TIME ebola

Christie and Cuomo Announce Mandatory Ebola Quarantine

Andrew Cuomo, Chris Christie
New York Governor Andrew Cuomo, center, and New Jersey Governor Chris Christie, right, speaks at a news conference, Oct. 24, 2014 in New York. Mark Lennihan—AP

State health department staff will be on the ground at state airports

Healthcare workers returning to New York or New Jersey from treating Ebola patients in West Africa will be placed under a mandatory quarantine, officials announced a day after a Doctors Without Borders MD was diagnosed with the virus in New York City.

N.J. Gov. Chris Christie and N.Y. Gov. Andrew Cuomo made the announcement as part of a broader procedural plan to help protect the densely packed, highly populated area from any further spread of the disease.

“Since taking office, I have erred on the side of caution when it comes to the safety and protection of New Yorkers, and the current situation regarding Ebola will be no different,” Gov. Cuomo said. “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.”

New York and New Jersey state health department staff will be present on the ground at JFK Airport in New York and Newark Liberty Airport in New Jersey. In addition to implementing the mandatory quarantine of health care workers and others who had direct contact with Ebola patients, health department officials in each state will determine whether others should travelers should be hospitalized or quarantined.

The announcement marks a dramatic escalation in measures designed to prevent the spread of Ebola in the United States. Previously, only individuals with symptoms of Ebola would be quarantined upon entry to the U.S. under a federal rule from the Centers for Diseases Control and the Department of Homeland Security.

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

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 Infectious Disease

University of Maryland Confirms Meningitis Cases

The University of Maryland has confirmed an unknown number of meningitis cases among its students.

“There are confirmed and suspected cases of viral meningitis and viral syndromes on campus, and they are being tracked carefully by the University Health Center in partnership with the Prince George’s County Health Department,” University Health Center Director Dr. David McBride said in a statement sent to TIME on Thursday. “We have reached out to the organizations that are primarily affected with information about the condition and what to do in the event that they are feeling unwell.”

Viral meningitis is less severe than bacterial meningitis, but it can still cause stiff necks, nausea and fever. There’s no specific medication for the illness, but most people recover within seven to 10 days. Hospitalization may be necessary in particularly severe cases.

College students are thought to be at a greater risk for viral meningitis than the general population due to the closeness of college life, like sharing cups, living with roommates and eating in dining halls.

TIME Infectious Disease

Amber Vinson’s Family Says She’s Ebola-Free

Amber Vinson Courtesy of the Vinson family

“Officials at Emory University Hospital and the Centers for Disease Control are no longer able to detect the virus in her body,” Vinson's family said in a statement

Amber Vinson, one of two health care workers based out of Dallas who contracted Ebola while caring for Thomas Eric Duncan, is reportedly cleared of the virus.

“Officials at Emory University Hospital and the Centers for Disease Control [and Prevention, or CDC] are no longer able to detect the virus in her body,” her family said in a statement released Wednesday. Vinson is reportedly still under treatment in the Serious Communicable Diseases Unit, but has been approved for transfer from the isolation unit.

Officials at the CDC and Emory University Hospital have not yet confirmed to TIME that Vinson is cleared of the virus, but in a recent image sent to TIME, Vinson can be seen smiling and looking alert.

Vinson’s mother Debra Berry said in a statement that she and the family are “ecstatic to receive this latest report on her condition.”

“We all know that further treatment will be necessary as Amber continues to regain strength, but these latest developments have truly answered prayers and bring our family one step closer to reuniting with her at home,” Berry said.

Vinson, along with Nina Pham, was infected with the deadly virus while caring for the first patient to be diagnosed with Ebola on U.S. soil during the current outbreak. According to the Dallas Morning News, about 108 people in Dallas are being monitored by the CDC for signs of Ebola, though some 66 people have already been cleared.

