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 University Hospital, 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.

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 Being Released After Declared Free of Ebola

Ebola patient and nurse Nina Pham is flown into Frederick Airport and transfered to NIH
Ashley King of Walkersville came out to send a positive message to Nina Pham, a nurse who treated Thomas Duncan, the Liberian man, who died of Ebola, who was flown into Frederick Airport and transferred to NIH to treat her now that she has Ebola October 16, 2014 in Frederick, MD. The Washington Post—The Washington Post/Getty Images

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 will be discharged, the National Institutes of Health said Friday.

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.

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.

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.

 

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.”

TIME ebola

WHO: Millions of Ebola Vaccine Doses Could Be Ready Next Year

Liberia Races To Expand Ebola Treatment Facilities, As U.S. Troops Arrive
U.S. Navy microbiologist Lt. Jimmy Regeimbal handles a vaccine box with blood samples while testing for Ebola at the U.S. Navy mobile laboratory on October 5, 2014 near Gbarnga, Liberia. John Moore—Getty Images

Five new experimental vaccines are expected to undergo testing

Pharmaceutical companies are committed to making millions of doses of Ebola vaccines available next year, the World Health Organization announced Friday.

The United Nations organization said that two vaccines are currently ready for clinical trials and five more experimental vaccines are expected to undergo testing in the first four months of 2015.

The remarks were made by WHO Assistant Director-General for Health Systems and Innovation Dr. Marie-Paule Kieny and publicized on the WHO’s Twitter account. Kieny cautioned that the the vaccines might be “proven not usable” but it’s still “prudent” to prepare a large amount, according to the Twitter account. Over 4,800 people have died from Ebola this year.

If early testing goes well, more advanced trials of the potential Ebola vaccines could take place in the West African countries hardest hit by the Ebola outbreak as soon as December.

TIME ebola

NYC Doctor With Ebola Described As a ‘Dedicated Humanitarian’

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

Friends and colleagues have high praise for Dr. Craig Spencer as he begins a fight for his life

The New York City-based doctor who tested positive for Ebola Thursday after working with virus patients in the West African country of Guinea is a high achiever and a “dedicated humanitarian,” the hospital where he works said in a statement.

Dr. Craig Spencer “is a committed and responsible physician who always puts his patients first,” said a statement from New York Presbyterian/Columbia University Medical Center, where Spencer serves as an emergency room doctor. Before being diagnosed with Ebola, Spencer had been working with humanitarian aid group Doctor’s Without Borders fighting the virus’ outbreak in West Africa.

Spencer, 33, left Guinea, one of the countries hardest hit by the recent Ebola outbreak, on Oct. 14. Spencer returned to the U.S. via New York’s John F. Kennedy International Airport on Oct. 17. He began showing symptoms on Thursday, Oct. 23, when his temperature was recorded at a slightly elevated 100.3 degrees fahrenheit, New York Gov. Andrew Cuomo said Friday morning, clarifying widespread reports Thursday that Duncan’s temperature was above 103 degrees. Ebola can incubate undetected in the body for up to 21 days before an infected person shows symptoms. Ebola patients are not contagious until they show symptoms, and they become increasingly contagious as they get more sick.

Spencer graduated from Baltimore’s Johns Hopkins University, studied Chinese language and literature at Henan University in China, earned a medical degree from Detroit’s Wayne State University School of Medicine and, in 2008, started his residency in New York, becoming a fellow at the Columbia University Medical Center’s International Medicine Program, according to information drawn from his LinkedIn profile by The Wall Street Journal. Spencer’s LinkedIn page has since been taken down.

“He was an outstanding student, humanitarian, excellent physician,” one of Spencer’s professors told the Journal. “He’s done a lot of good international work. He had been to parts of the world—marginalized, disenfranchised—working to improve the human condition.”

According to a friend who met Spencer through the website Couchsurfing, which connects travelers with free places to stay, he’s a runner who plays the banjo and speaks French, Chinese and Spanish.

TIME ebola

The #Ebowla Jokes Need to Stop

Charlotte Alter covers lifestyle, crime, and breaking news for TIME in New York City. Her writing has appeared in The New York Times and The Wall Street Journal.

As New Yorkers joke about catching Ebola from a bowling ball, just imagine how scared Dr. Craig Spencer must be

As soon as New Yorkers learned that Dr. Craig Spencer, a volunteer Doctors Without Borders physician who had recently returned from West Africa, had been diagnosed with Ebola, panic set in. And as soon as people learned that he’d been bowling the night before, that panic appeared to turn to a kind of sick joke. #Ebowla starting making the rounds on Twitter and finally, there was something about Ebola that is kind of funny.

