Thomas Eric Duncan. Image credit: The Daily Mail
Nothing makes a medical type, or even an ex-medical type like me, madder than hearing officials sprout total bullshit regarding diseases.We are being told that Thomas Eric Duncan, the gentleman ensconced in an isolation unit it Dallas, only had contact with a dozen or so people since he arrived in the United States.
Rubbish. Total garbage. The official version of him not being sick before he arrived in the US actually increases the likelihood of having far more contacts than is being stated.
Let’s break this down:
- Thomas Duncan arrived in the United States on September 20th after leaving Liberia on September 19th.
- SIX DAYS later on September 26th he takes himself to the hospital saying he feels unwell. He is sent home with antibiotics
- TWO DAYS later, on September 28th he returns to the hospital and is considered an Ebola risk and put into isolation.
Right, a few facts:
- ALL body fluids are infective after the symptoms start to show. Not just the faeces, vomit and blood officials keep telling us about. Sweat, seamen and tears are all body fluids.
- Visible symptoms, as in ‘Ebola is not infectious until symptoms the show’ is variable from person to person. A mild sore throat to one person may feel like a cactus stuck in their neck to another. This not only dictates how fast a person seeks medical assistance for the problem, but if the patient perceives there to actually BE a problem in the first place.
- Taking temperatures as a means of detecting a person has Ebola is akin to checking a lottery ticket before the draw and declaring it a winner! This is a ‘look, we are being proactive ‘PR thing. Having no fever now does not mean you will be fever free tomorrow, or even two hours after the ‘test’. In addition, fever is often not the first sign of a person carrying Ebola. Sore throat, feeling a bit ‘fluey’, and generally aching a bit usually precedes the acute (rapid) onset of fever that is so beloved by officialdom.
- The mean onset time of Ebola symptoms in the Liberian outbreak, where we can assume Thomas Duncan contracted the disease is 9 days. Minimum is 2 days, maximum 21 days, though by far the vast majority of people in the Liberian outbreak have started to show symptoms around the 9 day mark.
- We have no way of knowing if Thomas Duncan is an average patient, but we can assume he did not contract Ebola on US soil. So counting back from September 26th, when he first sought medical help, we can arrive at the date of 5th of September as the earliest date he could have become infected. we also have no way of knowing if he was having symptoms that were minor enough that he didn’t seek help. UPDATE: The Liberian government has stated that Mr Duncan had direct contact with an Ebola victim in Monrovia on September 15th. (source)
- We have to question why he left Liberia at this particular time. Is he an American returning home? A dual citizen? A Liberian visiting friends and family ? If it was the latter did he know he had been exposed and know his chances of survival were higher in the United States? UPDATE: Liberian government have confirmed Thomas Eric Duncan is a Liberian resident living in Monrovia. (source)
So Thomas Duncan arrives on a plane full of people, travelling from Liberia via Brussels, he seems well. He makes his way from the airport to his family…in a cab? Is he picked up by relatives or a friend? Does he use public transport? It doesn’t matter if he was not infective at that point, but nobody can be sure can they?
So he travels to his destination, one would assume he is meeting with family members and friends during this period. We know for sure he had contact with five school children, those kids attend four different schools so we can assume they are not all from one family. Families tend to put kids in the same schools. So there will have been a few parents of those kids around.
Did all these meetings take place at home? did they eat out, go to a movie? Go to the shopping mall? Did he stay indoors for the entire six days until he first attended the hospital?
When he did first attend the hospital one would assume that the place was not empty. There would have been other patients around, probably with relatives. Staff would be milling about. He would have had to check in at reception, a nurse would have spoken to him. He was prescribed antibiotics, where was the prescription filled out? He was infective during this period, and most likely a day or two before. Nobody goes to the hospital immediately unless they know a situation is life or limb threatening do they? Did he know or did he assume he was just a little unwell and wait? Who else did he interact with during this time period?
He returns home. By car, bus or train or on foot? Was he feverish and sweating? Did he vomit?
For the next two days he is at home, who visited that home?
Finally, an ambulance is called and he is taken back to the hospital. There would have been direct contact with the emergency team that attended to collect him, and the emergency team at the hospital. Those two groups of people alone amount to more than a dozen.
Whilst writing this article new details have emerged. Thomas Duncan shared a house in Monrovia with the Williams family. On September 15th he helped move a stricken woman to the hospital. He was in the cab with her. She was turned away from the hospital and returned home, helped from the cab by Duncan and her brother and father.
“He was holding her by the legs, the pa was holding her arms and Sonny Boy was holding her back,” said Arren Seyou, 31, who witnessed the scene and occupies the room next to Mr. Duncan’s.
Sonny Boy, 21, also started getting sick about a week ago, his family said, around the same time that Mr. Duncan first started showing symptoms. (my emphasis)
In a sign of how furiously the disease can spread, an ambulance had come to their house on Wednesday to pick up Sonny Boy. Another ambulance picked up a woman and her daughter from the same area, and a team of body collectors came to retrieve the body of yet another woman — all four appeared to have been infected in a chain reaction started by Marthalene Williams.
A few minutes after the ambulance left, the parents got a call telling them that Sonny Boy had died on the way to the hospital. (source)
Its very likely Thomas Duncan knew he had been infected with Ebola and that he decided to leave Liberia to secure better treatment in the United States. Why the hell didn’t he go right to the hospital when he arrived? Why take the chance? Depending on the outcome for Thomas Duncan we may never know.
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Contributed by Lizzie Bennett of Underground Medic.
Lizzie Bennett retired from her job as a senior operating department practitioner in the UK earlier this year. Her field was trauma and accident and emergency and she has served on major catastrophe teams around the UK. Lizzie publishes Underground Medic on the topic of preparedness.