Questions around healthcare quality for first Ebola patient to die in US


Scores of Africans get Ebola. = “Sorry, there’s no cure.”

White American doctor gets Ebola. = “Eureka! We quickly found a cure!”

White American nurse gets Ebola. = “Here’s the medicine. You’re cured.”

White American news journalist gets Ebola. = “We’ll fly you to Nebraska to get cured!”

Black gentleman in America gets Ebola. = “Sorry, we ran out of medicine. Our condolences to your family.”


Elguape, you’re late to playing the race card. Jesse Jackson already trumped you.

Worth noting that besides being black Mr. Duncan also had no health insurance.


He would have gotten it if he had just told them he had ebola.

Yes, he knew. He’d been carrying and otherwise been in contact with a person who had just died of it - he’d even taken her to an ebola clinic. Another family member in contact with her had also died of it.

Just impossible levels of denial there. Oh well, you know how guys are.

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He told the hospital he had been in Africa, the nurse noted it in his patient record, but didn’t tell the attending physician. The physician didn’t bother to check the notes and they sent him home. When he came back, they waited five days before administering medication that may have helped. Numerous points of failure here on the part of the hospital.


Did you know that race is not a playing card? In fact, you just demonstrated it’s a very serious issue.

I talked to a doctor tonight who said the guy presented with flu-like symptoms, which by itself doesn’t warrant admission to to hospital. But the staff should have noticed he had just come from Liberia. I’m not sure where he was born, but native Africans have a pretty noticeable accent.


Yes, lapses on the hospital’s part as well, but he should have told them he likely had ebola. There’s no way he could not have known except by insane levels of denial (possible!). That was the single biggest failure here.

As it was, nobody in the US was looking for it. The CDC was pooh poohing the idea that it would ever spread here. Their lack of alarm was perfectly understandable. We always do this - everyone piles on the first person or institution that gets hit with ‘they should have known!’ when they very likely would have shown the same lack of concern. It’s harrumphing ass-covering.


Alternatively: “For once, white people used as guinea pigs.” There’s actually been quite a lot of discussion as to whether or not ZMapp, the “cure” that’s been bandied about in the news, should be tried without the usual round of clinical trials. From Wikipedia:

Dr. Salim S. Abdool Karim (director of an AIDS research center in South Africa), responding to a question on how people may have reacted if ZMapp and other drugs would have been used first in Africans, said, “It would have been the front-page screaming headline: ‘Africans used as guinea pigs for American drug company’s medicine.’"


You cannot win. So you can as well not care.

Of course you can ‘win’ (if by ‘win’ you mean gain the trust and support of a demographic that has for 5 or 6 centuries now been aggressively shat on by white Europeans), however the middle of a growing epidemic may not be the best time to try and change the rules of the game. The general method is to a) win trust when there’s no emergency, then b) use that trust to get stuff done during an emergency.

You’re complaining that b) is impractical because a) hasn’t been done (or even attempted, really). Dr. Salim S. Abdool Karim isn’t the one to blame here.

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A better question to ask (since, well, you can draw any line when you have ONE data point…) is whether the 52 people who had to be tracked down in case they were exposed, would not have been placed at risk if the guy had been taken into observation the first time he showed up at the ER.

And he wasn’t, because he was uninsured.

Come on, America. When people suffering from severe fever and vomiting, possibly contagious, can’t get a hospital bed, that’s a public health risk.

  1. It’s a sure bet that any U.S. hospital paying attention will put Ebola screening into practice ASAP.
  2. This is how I read the headline: Questions around healthcare quality … in US

This instance stood out because EBOLA. But the underlying issues are there everyday.
Highly reliable healthcare in the US is still in its infancy Right Treatment Right Patient, Everytime

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One of the local news sources quoted one of the nurses saying that they asked him if he had been exposed to anyone with ebola, and he outright lied (as he did to the Liberian government before he left the country) and said “No.”

As you’ve pointed out, it’s difficult to treat people in a medical situation when they lie about important things like that.


Race is a huge determinant in economic status, which is pretty well the whole game when it comes to access to health care.

Mistakes may have been made at the hospital, and I’m sure the CDC is actively looking into protocols to prevent things like this from recurring, but playing the race card for the first patient in a country of 350 million who shows up with symptoms of a disease is a bit silly.

That’s absolutely true, and a general stain on the US healthcare system, but if he had told them he had been exposed to Ebola he would have been hospitalised and quarantined there and then, insurance or not.

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