Presidents and Pandemics: Barack Obama and the 2014 Ebola Outbreak
Ebola virus disease is a viral haemorrhagic fever that affects humans and other primates. It is caused by Ebola viruses. Signs and symptoms typically start between two days and three weeks after contracting the virus. The symptoms include a fever, sore throat, muscular pain, and headaches, followed by vomiting, diarrhea and a rash. The most severe symptoms are a decreased function of the liver and kidneys, causing some people to bleed both internally and externally. Ebola has a high risk of death, killing 25% to 90% of those infected, with an average of about 50%. The cause of death is usually low blood pressure from fluid loss, and typically occurs between 6 and 16 days after symptoms appear.
The virus spreads through direct contact with body fluids, such as blood from infected humans or other animals, or from contact with items recently contaminated with bodily fluids. Semen or breast milk from a person affected may carry the virus even for several weeks or even months after recovery. Fruit bats are believed to be the normal carrier of the virus and are able to spread the virus without being affected by it.
Four confirmed cases of Ebola were discovered in the United States in 2014. Eleven cases were reported in total, with the first was reported in September 2014. Nine of the people contracted the disease outside the US and traveled into the country, either as regular airline passengers or as medical evacuees. Of those nine, two people died. The two people who contracted Ebola in the United States were both nurses who treated an Ebola patient. Both recovered.
On September 30, 2014, the Center for Disease Control and Prevention (CDC) announced that Thomas Eric Duncan, a 45-year-old Liberian citizen who was visiting the United States from Liberia, had been diagnosed with Ebola in Dallas, Texas. Duncan had been visiting family in Dallas. He was treated at Texas Health Presbyterian Hospital Dallas. By October 4, Duncan's condition had deteriorated from "serious but stable" to "critical", and on October 8, Duncan died from Ebola. The other three cases diagnosed in the United States as of October 2014 were:
1. Nina Pham, a nurse who who had provided care to Duncan at the hospital (diagnosed on October 11th)
2. Amber Joy Vinson, another nurse who treated Duncan (diagnosed on October 14th)
3. Physician Craig Spencer, diagnosed in New York City on October 23rd. He had just returned from working with Doctors Without Borders in West Africa.
Hundreds of people were tested or monitored for potential Ebola virus infection, but the two nurses were the only confirmed cases of locally transmitted Ebola.
A number of a Americans had contracted the Ebola virus while working with medical teams trying in West Africa working to stop the epidemic. Kent Brantly, a physician and medical director in Liberia for the aid group Samaritan's Purse, and co-worker Nancy Writebol were infected in July 2014, while working in Monrovia. Both were flown to the United States at the beginning of August for further treatment in Atlanta's Emory University Hospital. Both recovered and were discharged from hospital on August 21st. On September 4, a Massachusetts physician, Rick Sacra, was airlifted from Liberia to be treated in Omaha, Nebraska at the Nebraska Medical Center. On September 25, Sacra was declared Ebola-free and released from the hospital. On September 9, Dr. Ian Crozier, the fourth U.S. citizen who contracted the Ebola virus arrived at Emory University Hospital in Atlanta for treatment. He was found to be the most severe case of the virus, and he was discharged from hospital in late October. On October 2, NBC News photojournalist Ashoka Mukpo, covering the outbreak in Liberia, tested positive for Ebola after showing symptoms. Mukpo was evacuated on October 6 to the University of Nebraska Medical Center for treatment in their isolation unit. On October 21, Mukpo was declared Ebola-free and allowed to return to his home in Rhode Island.
On November 13, Doctor Martin Salia from Sierra Leone, a permanent resident of the United States married to a U.S. citizen, was transported to the Nebraska Medical Center for treatment for Ebola. His initial Ebola test came back negative, but a second test for Ebola came back positive. He was critically ill and considered to be the sickest patient to be evacuated, but stable enough to fly. On November 17, Salia died from the disease.
