DALLAS — Ebola patient Thomas Eric Duncan told his fiancee the day he was diagnosed last week that he regrets exposing her to the deadly virus and had he known he was carrying Ebola, he would have “preferred to stay in Liberia and died than bring this to you,” a family friend said.
“He apologized to Louise the day they told him what he had,” said Saymendy Lloyd, a close friend of Louise Troh, the fiancee of Duncan, who is in critical condition and no longer responsive. “He told her, ‘I’m so sorry all of this is happening. . . . I would not put the love of my life in danger.’ ”
Family members gathered in Dallas and were able to see Duncan on Monday at Texas Health Presbyterian Hospital via a laptop camera in his hospital room. “He is not responsive at all. They said he was drugged and they put him in deep sleep,” said Lloyd, who was with the family.
She said the family members were saddened by the sight of Duncan.
Lloyd said this was the first time Duncan’s mother, who lives in North Carolina, saw her son since he came to the United States.
“She has not seen him for 12 years, and the first time she saw him was through a monitor,” said Lloyd. “She was very, very emotional. She told him to be strong, that she is praying for him, that she loves him and God is able to do all things.”
Troh, who is in mandated isolation in Dallas with her 13-year-old son and two other people, spoke by phone to Lloyd.
Duncan and Troh’s 19-year-old son, Eric Karsiah Duncan, tried to visit his father at the hospital Tuesday evening.
Speaking later at a news conference at Wilshire Baptist Church, the Angelo State University student thanked his mother’s church members.
“I’m praying for my family to be okay and my dad makes it out safely,” said Eric Duncan, who had not seen his father since he was 3 in Liberia. “I hope they find a cure for it.”
As Thomas Duncan fights for his life, Texas health officials are bracing for a critical week in Dallas, where they are watching for any signs that as many as 48 people who had contact with Duncan may develop symptoms of Ebola. Health officials say the incubation period for the disease is 21 days, but it could appear eight to 10 days after exposure.
Duncan began showing symptoms Sept. 24, when he first sought medical treatment at Texas Presbyterian, three blocks from the home of Troh. Duncan was sent home but was taken back to the hospital by ambulance Sept. 28. Two days later, last Tuesday, a blood test confirmed that he had Ebola. Health officials say the “10-day threshold” for the disease will fall within the next few days.
“This is a critical week. We need to be prepared in Dallas for what could happen if family members become ill,” said David Lakey, commissioner of the Texas Department of Health Services. “We are doing contingency planning and praying for what if. I have been concentrating on what we need to do now to protect Dallas.”
None of the 10 “high risk” people — including four people who lived in the apartment where Duncan stayed and six health-care workers — have developed symptoms, health officials said. Troh, who was moved to an undisclosed location with the three people who were in the apartment with Duncan, is still well, family members say. On Sunday, members of the Liberian community association were able to take her traditional Liberian food, including jollof rice, foo foo, cassava leaves and plantains. “She called me, ‘I’m eating some traditional Liberian food,’ ” Lloyd said. “She was very happy about that.”
Health officials say they are continuing to watch 38 other people who had “possible contact” with Duncan and were considered to be at lower risk. Twice a day, health officials are checking the temperature of the 48 people — of whom six are in mandated isolation.
“They receive one call a day [to ask for a temperature reading] and one visit per day,” said Sana Sayed, a spokeswoman for the city of Dallas. “A health worker makes a physical contact with the 48 people being monitored every single day, seeing them and checking their temperature.”
Lakey would not discuss why hospital protocols failed to detect Duncan the first time he visited Texas Health Presbyterian with a 101.1 fever, complaining of abdominal pains. The hospital’s decision to send him home put other people at risk.
“A lot of evaluations will take place to find out what happened on the first presentation to find out why wasn’t a diagnosis made,” Lakey said.
Dallas County Commissioner John Wiley Price criticized the hospital for failing to heed warnings sent in July about what protocols hospitals should follow to treat infectious diseases.
“I said at the outset, Presbyterian is a boutique hospital next to a little Ellis Island,” Price said, referring to the neighborhood where many residents are immigrants. “If you don’t have insurance, you’re not going to get treated. That’s the elephant in the room.”
Texas Health Resources, the hospital network that includes Texas Health Presbyterian, responded to criticism Tuesday by saying, “He was treated the way any other patient would have been treated, regardless of nationality or ability to pay for care. We have a long history of treating a multicultural community in this area.”
Thomas Frieden, director of the Centers for Disease Control and Prevention, said that the agency was exploring ways to increase the screening of passengers on both sides of the Atlantic.
“We’re working very intensively on the screening process,” Frieden said in a conference call with reporters Tuesday. “We’re looking at that entire process to see what more can be done.”
While he promised that “additional steps” were coming, Frieden did not elaborate on what that would include. Sen. Charles E. Schumer (D-N.Y.) said in an interview Tuesday that Frieden told him that the plan is to have “tougher types of screening on U.S. soil.”
Still, Frieden said the CDC has had teams on the ground working to strengthen the screening of passengers leaving West Africa. The screening has included taking temperatures, keeping an eye out for other symptoms and having travelers fill out questionnaires.
He said the CDC methods have been used to screen more than 36,000 people over two months. And of those travelers, a small portion of whom were coming to the United States, only 77 people had a fever or other symptoms that caused them to be taken out of line, he said. “As far as we know, none of those 77 people had Ebola,” Frieden noted.
Of course, these methods are not perfect, as was made clear when Duncan filled out a questionnaire, had his temperature taken by a person trained by the CDC and boarded multiple flights on his way to Dallas.
President Obama’s promise of stepped-up screening for Ebola at U.S. airports that handle international flights will fall on the shoulders of the Customs and Border Protection officers who greet passengers arriving from abroad.
Though they often seem preoccupied with scrutinizing passports and luggage, customs officers are trained to detect signs of illness, and they routinely do just that, officials said.
“CBP personnel review all travelers entering the United States for general overt signs of illnesses,” the agency said in a statement.
In addition to visual observations, CBP officers question passengers about their health and are instructed to alert the CDC if a passenger appears to be seriously ill. If a person is believed to have “a possible communicable disease,” they are isolated while the CDC and local authorities conduct the evaluation.
Federal law requires pilots to radio ahead if a passenger dies or falls ill with certain symptoms.
“If somebody comes in on a flight that has a fever or any one of those triggers, CDC can insert themselves at any point in the process,” said Rob Yingling, spokesman for the Metropolitan Washington Airports Authority, which runs Dulles International and Reagan National airports. “They can say [to the pilot], ‘Tell us more about this case,’ or they can actually physically go to the plane.”
The CDC maintains an office at Dulles and other major airports that handle international flights.
Meanwhile, up to 4,000 service members are expected to head to West African countries ravaged by the Ebola epidemic. They will be monitored several times a day and, if any of them contract Ebola, they will be flown back to the United States aboard a specially designed plane for treatment.
Among the tasks laid out for the military is the construction of 17 treatment centers for people with the disease. This will take until the middle of next month, according to Gen. David Rodriguez, chief of U.S. Africa Command.
Mark Berman, Ashley Halsey III, Dan Lamonthe and Amy Ellis Nutt contributed to this report from Washington.