Craig Spencer and Ebola: Responsible Public Health Response Needed

February 25, 2015


While treating Ebola patients in Guinea, Craig Spencer, MD, assistant professor of medicine at CUMC, took another volunteer’s advice and kept a daily journal of his perceived level of risk of being infected with the virus. Every day, he checked off “minimal risk.” Yet, as was widely reported in October 2014, Dr. Spencer entered Bellevue Hospital as the city’s first Ebola patient six days after returning to New York City.

In a perspective published online Feb. 25 in the New England Journal of Medicine, Dr. Spencer describes his experiences both in Guinea as a volunteer and after his return to the United States.

He describes the Ebola treatment center in Guinea as the most challenging place he had ever worked. “As a clinician and epidemiologist, I’ve worked in places just miles from active conflict and managed to grow used to the sight of soldiers and the sound of gunfire,” he writes. “But this microscopic virus, an invisible enemy, made me uneasy.”

Work in the treatment center, however, affirmed his commitment. “I’d never felt so deeply that my decisions could have a measurable impact on other people’s lives. …the satisfaction I got from treating ill patients washed away my fear and made me feel new again.”

Returning to New York presented its own challenges, as he monitored himself for signs of the virus. Fear was a daily emotion, so the morning he saw a rise in his temperature, “I felt almost relieved. Although my worst fear had been realized, having the disease briefly seemed easier than constantly fearing it.”

He writes about his illness as a missed opportunity for the news media to educate the public about the disease. “After my diagnosis, the media and politicians could have educated the public about Ebola. Instead, they spent hours retracing my steps through New York and debating whether Ebola can be transmitted through a bowling ball.”

“Fear in measured doses can be therapeutic and inform rational responses,” he writes, “but in excess, it fosters poor decision making that can be harmful.”

The perspective also discusses the harmful effects of public health restrictions that do not align with CDC recommendations. This “undermines and erodes confidence in our ability to respond cohesively to public health crises. As a society, we recognize the need for some of our best-trained physicians and public health professionals to participate in a potentially fatal mission because failing to stop the epidemic at its sources threatens everyone.

“We should also have faith that these professionals will follow proven, science-based protocols and protect their loved ones by monitoring themselves. It worked for me, and it has worked for hundreds of my colleagues who have returned from this and past Ebola outbreaks without infecting anyone.”

How can we get Ebola under control in Africa?