A U.S. clinician contracted Ebola while working in Port Loko, Sierra Leone. He was diagnosed with Ebola on March 10, 2015 and medically evacuated to the National Institutes of Health in Bethesda, Maryland on March 13. His condition was downgraded from serious to critical on March 16. Ten exposed colleagues were flown back to the U.S., going into isolation near the Ebola-rated hospitals at Nebraska, Georgia, and Maryland.On April 9, 2015, the clinician was upgraded to good condition and discharged.
On October 27, U.S. Army Chief of Staff Ray Odierno ordered a 21-day quarantine of all soldiers returning from Operation United Assistance.
In mid-October 2014, President Barack Obama appointed Ron Klain as the "Ebola response coordinator" of the United States. Klain had previously served as Joe Biden's and Al Gore's chief of staff. Klain was a lawyer by profession and had no medical or health care experience. Obama said, "It may make sense for us to have one person so that after this initial surge of activity, we can have a more regular process just to make sure that we're crossing all the T's and dotting all the I's going forward". Klain reported to White House Homeland Security Adviser Lisa Monaco and National Security Advisor Susan Rice, but did not coordinate with hospitals and the United States Public Health Service.
President Barack Obama attempted to calm public fears by hugging nurse Nina Pham in a meeting that he had with her in the Oval Office, following the nurse's discharge from hospital. President Obama also announced the formation of rapid response teams to travel to hospitals with newly diagnosed patients. A second set of teams were tasked with preparing hospitals in cities deemed most likely to see an Ebola virus case. Obama told the media, "We want a rapid response team, a SWAT team essentially, from the CDC to be on the ground as quickly as possible, hopefully within 24 hours, so that they are taking the local hospital step by step through what needs to be done.” The CDC developed two sets of teams, identified by the acronyms CERT (CDC Ebola Response Team) and FAST (Facility Assessment and Support Teams). The CERTs were composed of 10 to 20 people each, sent to a hospital with a suspected and/or laboratory confirmed Ebola virus case. The teams are drawn from 100 CDC workers and others. The FAST teams were to assist hospitals that have indicated they are willing to take on Ebola cases.
Starting in October 2014, U.S. government officials began questioning airplane passengers and screening them for fever at five U.S. airports: John F. Kennedy International Airport in New York, Newark Liberty International Airport in New Jersey, O'Hare International Airport in Illinois, Washington Dulles International Airport in Virginia, and Hartsfield–Jackson Atlanta International Airport in Georgia. These airports receive more than 94% of passengers from Guinea, Liberia, and Sierra Leone, the three countries most affected by Ebola. On October 23, the CDC announced that all passengers from these countries would receive 21-day monitoring.
On October 7, 2014, Connecticut governor Dannel Malloy signed an order authorizing the mandatory quarantine for 21 days of anyone, even if asymptomatic, who had direct contact with Ebola patients. Nine people were quarantined on October 22, in accordance with the Connecticut order. On October 24, New York Governor Andrew Cuomo and New Jersey Governor Chris Christie announced that they were imposing a mandatory 21-day quarantine on all air travelers returning to New York and New Jersey from West Africa who have had contact with Ebola patients. Cuomo said, "In a region like this, you go out three times, you ride the subway, you ride the bus, you could affect hundreds of people." On October 26, Cuomo modified the state's quarantine procedure, stating that people entering New York who have had contact with Ebola patients in West Africa would be quarantined in their homes for the 21 days, with twice daily checks to ensure their health has not changed and that they are complying with the order, and would receive compensation for lost wages. President Obama expressed his disagreement with the mandatory quarantine policy and attempted to persuade Governor Cuomo, Governor Christie, and Illinois Governor Pat Quinn to rescind these orders. Illinois later said that only people at high risk of Ebola exposure, such as not wearing protective gear near Ebola patients, will be quarantined.
On November 13, 2014, President Obama issued a presidential memorandum, invoking a federal law to immunize contractors hired by the U.S. Agency for International Development (USAID) from liability "with respect to claims, losses, or damage arising out of or resulting from exposure, in the course of performance of the contracts, to Ebola" during the emergency period.