As the alarming details of Dr. Spencer’s New York adventure emerged—a heroic stint caring for the sick in Guinea, a flight home, and then later, a subway ride, a walk along the High Line, a meal at a restaurant, an Uber ride—the fact that he went bowling the night before checking himself into Bellevue Hospital, where he was isolated immediately, was the detail that has captured the collective imagination.

And just as quickly, that fact turned into a deluge of Twitter jokes, each one hoping to be funnier than the next.

One could argue that this was a group-think defense mechanism to distract ourselves from the horror of Ebola’s presence in America’s most populous city. As one tweeter put it:

But somewhere along the line, the tone changed. It stopped being about bowling and started being about Spencer and his character.

This is a guy who signed up to work with Doctors Without Borders, arguably one of the more difficult jobs in the world, to help strangers in one of the most dangerous health zones on the planet. If you found out a United States Marine was playing CandyCrush right before he got blown up by a landmine, would you be laughing then?

Some expressed a similar callousness toward Amber Vinson, the Dallas nurse who contracted Ebola while treating Thomas Eric Duncan and then flew—with approval from the Centers for Disease Control and Prevention—from Cleveland to Dallas.

Do people think Vinson wanted to catch Ebola? Thankfully, Vinson appears to have recovered from the virus, according to NBC.

Some of Spencer’s critics are saying that because he began to feel sluggish on Tuesday, he should have immediately stayed home. These must be people who have themselves never felt a little worn out on a rainy day. Spencer told doctors he was taking his temperature twice a day as a precaution, and he did not yet have a fever on Wednesday, which means he was not symptomatic of Ebola.

Doctors Without Borders said Thursday night that Spencer had followed all recommended protocols for medical workers returning from the afflicted regions. “As long as a returned staff member does not experience any symptoms, normal life can proceed,” the organization said in a statement. “Self-quarantine is neither warranted nor recommended when a person is not displaying Ebola-like symptoms.”

While the Twitterverse is having a good chuckle over #ebowla, Spencer is in an isolation ward. Details of his condition have not yet been released, but it’s easy to imagine his psychological state. He must be terrified. He’s just spent a month watching what Ebola does to afflicted bodies, and now he’s alone, surrounded by hazmat suits, unsure if he’ll ever touch another human being. As Ebola survivor Dr. Kent Brantly wrote in TIME:

“During my own care, I often thought about the patients I had treated. Ebola is a humiliating disease that strips you of your dignity…I finally cried for the first time when I saw my family members through a window and spoke to them over the intercom. I had not been sure I would ever see them again.”

Spencer’s fiancée, Morgan Dixon, is also in isolation at Bellevue. Imagine how she must be feeling. Yesterday was just a normal New York morning, but last night she and her fiancé went to sleep alone, and while it’s too soon to say for sure, there is the risk—and almost certainly, for them, the fear—that they might never see each other again.

So far, every single person, including Spencer, who has been treated for Ebola in the United States became infected because they risked their lives to help others. That’s true of Brantly and the health worker he worked with, Nancy Writebol. It was true of Thomas Eric Duncan, who’d carried a neighbor to the hospital in Liberia, where she was turned away and sent home. And it was true of the two Dallas health care workers who contracted the virus from Duncan before he died.

We should be praising all of them, not mocking them. And as collective fear has morphed into scorn, the response, on Twitter anyway, is without empathy—and is truly embarrassing.

Still, this Ebola joke got it right:

 

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Diet/Nutrition

7 High-Protein Snacks You Can Eat on the Go

Edamame
Getty Images

Protein can help you lose weight because it increases satisfaction

The difference between a snack that has staying power and one that leaves you hungry an hour later? Protein. This nutrient is a hunger-busting powerhouse because it slows digestion and keeps blood sugar steady, and research shows protein helps keep cravings at bay. “Protein can help you lose weight because it increases satisfaction, and when you feel satisfied from your eating plan, you’re better able to stick with it,” says Alexandra Oppenheimer, RD, of Ambitious & Nutritious. But it’s not like you can cook up a chicken breast and eat it in the car, so we’ve rounded up 7 protein-packed snacks that you can take with you anywhere.

