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| A doctor’s mistaken Ebola test: ‘We were celebrating. . . . Then everything fell apart’ | A doctor’s mistaken Ebola test: ‘We were celebrating. . . . Then everything fell apart’ |
| (about 1 hour later) | |
| FREETOWN, Sierra Leone — When Martin Salia’s Ebola test came back negative, his friends and colleagues threw their arms around him. They shook his hand. They patted him on the back. They removed their protective gear and cried. | FREETOWN, Sierra Leone — When Martin Salia’s Ebola test came back negative, his friends and colleagues threw their arms around him. They shook his hand. They patted him on the back. They removed their protective gear and cried. |
| But when his symptoms remained nearly a week later, Salia took another test, on Nov. 10. This one came back positive, sending the Sierra Leonean doctor with ties to Maryland on a desperate, belated quest for treatment and forcing the colleagues who had embraced him into quarantine. | But when his symptoms remained nearly a week later, Salia took another test, on Nov. 10. This one came back positive, sending the Sierra Leonean doctor with ties to Maryland on a desperate, belated quest for treatment and forcing the colleagues who had embraced him into quarantine. |
| “We were celebrating. If the test says you are Ebola-free, we assume you are Ebola-free,” said Komba Songu M’Briwa, who cared for Salia at the Hastings Ebola Treatment Center in Freetown. “Then everything fell apart.” | “We were celebrating. If the test says you are Ebola-free, we assume you are Ebola-free,” said Komba Songu M’Briwa, who cared for Salia at the Hastings Ebola Treatment Center in Freetown. “Then everything fell apart.” |
| Salia is now in critical condition at the Nebraska Medical Center in Omaha, his family left to wonder what would have happened if he had received earlier treatment. | |
| His wife, Isatu, lives in New Carrollton, and they have two children, 12 and 20, also living in the United States. He has been a visitor to their Maryland home but has devoted most of his time to his medical work in Freetown. | His wife, Isatu, lives in New Carrollton, and they have two children, 12 and 20, also living in the United States. He has been a visitor to their Maryland home but has devoted most of his time to his medical work in Freetown. |
| In a statement Sunday night, the Omaha center, one of four U.S. facilities with a special biocontainment unit, said: “The patient is still in extremely critical condition. Staff members continue to use the maximum amount of supportive care possible and are using every treatment option available in an effort to save his life.” | |
| In a sign that the Ebola epidemic still poses a danger, even though it may have eased in parts of Liberia, the Centers for Disease Control and Prevention announced Sunday that airport screening will begin for travelers arriving in the United States from Mali, which lies inland from Sierra Leone and Liberia and has begun to report cases of the disease. | In a sign that the Ebola epidemic still poses a danger, even though it may have eased in parts of Liberia, the Centers for Disease Control and Prevention announced Sunday that airport screening will begin for travelers arriving in the United States from Mali, which lies inland from Sierra Leone and Liberia and has begun to report cases of the disease. |
| For Sierra Leone’s medical establishment, already rocked by Ebola, another doctor’s diagnosis was devastating national news. Since the outbreak started, 320 Sierra Leonean health workers have died of the disease. New billboards in Freetown show the faces of doctors who have died, with the words “Some of our national heroes killed by Ebola.” | For Sierra Leone’s medical establishment, already rocked by Ebola, another doctor’s diagnosis was devastating national news. Since the outbreak started, 320 Sierra Leonean health workers have died of the disease. New billboards in Freetown show the faces of doctors who have died, with the words “Some of our national heroes killed by Ebola.” |
| The hospital where Salia worked in Freetown has been shuttered, and three of his colleagues are being isolated in the surgery ward where he once treated patients. | The hospital where Salia worked in Freetown has been shuttered, and three of his colleagues are being isolated in the surgery ward where he once treated patients. |