Development of a vaccine for Ebola took considerably longer than for other pandemic viruses. An Ebola vaccine, rVSV-ZEBOV, was approved in the United States recently in December of 2019. Reports indicate that this vaccine is fully effective after ten days of being given.The vaccine was studied in Guinea between 2014, and 2016, and more than 100,000 people have been vaccinated against Ebola as of 2019.
The virus spreads through direct contact with body fluids, such as blood from infected humans or other animals, or from contact with items recently contaminated with bodily fluids. Semen or breast milk from a person affected may carry the virus even for several weeks or even months after recovery. Fruit bats are believed to be the normal carrier of the virus and are able to spread the virus without being affected by it.
Four confirmed cases of Ebola were discovered in the United States in 2014. Eleven cases were reported in total, with the first was reported in September 2014. Nine of the people contracted the disease outside the US and traveled into the country, either as regular airline passengers or as medical evacuees. Of those nine, two people died. The two people who contracted Ebola in the United States were both nurses who treated an Ebola patient. Both recovered.
On September 30, 2014, the Center for Disease Control and Prevention (CDC) announced that Thomas Eric Duncan, a 45-year-old Liberian citizen who was visiting the United States from Liberia, had been diagnosed with Ebola in Dallas, Texas. Duncan had been visiting family in Dallas. He was treated at Texas Health Presbyterian Hospital Dallas. By October 4, Duncan's condition had deteriorated from "serious but stable" to "critical", and on October 8, Duncan died from Ebola. The other three cases diagnosed in the United States as of October 2014 were:
1. Nina Pham, a nurse who who had provided care to Duncan at the hospital (diagnosed on October 11th)
2. Amber Joy Vinson, another nurse who treated Duncan (diagnosed on October 14th)
3. Physician Craig Spencer, diagnosed in New York City on October 23rd. He had just returned from working with Doctors Without Borders in West Africa.
Hundreds of people were tested or monitored for potential Ebola virus infection, but the two nurses were the only confirmed cases of locally transmitted Ebola.
A number of a Americans had contracted the Ebola virus while working with medical teams trying in West Africa working to stop the epidemic. Kent Brantly, a physician and medical director in Liberia for the aid group Samaritan's Purse, and co-worker Nancy Writebol were infected in July 2014, while working in Monrovia. Both were flown to the United States at the beginning of August for further treatment in Atlanta's Emory University Hospital. Both recovered and were discharged from hospital on August 21st. On September 4, a Massachusetts physician, Rick Sacra, was airlifted from Liberia to be treated in Omaha, Nebraska at the Nebraska Medical Center. On September 25, Sacra was declared Ebola-free and released from the hospital. On September 9, Dr. Ian Crozier, the fourth U.S. citizen who contracted the Ebola virus arrived at Emory University Hospital in Atlanta for treatment. He was found to be the most severe case of the virus, and he was discharged from hospital in late October. On October 2, NBC News photojournalist Ashoka Mukpo, covering the outbreak in Liberia, tested positive for Ebola after showing symptoms. Mukpo was evacuated on October 6 to the University of Nebraska Medical Center for treatment in their isolation unit. On October 21, Mukpo was declared Ebola-free and allowed to return to his home in Rhode Island.
On November 13, Doctor Martin Salia from Sierra Leone, a permanent resident of the United States married to a U.S. citizen, was transported to the Nebraska Medical Center for treatment for Ebola. His initial Ebola test came back negative, but a second test for Ebola came back positive. He was critically ill and considered to be the sickest patient to be evacuated, but stable enough to fly. On November 17, Salia died from the disease.
A U.S. clinician contracted Ebola while working in Port Loko, Sierra Leone. He was diagnosed with Ebola on March 10, 2015 and medically evacuated to the National Institutes of Health in Bethesda, Maryland on March 13. His condition was downgraded from serious to critical on March 16. Ten exposed colleagues were flown back to the U.S., going into isolation near the Ebola-rated hospitals at Nebraska, Georgia, and Maryland.On April 9, 2015, the clinician was upgraded to good condition and discharged.