TIME ebola

Faster Ebola Tests Could Help Stem the Outbreak in West Africa

Liberia Races To Expand Ebola Treatment Facilities, As U.S. Troops Arrive
A health worker in Paynesville, Liberia, carries a girl awaiting her test results John Moore—Getty Images

Better Ebola testing in West Africa would save lives and could help bring an end to the outbreak

The dying at the tin-roofed clinic in the rural Kono district of Sierra Leone comes at a ruthless pace. In the first two weeks of October, 20 out of the 22 patients seeking treatment for Ebola died. That fatality rate, high even by the lethal standards of Ebola, could easily be brought down, says Dan Kelly, an infectious-disease doctor who is currently in Kono with the Wellbody Alliance, a medical nonprofit organisation he set up eight years ago. “The ability to test for Ebola, to test quickly, has become ever more important,” says Kelly, who believes the high death toll in the Kono clinic was due in part to the fact that there is no place to test for Ebola in the entire district. Instead, blood samples from suspected Ebola patients have to be sent to the capital over rutted mud roads that are often washed out by rain. “Even if we have the best treatments available, without a timely diagnosis people are still going to die,” says Kelly.

Work out quickly who does and does not have Ebola and you’ll get a long way toward stopping an outbreak that has killed at least 4,877 and infected thousands more. Right now that simple proposition can feel like a fantasy. In Guinea, Sierra Leone and Liberia, the three countries with the most cases, the need for rapid test results far outpaces the capacity to carry them out.

That means patients often aren’t getting treatment until it’s too late, when the disease has ravaged their bodies beyond repair, and when they may have already infected friends and family. “If patients are promptly diagnosed and receive aggressive supportive care, the great majority, as many as 90%, should survive,” wrote the global health expert Paul Farmer in a recent issue of the London Review of Books.

Even in a top U.S. laboratory it can take up to eight hours to search a blood sample for Ebola through an expensive and complex array of technical hardware and computer software called a polymerase chain reaction (PCR) test. The U.S. Centers for Disease Control and Prevention and the U.S. military have helped by setting up four additional labs in West Africa over the past six months—Liberia now has a total of five, Sierra Leone four and Guinea three—but capacity is still limited to about 100 tests per lab per day, not nearly enough to cope with an epidemic that could grow to 10,000 new cases a week by December, according to the World Health Organization. Laurie Garrett, an expert on Ebola at the Council on Foreign Relations and author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance, says that number could be brought down through better testing. “The only thing that makes a dent when you model what is going on with the epidemic now and what it looks like in two months, is being able to separate the infected from the non-infected.”

Health care workers on the ground say that more PCR labs are urgently needed. “Crushing this epidemic means getting 70% of the population with Ebola into isolation and care,” Kelly says. That could be achieved, he believes, by putting a PCR lab in every district.

The challenges don’t stop there. Testing can create risks even as it offers solutions. Medical personnel must draw blood from patients for a PCR test, a potentially lethal process for caregivers. “Taking samples is extremely dangerous,” says Dr. Estrella Lasry, a tropical medicine adviser in Liberia for Doctors Without Borders (MSF). At any time you risk a needlestick injury that can expose you to the virus.”

And then there’s the risk that patients without Ebola are being exposed to patients with the disease. Lasry estimates that 30% to 50% of people coming into the MSF clinics end up testing negative for Ebola and instead have other illnesses like malaria that have similar early symptoms. All those being tested for Ebola must wait in holding centers for their results, to ensure they don’t have an opportunity to infect others back at home if they test positive. That means patients with other illnesses must wait among patients with Ebola, increasing the chances of transmission.

Kelly hopes researchers can develop a test that could give readings at a clinic immediately and wouldn’t require trained technicians to interpret the results. “It would be a game changer if you could immediately identify patients needing quarantine from those who do not,” he says. Several versions of so-called point-of-care rapid diagnostic tests are already in development, but while some are at the testing stage, it is not clear when they could actually be used on the ground.

One U.S. company, Corgenix, received a $2.9 million grant in June from the National Institutes of Health to perfect its prototype, a pregnancy-test-style slip of paper that reveals a dark red line within 15 minutes when exposed to a drop of Ebola-infected blood. Instead of needles and syringes, test takers need only a pinprick to get the sample, much like an insulin test for diabetes patients. These tests, which would cost anywhere from $2 to $10 (PCR tests average about $100 each) could also be used in airports to confirm whether someone with symptoms has Ebola.