| The doctors who tended to him here appeared to be unaware that an early Ebola test — taken within the first three days of the illness — is often inconclusive. In a country where information about the disease continues to move slowly, it was another potentially tragic mistake. | The doctors who tended to him here appeared to be unaware that an early Ebola test — taken within the first three days of the illness — is often inconclusive. In a country where information about the disease continues to move slowly, it was another potentially tragic mistake. |
| In many cases, a negative test at that stage means nothing because “there aren’t enough copies of the virus in the blood for the test to pick up,” said Ermias Belay, the head of the CDC’s Ebola response team in Sierra Leone. | In many cases, a negative test at that stage means nothing because “there aren’t enough copies of the virus in the blood for the test to pick up,” said Ermias Belay, the head of the CDC’s Ebola response team in Sierra Leone. |
| But M’Briwa and others treated the test as definitive, even though Salia remained feverish and weak. The first results were delivered by a team of Chinese lab technicians who had opened a nearby hospital. (The technicians declined Sunday to speak about Salia’s case.) | But M’Briwa and others treated the test as definitive, even though Salia remained feverish and weak. The first results were delivered by a team of Chinese lab technicians who had opened a nearby hospital. (The technicians declined Sunday to speak about Salia’s case.) |
| Nancy Jongowai Neeconthe, a nurse who has worked with Salia for two years, saw that he was crying after the negative test result came back. Caught up in the emotional moment, she hugged him outside the Ebola ward, a converted police training base. | Nancy Jongowai Neeconthe, a nurse who has worked with Salia for two years, saw that he was crying after the negative test result came back. Caught up in the emotional moment, she hugged him outside the Ebola ward, a converted police training base. |
| “Thank God,” she remembers saying. | “Thank God,” she remembers saying. |
| But after he was released from Hastings, Salia’s symptoms worsened. He had a high fever and diarrhea. He vomited uncontrollably. He prescribed himself malaria medication, but it made no difference. | But after he was released from Hastings, Salia’s symptoms worsened. He had a high fever and diarrhea. He vomited uncontrollably. He prescribed himself malaria medication, but it made no difference. |
| “I’m really feeling my body,” he told Neeconthe. | “I’m really feeling my body,” he told Neeconthe. |
| He called his colleague Alhali Osman Smith, who worked with him at Freetown’s Kissy United Methodist Hospital. | He called his colleague Alhali Osman Smith, who worked with him at Freetown’s Kissy United Methodist Hospital. |
| “He told me he thought he still might have Ebola,” Smith said, “in spite of what the test said.” | “He told me he thought he still might have Ebola,” Smith said, “in spite of what the test said.” |
| It took five more days for Salia to take a second Ebola test, this one administered by South Africans at Lakka Hospital in Freetown. It came back positive. | It took five more days for Salia to take a second Ebola test, this one administered by South Africans at Lakka Hospital in Freetown. It came back positive. |
| Although the United Methodist hospital where Salia and Smith work doesn’t treat Ebola, both doctors knew that their patients could be infectious. A woman giving birth, a man complaining of abdominal pain — any of them could be carrying the disease. Salia wore gloves but never the full protective gear used in the country’s Ebola wards. | Although the United Methodist hospital where Salia and Smith work doesn’t treat Ebola, both doctors knew that their patients could be infectious. A woman giving birth, a man complaining of abdominal pain — any of them could be carrying the disease. Salia wore gloves but never the full protective gear used in the country’s Ebola wards. |
| His colleagues say he couldn’t pinpoint how he had contracted the disease. | His colleagues say he couldn’t pinpoint how he had contracted the disease. |
| Salia had worked at the Methodist hospital for nearly three years. He also worked at Connaught Hospital, Sierra Leone’s largest government hospital, and lectured at the country’s only medical school. | Salia had worked at the Methodist hospital for nearly three years. He also worked at Connaught Hospital, Sierra Leone’s largest government hospital, and lectured at the country’s only medical school. |
| He seemed to be working all the time. | He seemed to be working all the time. |
| “His hobby was surgery,” said John K. Yambasu, bishop of the United Methodist Church in Sierra Leone and chairman of the Religious Leaders Task Force on Ebola. | “His hobby was surgery,” said John K. Yambasu, bishop of the United Methodist Church in Sierra Leone and chairman of the Religious Leaders Task Force on Ebola. |
