hospital spokesperson told TIME.

What if you get sent to a hospital that’s out of network?

Being treated at out-of-network hospital or by an out-of-network doctor could, in theory, result in a hefty bill. Getting out-of-network treatment covered by your insurance company is decided on a case-by-case basis based on medical necessity. While insurers have the legal right to refuse to cover this type of treatment, says Sabrina Corlette of the Center on Health Insurance Reforms at Georgetown University, it’s highly unlikely that they would sack the patient with the bill.

If your stuff needs to be incinerated, does insurance cover that?

One of the surefire ways to get rid of any lingering virus within an Ebola patient’s home is to incinerate their belongings. But do they get reimbursed? Most likely. If a government body or medical professional recommends or requires the destruction of property as a preventative measure in the spread of the virus, the value of the destroyed items would most likely be covered at the cost to replace them, or at depreciated value under a home, business or renters policy, says Amy Bach, executive director of United Policyholders.

Does insurance cover experimental drugs?

No, but that’s because there’s typically no cost involved at all when a drug is still in research and development.

 

TIME ebola

Dallas Nurse Released After Declared Free of Ebola

Pham is Ebola-free

A Dallas nurse who was infected with Ebola while treating a patient with the disease is free of the virus and has been discharged, the National Institutes of Health said Friday. Pham will head home to Texas Friday after first meeting with President Barack Obama, according to the President’s schedule.

Nina Pham was admitted to the National Institutes of Health Clinical Center in Bethesda, Maryland on Oct. 16 and has made a speedy recovery. She fell ill while caring for Thomas Eric Duncan, a Liberian man who was diagnosed with Ebola in Dallas and died of the disease Oct. 8. “We think of the National Institutes of Health as National Institutes of Hope, and hope went up a notch,” said NIH director Francis Collins in a press conference introducing Pham Friday.

Pham said at that conference she felt “fortunate and blessed” to be Ebola-free. She’s now heading back to Texas to return to a normal life and spend time with her dog, who has also been declared free of the virus. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), said they confirmed Pham’s health five times, calling Pham “an extraordinarily courageous and lovely person.”

The treatment unit in which Pham was treated was built in 2011 as part of a bioterrorism preparation plan. The seven-bed unit is designed to care for patients with serious communicable diseases and has a staff of 50 to 60 highly-trained infectious disease experts and health care workers. The unit has special ventilation systems and waste disposal systems.

Pham received donated plasma from fellow Ebola survivor Dr. Kent Brantly, but it’s unclear how much of an impact that had on her recovery. Pham has asked for privacy for herself and her family.

News of Pham’s impending release comes just hours after Bellevue Hospital in New York City confirmed it’s treating that city’s first case of the Ebola virus.

Emory University Hospital also announced on Friday that another Dallas nurse battling Ebola, Amber Vinson, no longer has the virus in her blood, though she will remain in the hospital for supportive care.

TIME Sex/Relationships

Manly Men Are Not Always the Best Choice, Study Says

It’s a Hollywood stereotype: Men prefer to partner up with feminine-looking women, and women favor masculine men. But even when you allow for same-gender couples and variations in personal preference, plenty of research suggests that the proposition is generally true. “It’s been replicated many times across different cultures,” says Isabel Scott, a psychologist at Brunel University in Uxbridge, on the outskirts of London, “so people tend to assume it’s universal.” A new study in Proceedings of the National Academy of Sciences challenges that thinking, however.

Historically, human studies have shown that women with more feminine faces tend to have higher estrogen levels, which are in turn associated with reproductive health. In men, the argument is that masculine-looking faces are associated with stronger immune systems—always a good thing in a mate, especially if that trait is passed on to the kids. Masculine appearance may also a sign of a dominant and aggressive personality, but our distant female ancestors might plausibly have gravitated toward these men anyway, for the sake of their children’s health.

These theories fall under the rubric of evolutionary psychology—the idea that many of our fundamental behaviors have evolved, just as our bodies did, to maximize reproductive success. But as in many cases with evolutionary psychology, it’s easier to come up with a plausible explanation than to demonstrate that it’s correct. In this case, says Scott, “the assumptions people were making weren’t crazy. They just weren’t fully tested.”

To correct that, Scott and the 21 colleagues who put together the new study used computer simulations to merge photos of men’s and women’s faces into composite, “average” faces of five different ethnicities. Then they twirled some virtual dials to make more and less masculine-looking male faces and more or less feminine female versions. (“More masculine” in this case means that they calculated the specific differences between the average man’s face and the average woman’s for each ethnicity, then exaggerated the differences. “Less masculine” means they minimized the differences. Same goes, in reverse, for the women’s faces.)

Then they showed the images to city-dwellers in several countries and also to rural populations in Malaysia, Fiji, Ecuador, Central America, Central Asia and more—a total of 962 subjects. “We asked, ‘What face is the most attractive’ and ‘What face is the most aggressive looking,'” says Scott.

The answers from urban subjects more or less confirmed the scientists’ expectations, but the others were all over the place. “This came as a big surprise to us,” Scott says. “In South America,” for example, “women preferred feminine-looking men. It was quite unexpected.”

If these preferences had an evolutionary basis, you’d expect them to be strongest in societies most similar to the ones early humans lived in. “These are clearly modern preferences, though,” Scott says, which raises the question of why they arose.

One idea, which she calls “extremely speculative at this point,” is that when you pack lots of people together, as you do in a city, stereotyping of facial characteristics might be a way of making snap judgements. “In urban settings,” she says, “you encounter far more strangers, so you have a stronger motive to figure out their personalities on zero acquaintance.”

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