On Thursday, Dr. Craig Spencer, who had recently been in Guinea treating Ebola patients for Doctors Without Borders, tested positive for Ebola in New York, America’s most populous city. While Spencer’s work in West Africa risking his life fighting this horrific disease is commendable and selfless, his subsequent behavior isn’t.
Spencer, who lives in Harlem, was on a self-monitoring regimen since his return from Guinea nine days ago, on October 14. Since then, he has not been seeing patients at NewYork-Presbyterian Hospital/Columbia University Medical Center, where he is a fellow of international emergency medicine. On Tuesday night, according to the Times, he began to feel sluggish. By Thursday morning, he had a fever of 103. In between, he went bowling in Williamsburg, Brooklyn, and took the subway there. While medical professionals have been reassuring us that a person with Ebola is not contagious until someone begins showing symptoms, it’s worth noting this little nugget in the Times piece:
A health care worker at the hospital said that Dr. Spencer seemed very sick and it was unclear to the medical staff why he had not gone to the hospital earlier, since his fever was high, at 103.
Which is to say, if Spencer, out of an abundance of caution, stayed home from work in order not to infect his patients and colleagues, why in god’s good name was he going bowling across the East River? What was in that bowling alley that was so pressing that he needed to get on a crowded, poorly ventilated subway car a full day after the onset of symptoms? (UPDATE: The Times changed the language of their article on Friday, eliminating the reference to his temperature in the above sentence and clarifying elsewhere, "Health officials initially said that Dr. Spencer had a 103-degree fever when he reported his symptoms to authorities at around 11 a.m. on Thursday. But on Friday, health officials said that was incorrect and that Dr. Spencer reported having a 100.3-degree fever.")
This is not the first time we’ve seen this movie. There was, for example, Amber Vinson, the nurse who treated Thomas Eric Duncan as he lay dying of Ebola in a Dallas hospital. Vinson was also on a self-monitoring regimen, taking her temperature twice a day. And yet, she took two flights, the last of which was while she had a fever that was elevated enough for her to call Texas health officials, who then called the CDC. The next morning, she was in the hospital with the third confirmed case of Ebola in the U.S. The CDC apparently gave her the green light, though now they are saying that there is “the possibility that she was exhibiting symptoms for days before she sought medical attention.”
That is, Vinson knew what was happening—she was starting to display symptoms, i.e., had become contagious—and yet she called to get permission anyway.
There's still a lot we don't know about Vinson and Spencer's cases. But it’s well known among those of us who have loved ones in the healthcare profession that many of these valiant souls never think it’ll happen to them. And it’s also well known that Ebola is pretty hard to transmit because it is not airborne. And yet, it has been one year since my last health-related rant, so I might as well use the opportunity to rant about how good Americans are at spreading germs.
This is something my Soviet family and I could never get used to in the States, the stubbornness with which Americans trudge to work or school with triple-digit fevers or noses like spigots, the obliviousness with which an American will greet you with a hug and then say, “I’m sick!,” or reach to try your drink while hacking up a lung. Come to think of it—why are they even at the bar with you? Or the way Americans cough with childlike abandon, like a sprinkler. Or sneeze like no one is watching.
Don’t believe me? Just look at this survey by the National Foundation for Infectious Diseases, published at the height of flu season in 2011, that shows that a full two-thirds of Americans don’t stay home—as the CDC advises them to do—despite having symptoms of the flu and therefore being highly contagious. Forty percent said that the stuff they needed to do outside the home—work, school, trying my beverage—was more important than the risk of spreading the flu. That is, Ms. Vinson just had to go to Cleveland, even though she put at risk—however small—over a hundred people on that plane on the way there, and a hundred more on the way back. We still have no idea how many people Spencer put at risk because just had to go bowling, but it's likely more than a hundred.
Why do people do this? Well, the survey strongly implies ignorance—68 percent didn’t know that a flu virus can be transported, via cough or snot pellet, five or six feet—and, for hourly-wage workers it is probably not selfishness but dire necessity that propels them to handle your coffee lid with infected hands. For some, it must just be the Protestant work ethic.
But I think it’s something else. From where I sit, it often looks like the other side of American individualism, which becomes selfishness when you lay it on thick. It’s the belief that you and your needs are acutely exceptional and important, and take precedence over those of the people around you. It’s the unspoken belief that your day radiating sickness at the office is worth a couple of your colleagues being bedridden with your flu for a week. You may not be actively thinking that, but that’s the math your actions—and those of the 40 percent polled in that survey—imply. It’s selfishness and solipsism, pure and simple.
For proof, I refer you back to the survey: 66 percent still go to the office while showing symptoms of the flu, and 59 percent said they were annoyed at those who did so because it jeopardized their own health. I’m no math major, but that there looks like some overlap.
We’ll likely ride out this Ebola thing without it spreading too much further, but flu season is around the corner. So please, if you’re feeling sluggish and febrile, be a mensch and don’t go bowling.