The faltering response to a Liberian’s Ebola diagnosis in Texas contrasted starkly to the mobilization after the mere suspicion of the disease in a local law enforcement officer. Some wonder whether it was no coincidence
Mamie Mangoe, a friend of the Duncan family, wipes a tear away during a memorial service for Ebola victim Thomas Eric Duncan. Photograph: Nathan Hunsinger/AP
Stanley Gaye, president of the Liberian Community Association of Dallas-Fort Worth, said that many people were raising questions about the standard of care Duncan received, but he is urging the community to keep anger in check and wait until Duncan’s fiancee, Louise Troh, and the rest of her quarantined family are given the all-clear.
“They have questions about the hospital and how the family was treated and how he was treated. Those are all the concerns, but I told them this is not a time to talk about it, this is a time to grieve with the family and pray for the family,” he said. “The proper thing to do is to investigate and see if they did anything intentional.”
“This is a city that lived through JFK. We don’t want any more of that happening,” said Troh’s pastor, George Mason. “We don’t want that sort of thing to reoccur. Anybody that’s lived in Dallas for a long period of time would tell you that that story haunts the city of Dallas. We believe we have come a long way since then and we have much more transparency,” he said.
Apparently responding to these kinds of concerns, the hospital released a statement Thursday in which it said, “We’d like to correct some misconceptions that have been reported about Mr. Duncan’s first visit. Our care team provided Mr. Duncan with the same high level of attention and care that would be given any patient, regardless of nationality or ability to pay for care. In this case that included a four-hour evaluation and numerous tests. We have a long history of treating a multicultural community in this area.”
Allegations of official cover-ups and a lack of transparency cut deeper here than in many places. Texas is an independent-minded state with an innate distrust of the federal government and Dallas is still best known for some people as the site of the assassination of John F Kennedy, an event that inspired perhaps the most famous and enduring collection of conspiracy theories in Western culture.
“We’re looking for moments to help correct the view of Dallas or to have some redemption about that, to be honest. This was a moment, and you realise we might have had another bobble as we began, but these public officials now are redoubling their efforts to see that we can do everything right in the wake of it.”
The geography of Duncan’s sickness and death has also underlined that this is a city, like so many in America, with a stark racial and economic divide.
On the north Dallas landscape, opulent shopping malls and the sprawling hospital campus act as a kind of bulwark separating the densely populated and deprived Vickery Meadow area – home to a diverse range of immigrants, including Troh – from some of the richest residents in America a short drive to the west across Highway 75. That area, Highland Park, almost entirely white and home to the George W Bush Presidential Library, was described by Mother Jones in 2011 as “the most enthusiastically Republican enclave in the country”.
The Ebola scare has prompted a rare moment of crossover between the two communities. The Dallas Morning News reported that the Highland Park school district sent a note aiming to reassure parents that their children could not contract Ebola through contact with the daughter of Clay Jenkins, a judge who is in charge of emergency management for Dallas County and who drove Troh and her family from her apartment to a temporary home in an undisclosed location.
Vickery Meadow is no longer invisible. “One of my own hopes is that out of all of this, at least people in Dallas could raise their awareness of the conditions in Vickery Meadow. It is not good and it has not been good for a long time,” said Mark Wingfield, associate pastor at Troh’s church. “There is substandard housing, it is in many places an urban ghetto and I think most people in Dallas if they don’t ever drive through there don’t even know it exists.”
But so far the publicity and alarm appear to have made locals even more unwilling to circulate in the area. Attendance at schools near Troh’s apartment was down 10% in the wake of news that five area pupils may have come into contact with Duncan, according to Dallas school district figures.
The Dallas Foundation, which links donors with non-profit agencies, said in a statement that it is focusing efforts on helping Vickery Meadow because “the backlash from this attention has had negative consequences for a neighborhood already plagued by poverty, affecting residents’ ability to work as well as the delivery of volunteer services within the community.”
Alben Tarty, a Liberian community spokesman, said a fear of stigmatisation after the first diagnosed case of Ebola in the US has led to “rumours” that some Liberians’ jobs might be in jeopardy.
Frisco, a prosperous and bland modern suburb 25 miles north of downtown Dallas, is normally chiefly known as the home of Major League Soccer’s FC Dallas and the RoughRiders minor league baseball team.
But for a time on Wednesday it was the epicentre of the rolling-news universe, as events at an urgent care centre prompted scenes reminiscent of a contagion disaster movie. Media rushed to provide live coverage of a sheriff’s deputy in a surgical mask being taken to a hospital isolation room by men covered from head to toe in protective clothing.
The deputy, Michael Monnig, did visit the apartment where Thomas Eric Duncan, who died from the virus on Wednesday, had stayed after arriving in the US from Liberia. But on Thursday afternoon, Texas officials said Monnig had tested negative for the virus.
Still, on Wednesday no one was taking any chances; better to risk alarming the general population by responding urgently and forcefully with officials in hazmat gear than prompt fresh doubts about the competence of authorities by downplaying the drama, acting slowly and not wearing any protective clothes at all.
The contrast in the speed and scale of the response in Frisco compared with events at the low-rent Ivy Apartments complex was jarring: despite confirmation on Tuesday last week that Duncan had Ebola, it was not until last Thursday that the authorities made a concerted effort to control who could enter and exit the apartment where he had stayed, and not until Saturday before the unit was cleaned and decontaminated by a professional crew. As various local and federal agencies appeared to debate and dawdle, the action achieved the rare feat of seeming at once chaotic and slow-moving.
The 5,000- to 10,000-strong Liberian community in the Dallas-Fort Worth metroplex has noted shortcomings in the way Duncan’s case was handled. Official accounts suggest he first developed symptoms on 24 September and went to nearby Texas Health Presbyterian hospital two days later, where staff failed to take his travel history into account and sent him away with antibiotics. By 28 September he was so ill that an ambulance was called to take him back.
Without making any specific judgment on Duncan’s case, Centers for Disease Control and Prevention (CDC) director Tom Frieden said at a media briefing on Wednesday that “the earlier someone is diagnosed, the more likely they will be able to survive.”
Three other patients hospitalised in the US after contracting Ebola in west Africa, including one man from Fort Worth, received experimental treatments and survived. On Tuesday, Dallas County commissioner John Wiley Price, who is black, told a court meeting that “if a person who looks like me shows up without any insurance, they don’t get the same treatment … It’s historically what has happened in this community.”
Frisco emergency personnel cordoned off Michael Monnig’s vehicle. Treatment of Monnig’s case, some say, has proceeded in stark contrast to how Thomas Eric Duncan’s case was handled. Photograph: Larry W. Smith/EPA
Tarty said he has heard stories of home care workers and food handlers being sent home from their jobs because their employers feared they might have been exposed to the disease. He said he doesn’t know if the stories are true; nonetheless, their mere circulation has made some in the community very anxious.
With Duncan the only confirmed case, Ebola’s capacity to frighten is so far greatly outpacing its ability to infect Texans. “The concern is the stress of this and the fear of this could be more damaging to the community than the virus itself,” Lakey said at a news conference on Monday.
Dallas is waiting to discover whether any of the 10 people in Texas officials say had close contact with Duncan, as well as 38 others who may have had contact, will present Ebola symptoms. According to the CDC, the maximum incubation period is 21 days but symptoms usually start to show 8 to 10 days after exposure. If nothing develops by the end of the week, confidence will grow that, despite the missteps which delayed his move into isolation, Duncan will remain the city’s lone case, and Dallas’s affected communities can start rebuilding trust and repairing social fractures.
“We are very hopeful and keep praying that it continues that way,” said Gaye.