| After the second test, M’Briwa remembers that a team of American doctors came by Hastings to inquire about Salia and lay the groundwork for his evacuation. | After the second test, M’Briwa remembers that a team of American doctors came by Hastings to inquire about Salia and lay the groundwork for his evacuation. |
| The treatment center was overflowing. The disease had spread rapidly throughout Freetown and western Sierra Leone. The 120 beds at Hastings were no longer enough. | The treatment center was overflowing. The disease had spread rapidly throughout Freetown and western Sierra Leone. The 120 beds at Hastings were no longer enough. |
| Still, the doctors tried to give Salia special treatment. They checked on him every hour. They let him spend time with patients who were soon to be released, rather than those in the ward, who writhed in their own filth. | Still, the doctors tried to give Salia special treatment. They checked on him every hour. They let him spend time with patients who were soon to be released, rather than those in the ward, who writhed in their own filth. |
| One day, M’Briwa remembers, a 2-year-old boy who survived the disease approached Salia. | One day, M’Briwa remembers, a 2-year-old boy who survived the disease approached Salia. |
| “I am fine, and you’re going to be fine, too,” the boy said. | “I am fine, and you’re going to be fine, too,” the boy said. |
| On Saturday, Smith stood next to Salia’s ambulance near the Freetown airport’s tarmac. He held Salia’s passport for him, eventually handing it to a U.S. official, afraid that it would otherwise be contaminated by the disease. | On Saturday, Smith stood next to Salia’s ambulance near the Freetown airport’s tarmac. He held Salia’s passport for him, eventually handing it to a U.S. official, afraid that it would otherwise be contaminated by the disease. |
| The State Department facilitated the evacuation at the request of Salia’s wife, a U.S. citizen, according to a statement issued Saturday by Jen Psaki, the department spokeswoman. Isatu Salia has agreed to reimburse the government for any expenses, Psaki said. A State Department spokesman said Sunday that the U.S. government has not yet calculated the cost of the flight. | The State Department facilitated the evacuation at the request of Salia’s wife, a U.S. citizen, according to a statement issued Saturday by Jen Psaki, the department spokeswoman. Isatu Salia has agreed to reimburse the government for any expenses, Psaki said. A State Department spokesman said Sunday that the U.S. government has not yet calculated the cost of the flight. |
| By mid-afternoon Saturday, Salia had arrived in Omaha. His colleagues rejoiced. | By mid-afternoon Saturday, Salia had arrived in Omaha. His colleagues rejoiced. |
| “The tests they have in the U.S., they’re much better than the tests we have here,” Smith said. | “The tests they have in the U.S., they’re much better than the tests we have here,” Smith said. |
| But Salia was in such bad shape, he had to be removed from the plane in what’s called an “isopod,” because he was too weak to walk. | |
| Members of his family had gathered at the Omaha hospital Sunday, said Taylor Wilson, a spokesman at the Nebraska Medical Center, but he declined to specify who was there or whether any of them had communicated with Salia since arriving. | Members of his family had gathered at the Omaha hospital Sunday, said Taylor Wilson, a spokesman at the Nebraska Medical Center, but he declined to specify who was there or whether any of them had communicated with Salia since arriving. |
| And now Neeconthe, Smith and several others who interacted closely with Salia are quarantined. So far, none are symptomatic. But all are frustrated that their celebration of what appeared to be good news ended this way. | |
| “We heard about the good results, and now look at the situation,” Neeconthe said. | “We heard about the good results, and now look at the situation,” Neeconthe said. |
| On Sunday morning, Yambasu prayed over those quarantined, lifting his hands in the air but keeping his distance. | On Sunday morning, Yambasu prayed over those quarantined, lifting his hands in the air but keeping his distance. |
| “We thank you for standing by our friend during his illness,” he said. “And we pray that you will emerge healthy from this quarantine after 21 days.” | “We thank you for standing by our friend during his illness,” he said. “And we pray that you will emerge healthy from this quarantine after 21 days.” |
| Dina ElBoghdady and Lena Sun contributed to this report. | Dina ElBoghdady and Lena Sun contributed to this report. |