Single-serve cottage cheese

Protein: 20 grams per 5-ounce serving

Think Greek yogurt is the be-all-end-all for high-protein dairy snacks? Think again: A single-serving container of nonfat cottage cheese boasts 3 grams more protein than a typical serving of Greek yogurt and is just 110 calories. Plus, it gives you 125 milligrams of bone-building calcium. (Keep in mind, though, it runs high in sodium, supplying 20 to 30% of your daily quota.)

HEALTH.COM: 14 Non-Dairy Foods That Are High in Calcium

Hardboiled egg

Protein: 6 grams per egg

Eggs used to be considered a nutritional no-no due to their high cholesterol content. Today, though, most nutritionists agree that they’re a powerhouse breakfast or snack when enjoyed in moderation. In addition to protein, the humble egg gives you a hearty dose of vitamin D and vitamin B-12 for just 77 calories apiece. Best part: they’re easy to take on the run—just remember to peel them before you go to make eating them on your commute a snap. Even better: some convenience and grocery stores sell hardboiled eggs in packages of two, so they’re a snap to snatch up when traveling.

Watch the video: How to Peel a Hard-Boiled Egg With a Spoon

Peanut butter pack

Protein: 8 grams per 1.15-ounce pack

You probably wouldn’t throw a jar of peanut butter into your handbag, but for convenience and natural portion control, you can carry individual squeeze packs of nut butters, like those from Justin’s, alongside your wallet and mobile phone. A single-serving portion of Justin’s peanut butter contains 190 calories and is made with just peanuts and palm fruit oil—no added sugars here. Smear on a banana to up the antioxidants and fiber, suggests Oppenheimer.

Mini cheeses or string cheese

Protein: 6 to 8 grams per serving

Personal packages of cheese like Mini Babybel wheels or Sargento sticks are great because they’re individually wrapped for easy toss-in-your-purse portability—and they won’t get squished, either. If you’re trying to lose weight, choose one that says “part-skim” on the label, advises New York City registered dietitian Martha McKittrick. “You can still get some satiating fat but will save calories,” she says.

Single-serve oatmeal packets or cups

Protein: About 4 grams per packet or cup

Just add hot water, stir, and you’ve got a warm bowl of protein- and fiber-packed oats in minutes for 150 to 200 calories per serving (depending on which flavor you choose). Quaker, Dr. McDougall’s, N’Joy, and other companies sell single-serving cups of oatmeal, but you could also simply carry a packet with you—you can ask for a cup at any fast-food place or coffee shop. For times you need a little something extra to fill you up, slice a banana into your oats or toss in a few almonds.

HEALTH.COM: The Best Foods to Eat for Breakfast

Edamame

Protein: 8 grams per half cup

In addition to belly-filling protein, a 90-calorie microwave package of edamame (soybeans in their pods) supplies 3 grams of fiber. The combo of protein and fiber is potent against hunger. Got a crunchy craving? You’re in luck: one serving of dry roasted edamame has even more protein: 14 grams.

Roasted chickpeas

Protein: 7 grams per quarter-cup serving

For only 120 calories per serving, these beans offer 5 grams each of protein and fiber. Better yet, a daily serving of dietary pulses like chickpeas (as well as beans, lentils, and peas) can lower LDL cholesterol levels, according to research in the Canadian Medical Association Journal. Make your own by mixing rinsed and drained chickpeas in a bowl with olive oil and your choice of spices (we love chili powder, cumin, salt, and pepper) and then baking them in an oven preheated to 425 degrees for about 45 minutes.

Discover 10 more high-protein snacks at Health.com

TIME ebola

How Ready Is New York City for Ebola?

The city says it's much more prepared for Ebola than Dallas

Doctors Without Borders physician Dr. Craig Spencer tested positive for Ebola on Thursday, Oct. 23, at Bellevue Hospital in New York City, immediately testing the strength of the city’s preparation for the deadly disease.

Given the mistakes made during the first case of diagnosed Ebola in the United States—Thomas Eric Duncan in Dallas—New York City has more fears to quell and also more to prove. Can it do better than Dallas?

Its leaders certainly think so.

New York City has been prepping and drilling its hospitals for the possibility of an Ebola patient since July 28, when it was confirmed that Americans Dr. Kent Brantly and Nancy Writebol had contracted Ebola in Liberia. “I wanted to know that our staff was able to handle [a possible Ebola patient],” says Dr. Marc Napp, senior vice president of medical affairs at Mount Sinai Health System.