On October 27, U.S. Army Chief of Staff Ray Odierno ordered a 21-day quarantine of all soldiers returning from Operation United Assistance.
In mid-October 2014, President Barack Obama appointed Ron Klain as the "Ebola response coordinator" of the United States. Klain had previously served as Joe Biden's and Al Gore's chief of staff. Klain was a lawyer by profession and had no medical or health care experience. Obama said, "It may make sense for us to have one person so that after this initial surge of activity, we can have a more regular process just to make sure that we're crossing all the T's and dotting all the I's going forward". Klain reported to White House Homeland Security Adviser Lisa Monaco and National Security Advisor Susan Rice, but did not coordinate with hospitals and the United States Public Health Service.
President Barack Obama attempted to calm public fears by hugging nurse Nina Pham in a meeting that he had with her in the Oval Office, following the nurse's discharge from hospital. President Obama also announced the formation of rapid response teams to travel to hospitals with newly diagnosed patients. A second set of teams were tasked with preparing hospitals in cities deemed most likely to see an Ebola virus case. Obama told the media, "We want a rapid response team, a SWAT team essentially, from the CDC to be on the ground as quickly as possible, hopefully within 24 hours, so that they are taking the local hospital step by step through what needs to be done.” The CDC developed two sets of teams, identified by the acronyms CERT (CDC Ebola Response Team) and FAST (Facility Assessment and Support Teams). The CERTs were composed of 10 to 20 people each, sent to a hospital with a suspected and/or laboratory confirmed Ebola virus case. The teams are drawn from 100 CDC workers and others. The FAST teams were to assist hospitals that have indicated they are willing to take on Ebola cases.
Starting in October 2014, U.S. government officials began questioning airplane passengers and screening them for fever at five U.S. airports: John F. Kennedy International Airport in New York, Newark Liberty International Airport in New Jersey, O'Hare International Airport in Illinois, Washington Dulles International Airport in Virginia, and Hartsfield–Jackson Atlanta International Airport in Georgia. These airports receive more than 94% of passengers from Guinea, Liberia, and Sierra Leone, the three countries most affected by Ebola. On October 23, the CDC announced that all passengers from these countries would receive 21-day monitoring.
On October 7, 2014, Connecticut governor Dannel Malloy signed an order authorizing the mandatory quarantine for 21 days of anyone, even if asymptomatic, who had direct contact with Ebola patients. Nine people were quarantined on October 22, in accordance with the Connecticut order. On October 24, New York Governor Andrew Cuomo and New Jersey Governor Chris Christie announced that they were imposing a mandatory 21-day quarantine on all air travelers returning to New York and New Jersey from West Africa who have had contact with Ebola patients. Cuomo said, "In a region like this, you go out three times, you ride the subway, you ride the bus, you could affect hundreds of people." On October 26, Cuomo modified the state's quarantine procedure, stating that people entering New York who have had contact with Ebola patients in West Africa would be quarantined in their homes for the 21 days, with twice daily checks to ensure their health has not changed and that they are complying with the order, and would receive compensation for lost wages. President Obama expressed his disagreement with the mandatory quarantine policy and attempted to persuade Governor Cuomo, Governor Christie, and Illinois Governor Pat Quinn to rescind these orders. Illinois later said that only people at high risk of Ebola exposure, such as not wearing protective gear near Ebola patients, will be quarantined.
On November 13, 2014, President Obama issued a presidential memorandum, invoking a federal law to immunize contractors hired by the U.S. Agency for International Development (USAID) from liability "with respect to claims, losses, or damage arising out of or resulting from exposure, in the course of performance of the contracts, to Ebola" during the emergency period.
Development of a vaccine for Ebola took considerably longer than for other pandemic viruses. An Ebola vaccine, rVSV-ZEBOV, was approved in the United States recently in December of 2019. Reports indicate that this vaccine is fully effective after ten days of being given.The vaccine was studied in Guinea between 2014, and 2016, and more than 100,000 people have been vaccinated against Ebola as of 2019.