Thomas Eric Duncan, the first person ever diagnosed with Ebola in the United States, died Wednesday morning, according to the hospital in Dallas that had been treating him.
Duncan’s death came eight days after his diagnosis, which set off a panicked search for anyone who may have had contact with him and sparked new fears over how ready hospitals and government agencies are for any additional Ebola cases in the country. He died at 7:51 a.m., Texas Health Presbyterian Hospital said.
“He fought courageously in this battle,” the hospital said in a statement. “Our professionals, the doctors and nurses in the unit, as well as the entire Texas Health Presbyterian Hospital Dallas community, are also grieving his passing. We have offered the family our support and condolences at this difficult time.”
The Duncan family said in a statement that they are devastated by the news of his death, particularly given that he had recently been receiving experimental treatments. They also alluded to the fact that Duncan’s entire treatment came after considerable delays that remain unexplained.
“We had high hopes that Thomas would survive this scourge and we were optimistic that…delayed hospital protocols would help Thomas survive,” the family said. “We are hopeful that remedies here and and in parts of the world will be taken for those who have become inflicted with this horrible disease.”
Duncan had first sought treatment on Sept. 25, five days after he arrived in Dallas. But for reasons that still remain unclear nearly two weeks later, he was released by the hospital, despite telling them that he had traveled from Liberia and that he had a fever and some abdominal pain.
It is unclear why he was released. The health-care system that runs Texas Health Presbyterian initially said that a nurse had not shared Duncan’s travel history with the entire medical team, releasing a statement saying that his travel history was not visible to both the doctor and the nurse in the hospital’s electronic medical records. The hospital reversed course late Friday night, saying that the travel history was visible to both the doctor and the nurse, but it still has not explained how the mistake was made.
Dallas County Judge Clay Jenkins and a family pastor told Louise Troh, Duncan’s fiancee, about the man’s death on Wednesday morning. George Mason, Troh’s pastor, said that the news came as a shock to Troh and Duncan’s family because they did not think his death was “imminent.”
“She expressed all the what if’s: What if they had taken him right away, and what if they had been able to get the treatment to him earlier,” Mason said at a news conference on Wednesday
Troh was last able to speak with Duncan by phone on Friday, before his condition deteriorated, Mason said.
Like Troh, other relatives were grief-stricken in the wake of Duncan’s death. Mawhen Jallah, one of Troh’s daughters, sobbed during a phone call Wednesday. “I am so sad for Eric,” she said. Youngor Jallah, Troh’s other daughter, could be heard weeping in the background during a different phone call on Wednesday morning.
Family members in Dallas were able to see Duncan on Monday at the hospital via a laptop camera in his hospital room. He was on dialysis and a respirator, according to health officials. Saymendy Lloyd, a family spokeswoman, had said that the family was told that Duncan’s liver was improving and his fever was dropping.
Duncan has been in isolation since he was brought back to the hospital in an ambulance on Sept. 28. However, this was more than two days after Duncan first sought treatment. Some of those close to Duncan said they felt he was not properly treated because he was not American.
“He is a Liberian man,” Massa Lloyd, a close friend of Troh, said Wednesday. “The family feels he wasn’t getting the right treatment because he was an African man. They feel America is fighting only for the white man, not the black man.”
The loss was described as particularly painful because of the delay in Duncan’s treatment, which allowed him to interact with other people while symptomatic and prevented him from getting care sooner.
“It’s devastating,” Princess Duo, 32, a longtime friend of Troh’s and her family. “It’s not just the fact that he’s dead. But it’s just the way in which it happened. That’s what hurts the most.”
Duncan was one of a handful of other Ebola patients who have received experimental drugs during the course of the outbreak. Two U.S. missionaries infected this summer while working in West Africa were given doses of another unapproved drug, known as ZMapp, but the limited supplies of that drug were soon exhausted. An experimental medicine from a Canadian company, Tekmira, was given to another American doctor who was flown to Nebraska from West Africa for treatment.
The experimental treatment for Duncan did not begin until the weekend, several days after he was placed in isolation. Duncan’s family members have questioned why experimental treatments were not used sooner. “We want him to live,” Mawhen Jallah said before Duncan was given this treatment. “So we want the drug the other people used to get saved if they have it.”