“We’ve prepared for a variety of different things in the past: anthrax, H1N1, small pox, 9/11, Hurricane Sandy,” Kenneth Raske, president of the Greater New York Hospital Association (GNYHA) told TIME. “This preparation is not unusual.”

New York City is also one of the first cities to adopt a new system that designates one hospital within a region—Bellevue in this instance—to be the headquarters for Ebola care. If there’s a patient who is a risk, like Spencer, Bellevue will take the patient. Should a potential Ebola case walk into the emergency room of another hospital, those patients can be transferred to Bellevue.

This is not the first time New York officials have responded to a possible Ebola case. In early August, Mount Sinai announced it had a patient with a travel history and symptoms that were a red flag for Ebola. The emergency room isolated the patient and the hospital sent blood for tests to the Centers for Disease Control and Prevention (CDC)—tests that ultimately came back negative.

The city wasn’t as lucky with Spencer, who had been self-monitoring since returning from Liberia. Spencer notified Doctors Without Borders when he ran a temperature on Thursday morning. Staff from New York’s Bellevue hospital were soon at his doorstep in hazmat suits, ready to take him in for treatment to the hospital.

“We were hoping [this] wouldn’t happen but we were realistic,” New York Governor Andrew Cuomo said in a press conference at Bellevue Thursday night. “We can’t say this was an unexpected circumstance.”

Cuomo noted that New York City had the advantage of learning from Dallas’ experience and its mistakes. Texas Presbyterian Hospital failed to diagnose Duncan with Ebola right away, despite his Ebola-like symptoms and the fact he’d been in Liberia.

“The trigger went off again when the nurses got sick in Dallas,” says Mount Sinai’s Napp. New York officials worked closely with the CDC and local health departments as well as with JFK Airport to ensure procedures were in place for identifying people who may be at risk for Ebola at every point of entry to the country. On Oct. 21, the city hosted an Ebola education session that was run by area health experts, with members of the CDC who demonstrated the proper donning and doffing personal protective equipment (PPE). Over 5,000 health care workers and hospital staff members took part.

“As a result of the missteps in Dallas, there were a whole new series of protocols,” says Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City.

There are some challenges—New York has spent time and energy preparing based on now outdated CDC guidelines. The new CDC guidelines for PPEs were only announced on Oct. 20, which doesn’t give the city much time to “practice, practice, practice” them as CDC director Dr. Tom Frieden has suggested.

And New York City has the challenge of sheer size and density. New Yorkers live in very close quarters with one another. Thankfully, Ebola isn’t an airborne disease, so even though Spencer traveled Brooklyn to go bowling, since he wasn’t symptomatic, anyone he might have encountered is at very low risk of contracting the disease.

For now, New York City has just one patient, and it plans to get it right. Doing so might restore American confidence in the system—but failure would be devastating.

Read next: Can You Get Ebola From Subway Poles and Bowling Balls?

TIME ebola

Can You Get Ebola From Subway Poles and Bowling Balls?

New York City Subway System
Getty Images

Lots and lots of research says no

Concerns were raised Thursday that the New York City doctor Craig Spencer, MD, who has been diagnosed with Ebola, had been to a Brooklyn bowling alley, had ridden the subway, and been inside an Uber taxi.

So, can you get Ebola from bowling balls or subway poles, or Uber doorhandles for that matter?

The short—and accurate—answer is no, and that’s based on what scientists know after decades of studying Ebola. Spencer was not symptomatic at the time, according to reports, which means he was not contagious at the time.

But, you may ask again, shouldn’t people who rode on the same train, in the same taxi or who touched the same bowling balls as Spencer, worry a little?

The research that exists says, again, no. The virus only survives inside bodily fluid of an infected person—meaning their blood, sweat, vomit or feces—that then comes into contact with an open sore or the mucus membranes of another person.

Data suggests the virus can, in theory, survive on surfaces if it’s inside a liquid. But the only confirmed case of a person getting Ebola from an object or material that can carry infection was during an Ebola outbreak more than a decade ago in Gulu, Uganda, when a patient got the disease by sleeping with a blanket that had been used by an Ebola patient. Based on what we know about transmission of the virus, that blanket must have had an infected person’s wet bodily fluids on it.

A study from 2007 by researchers at the Tulane School of Public Health and Tropical Medicine sampled 31 objects and surfaces that were not visibly bloody—they looked at bed frames, stethoscopes, etc—inside an isolation ward that treated Ebola patients. All specimens tested negative for the virus, suggesting the risk of transmission from surfaces was extremely low.

Read next: How Ready Is New York City for Ebola?