If the Corgenix test had been available, says one of its lead researchers, Robert F. Garry, a professor of microbiology and immunology at Tulane University School of Medicine in New Orleans, it might have helped diagnose Amber Vinson, an American nurse infected with Ebola, before she boarded a flight from Cleveland to Dallas on Oct. 13. “This is a test that could be used anywhere you would want to test for Ebola,” says Garry. “Anyone could use it, and anyone could read it.”

With the epidemic worsening in West Africa, medical staff in Ebola-hit countries can’t afford to wait for companies like Corgenix to bring their product to market. Kelly has been hearing about better, faster tests almost since he started working on Ebola in June. He fears that pinning hopes on future technologies undermines efforts to ramp up testing facilities. “Everyone says they have a new test, but at this point I’m like, ‘Show me the money,’” says Kelly. “ We already have a working technology that is deployable. Get me a PCR in every district capital, and then we can start talking about faster tests.”

Garry says he has people in every U.S. time zone working “as fast as humanly possible” to get the Corgenix test out. “We want to make an impact on this outbreak,” he says. “With enough tests, we can shut it down it down.” Without them, Ebola may be here to stay.

TIME Infectious Disease

There Are Half a Million More Tuberculosis Cases Than Once Believed

INDIA-HEALTH-TB-TREATMENT-MSF FRANCE
An Indian tuberculosis patient rests at the Rajan Babu Tuberculosis Hospital in New Delhi on March 24, 2014. AFP—AFP/Getty Images

The disease killed 1.5 million people last year

Nearly half a million more people have tuberculosis than was previously estimated, the World Health Organization said Wednesday, adding to the 9 million people who developed the disease in 2013.

The epidemic killed 1.5 million people in 2013, including 360,000 people who were HIV positive, according to the WHO. The disease has been declining, however, by a rate of 1.5% per year, while its mortality rates have dropped 45% since 1990.

“Following a concerted effort by countries, by WHO and by multiple partners, investment in national surveys and routine surveillance efforts has substantially increased,” said Dr. Mario Raviglione, director of the WHO’s Global Tuberculosis Program. “This is providing us with much more and better data, bringing us closer and closer to understanding the true burden of tuberculosis.”

The WHO said $8 billion is needed each year to combat the epidemic, but there’s currently a $2 billion annual shortfall.

TIME ebola

Ebola Vaccine Testing Could Start Soon

WHO hopes for clinical trials to begin in January

An Ebola vaccine could begin testing in the next few weeks and be ready for clinical trials in West Africa by January, the World Health Organization announced Tuesday.

Still, questions remain about when the drug may be available for the public at large and how many doses will be available, according to CNN.

“It will be deployed in the form of trials,” said WHO official Marie Paule Kieny, noting the number of available trials would be in the tens of thousands, not millions.

Initial tests will be available in countries like the United States and England before moving to West Africa, CNN reported.

Currently, there is no vaccine for Ebola, which has killed more than 4,500 people, almost entirely in West Africa, in the latest outbreak. Health officials have been working on a vaccine for years, and now have expedited their efforts in the face of the current crisis.

[CNN]

TIME ebola

The Psychology Behind Our Collective Ebola Freak-Out

Airlines and the CDC Oppose Ebola Flight Bans
A protester stands outside the White House asking President Barack Obama to ban flights in effort to stop Ebola on Oct. 17, 2014 in Washington, DC. Olivier Douliery—dpa/Corbis

The almost-zero probability of acquiring Ebola in the U.S. often doesn’t register at a time of mass fear. It’s human nature

In Hazlehurst, Miss., parents pulled their children out of middle school last week after learning that the principal had recently visited southern Africa.

At Syracuse University, a Pulitzer Prize–winning photojournalist who had planned to speak about public health crises was banned from campus after working in Liberia.