Still, it will be difficult to know how much of a role the experimental drug ultimately played due to the timing, said Thomas Geisbert, a professor at the University of Texas Medical Branch at Galveston who has researched the Ebola virus for decades.
“It may have been given so late that it doesn’t make a difference either way,” Geisbert said Monday.
For public health officials, attention now turns to how they will handle Duncan’s body. “When the person has just died, that is when the body is most contagious,” Tarik Jasarevic, a spokesman for the World Health Organization, said in August. “It’s when the virus is overtaking the whole body.”
The Centers for Disease Control and Prevention has issued guidelines for safe handling of the remains of Ebola patients, which notes that “handling of human remains should be kept to a minimum.”
After Duncan’s body is carefully enclosed in two bags that are then disinfected, it will be cremated, the Texas Department of State Health Services said Wednesday. The family agreed to have his body cremated.
“Transportation of remains that contain Ebola virus should be minimized to the extent possible,” the CDC guidelines say. Moving human remains out of the United States, the CDC says, “would need to comply with the regulations of the country of destination, and should be coordinated in advance with relevant authorities.”
Duncan had told his fiancee the day he was diagnosed that he regretted exposing her to the virus, saying that he never would have come to the United States if he knew he was infected.
“He apologized to Louise the day they told him what he had,” Lloyd said Tuesday. “He told her, ‘I’m so sorry all of this is happening. . . . I would not put the love of my life in danger.’ ”
Some of Troh’s relatives expressed worry in addition to sadness, because Duncan had been around up to 48 people who may have been exposed to the disease. Authorities say 10 of these people remain high-risk, while the others are considered at a lower risk of contracting the disease.
“I feel terrible…I’m thinking of other people who come in contact with him,” Manie Mangoe, 25, who is a relative of Troh, said Wednesday. “I’m worried.”
— Dr. Tom Frieden (@DrFriedenCDC) October 8, 2014
Authorities who had spent time with Duncan’s relatives offered their condolences on Wednesday morning. “My thoughts are with the family and friends of Thomas Eric Duncan at this time, especially his fiancée Louise, their son Karsiah and all those who loved him,” Dallas County Judge Clay Jenkins said in a statement Wednesday. “We are also thinking of the dedicated hospital staff who assisted Mr. Duncan daily while he fought this terrible disease. We offer prayers of comfort and peace to everyone impacted by his passing.” State and local health officials, who continue to monitor the 48 people who had contact with Duncan for Ebola symptoms, also sent out messages aimed at the family:
Per Presby, Mr. Duncan passed away at 7:51 this morning. The City of Dallas offers our deepest condolences to his loved ones. — Sana Syed (@dallaspiosana) October 8, 2014
“The past week has been an enormous test of our health system, but for one family it has been far more personal,” David Lakey, commissioner of the Texas Department of State Health Services, said in a statement. “Today they lost a dear member of their family. They have our sincere condolences, and we are keeping them in our thoughts.”
The department vowed to continue fighting to contain the spread of Ebola in Texas. While authorities said about 10 people remain at high risk due to contact with Duncan, including relatives who have been isolated, no one else has shown any symptom of the disease so far.
“This hurts deeply and we were hoping that this was not going to happen,” Dallas Mayor Michael Rawlings said at a city council meeting Wednesday. “This is sad news for all involved. We will continue to do everything possible with our partners with the county to protect our public health in all of the city of Dallas.”
Eric Williams, who is running as an independent for Congress from District 30 in Dallas, called on Texas Gov. Rick Perry (R) to open a “investigation of wrongful death” of Duncan.
“We need to know why it happened,” Williams said outside Texas health Presbyterian Hospital Wednesday. “This disease will move from one person to another. We don’t need to make mistakes again. The hospital made a grave error when it turned Duncan away the first time. It mistreated him because he didn’t get the experimental drugs.”
Brown reported from Dallas, Tex. Brady Dennis, Abby Phillip, Abby Ohlheiser, J. Freedom du Lac, Elahe Izadi and Juliet Eilperin in Washington, D.C., contributed to this report.
[This post has been updated. First published: 11:18 a.m. Last updated: 3:54 p.m.]