TIME ebola

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

A doctor diagnosed in New York City raises public health questions in one of the world's most densely populated urban areas

Dr. Craig Spencer, 33, of New York was diagnosed with Ebola Thursday night after he was isolated at Bellevue Hospital. Before he was rushed to Bellevue in Manhattan earlier Thursday afternoon, the Medecins Sans Frontiers (MSF) MD took a subway to Brooklyn on Wednesday night where he spent a few hours at a bowling alley, and then took an Uber car back home. Health officials say that he was not symptomatic—and therefore not contagious—at the time. The next morning, he took his temperature and reported that it was 103F, and immediately reported it to MSF, which then notified the state and city health departments. (New York Gov. Andrew Cuomo said Friday morning the doctor’s temperature had been 100.3F, not 103F as previously reported.)

The diagnosis has raised concerns about how quickly Ebola could spread in a city as densely packed and populated as New York. But in a late night press conference, the mayor and governor of New York, as well as the city and state health commissioners were quick to assure the public that New York was prepared for such a case, and that everything had gone according to plan in identifying, isolating and bringing Spencer to Bellevue. “We are as ready as one could be for this circumstance,” said Cuomo. “What happened in Dallas was the exact opposite. Dallas unfortunately was caught before they could really prepare, before they knew what they were dealing with. We had the advantage of learning from the Dallas experience.”

President Barack Obama meanwhile spoke on the phone Thursday night with Cuomo and, separately, with New York City Mayor Bill de Blasio, offering any additional federal support necessary in terms of patient care, the maintenance of safety protocols for healthcare workers, and the identifying of any of Spencer’s contacts who might be at risk of exposure.

The public has been assured that riders of the subway, and even residents of Spencer’s apartment building, are at very low risk of getting infected. “There is no reason for New Yorkers to be alarmed,” said de Blasio. “Ebola is an extremely hard disease to contract.”

As sobering as the Dallas experience was for that city, widespread cases in New York are unlikely, they said, because Spencer was asymptomatic when he was in public places, and because Ebola is only spread from person-to-person when two conditions are met.

First, the infected person must be symptomatic, meaning he has a fever, is feeling nauseous, has a headache or is otherwise feeling ill; and there must be direct contact with his body fluids — saliva, sweat, blood, urine, vomit or feces — at this time with another person’s mucous membranes such as in the eyes, nose or mouth, or with an open wound.

City health commissioner Dr. Mary Travis Bassett said that Spencer had gone for a three mile jog, and that the night he visited the bowling alley, also strolled along an outdoor area in downtown Manhattan where he ate at a restaurant. He was taking his temperature twice a day since leaving from Guinea on Oct. 14 and did not have a fever until the morning of Oct. 23, the night after he visited the bowling alley and after his other excursions. Bassett said that since Spencer was a doctor and fully aware of his risk of having been infected with Ebola, he had been limiting his contact with others since arriving back in the U.S. once Oct. 17.

And because Spencer was alone in his apartment when he began feeling ill, with a fever and some gastrointestinal problems, the number of people who may have had direct contact with him when he started becoming contagious is small. New York City health officials said on Thursday that Spencer’s fiancee was in isolation at a hospital, two of his friends and the driver of the Uber car he rode were being monitored.

On Thursday night, Uber issued a statement saying they had confirmed with both CDC and New York health officials that “neither our driver partner nor any of his subsequent passengers are at risk.” The statement added, “Our thoughts are with the patient and his loved ones.”

Spencer’s apartment is cordoned off, and officials will likely sterilize or incinerate all of its contents, as they did with the apartment in which Dallas Ebola patient Thomas Eric Duncan lived, and with the apartment of Nina Pham, one of the nurses whom Duncan infected.

New York State has designated eight hospitals to care for Ebola patients, including Bellevue. While all 200 are prepared to isolate and initially handle anyone who might come in with suspected Ebola, if they test positive they will be transferred to one of the eight hospitals that are designed to treat patients with staff that has drilled in the proper protocols for protective equipment and handling and removal of waste. At Bellevue, for example, the lab for testing blood samples is contained within the isolation unit so samples from infected patients are not mingled with those of other patients.

Given the mistakes made in Dallas, in which one patient infected with Ebola transmitted the virus to two health care workers, New York City is on alert. However, in a press conference late Thursday night, Mayor Bill de Blasio assured the city that Bellevue had been drilling for this possibility for months.

With additional reporting by Zeke Miller

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