An office building in Brecksville, Ohio, closed where almost 1,000 people work over fears that an employee had been exposed to Ebola.

A high school in Oregon canceled a visit from nine students from Africa — even though none of them hailed from countries containing the deadly disease.

All over the U.S., fear of contracting Ebola has prompted a collective, nationwide freak-out. Schools have emptied; businesses have temporarily shuttered; Americans who have merely traveled to Africa are being blackballed.

As the federal government works to contain the deadly disease’s spread under a newly appointed “Ebola czar,” and as others remain quarantined, the actual number of confirmed cases in the U.S. can still be counted on one hand: three. And they’ve all centered on the case of Thomas Eric Duncan, who died Oct. 8 in a Dallas hospital after traveling to Liberia; two nurses who treated him are the only other CDC-confirmed cases in the U.S.

The almost-zero probability of acquiring something like Ebola, given the virus’s very real and terrifying symptoms, often doesn’t register at a time of mass paranoia. Rationality disappears; irrational inclinations take over. It’s human nature, and we’ve been acting this way basically since we found out there were mysterious things out there that could kill us.

“There are documented cases of people misunderstanding and fearing infectious diseases going back through history,” says Andrew Noymer, an associate professor of public health at the University of California at Irvine. “Stigmatization is an old game.”

While there was widespread stigma surrounding diseases like the Black Death in Europe in the 1300s (which killed tens of millions) and more recently tuberculosis in the U.S. (patients’ family members often couldn’t get life-insurance policies, for example), our current overreaction seems more akin to collective responses in the last half of the 20th century to two other diseases: polio and HIV/AIDS.

Concern over polio in the 1950s led to widespread bans on children swimming in lakes and pools after it was discovered that they could catch the virus in the water. Thirty years later, the scare over HIV and AIDS led to many refusing to even get near those believed to have the disease. (Think of the hostile reaction from fellow players over Magic Johnson deciding to play in the 1992 NBA All-Star Game.)

Like the first cases of polio and HIV/AIDS, Ebola is something novel in the U.S. It is uncommon, unknown, its foreign origins alone often leading to fearful reactions. The fatality rate for those who do contract it is incredibly high, and the often gruesome symptoms — including bleeding from the eyes and possible bleeding from the ears, nose and rectum — provoke incredibly strong and often instinctual responses in attempts to avoid it or contain it.

“It hits all the risk-perception hot buttons,” says University of Oregon psychology professor Paul Slovic.

Humans essentially respond to risk in two ways: either through gut feeling or longer gestating, more reflective decisionmaking based on information and analysis. Before the era of Big Data, or data at all, we had to use our gut. Does that look like it’s going to kill us? Then stay away. Is that person ill? Well, probably best to avoid them.

“We didn’t have science and analysis to guide us,” Slovic says. “We just went with our gut feelings, and we survived.”

But even though we know today that things like the flu will likely kill tens of thousands of people this year, or that heart disease is the leading cause of death in the U.S. every year, we’re more likely to spend time worrying about the infinitesimal chances that we’re going to contract a disease that has only affected a handful of people, thanks in part to its frightening outcomes.

“When the consequences are perceived as dreadful, probability goes out the window,” Slovic says. “Our feelings aren’t moderated by the fact that it’s unlikely.”

Slovic compares it to the threat from terrorism, something that is also unlikely to kill us yet its consequences lead to massive amounts of government resources and calls for continued vigilance from the American people.

“Statistics are human beings with the tears dried off,” he says. “We often tend to react much less to the big picture.”

And that overreaction is often counterproductive. Gene Beresin, a Harvard Medical School psychiatry professor, says that fear is causing unnecessary reactions, oftentimes by parents and school officials, and a social rejection of those who in no way could have caught Ebola.

“It’s totally ridiculous to close these schools,” Beresin says. “It’s very difficult to catch. People need to step back, calm down and look at the actual facts, because we do have the capacity to use our rationality to prevent hysterical reactions.”

Read next: Nigeria Is Ebola-Free: Here’s What They Did Right

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