A local longshoremen's union in Baltimore briefly refused to work a ship from West Africa. Questions about a patient's medical transport sparked a fury. And Rep. Andy Harris, a Baltimore County Republican and a doctor, called for a ban on travel from disease-affected regions.
Fears about the deadly Ebola virus mounted Thursday across the country and in Maryland — spilling further into business, transportation and politics — even as government officials sought to regain the public's confidence in their ability to stop the disease from spreading.
Two infected Dallas nurses were moved, one to the National Institutes of Health Clinical Center in Bethesda and the other to Emory University in Atlanta, as people asked why one was allowed on a commercial flight home from Ohio on Monday. Further questions arose when an unprotected man was seen Wednesday with a hazmat-suited crew transporting one of them from Dallas to Atlanta.
At the port of Baltimore, International Longshoremen's Association Local 333 delayed loading used vehicles onto a ship bound for West Africa for about 45 minutes out of fear of Ebola being on board, port officials said. The dockworkers resumed working the ship after those fears were deemed unfounded, said Richard Scher, a Maryland Port Administration spokesman.
President Barack Obama canceled his scheduled plans for a second straight day to focus on new Ebola directives for the Centers for Disease Control and Prevention, including ordering the federal agency to immediately send a "SWAT team" of trained professionals to deal with Ebola cases anywhere in the country.
Congressional Republicans pressed CDC Director Thomas Frieden on the possibility of a travel ban during a hearing Thursday on Capitol Hill. The Obama administration has argued against such a ban, but Frieden did not rule one out.
Harris, a Johns Hopkins trained anesthesiologist who attended the hearing, said the fact the CDC is still making "numerous and continuous changes to its protocols" means it doesn't really know how to respond to Ebola.
"The public perception is that the government either doesn't know what they're doing or are not doing the right thing," Harris said.
Ebola has killed thousands in West Africa, but the United States has seen only a few isolated cases, including the two nurses who treated a Liberian man in Dallas. One of the nurses, Nina Pham, was being transported to the NIH on Thursday via Frederick Municipal Airport.
In a statement, the NIH — which also treated an American doctor exposed to Ebola in Sierra Leone — said it is "taking every precaution to ensure the safety of NIH patients, staff and the public," and that the center's Special Clinical Studies Unit "is specifically designed to provide high-level isolation capabilities and is staffed by infectious disease and critical care specialists."
The NIH said the unit's staff "is trained in strict infection control practices optimized to prevent spread of potentially transmissible agents such as Ebola."
The fact the two nurses contracted the disease — despite such resources — has stoked fears that the virus could gain a foothold in the United States. For some, those fears seem to be outweighing repeated reassurances from medical professionals that the virus is only transmitted through direct contact with the bodily fluids of someone who is ill, and that the average American has an exceedingly small chance of becoming infected.
Skeptics seize on any perceived mistake to criticize the response. When news reports showed a man without protective gear walking with a clipboard on the Dallas tarmac with a group of hazmat-suited medical providers attending to Amber Vinson, the other infected nurse, the images spread rapidly on the Internet. The criticism took on a life of its own, trending on social media under the hashtag #clipboardguy.
The frenzy began dying down after the company providing the transport — Phoenix Air — explained the man's role in the operation. Randy Davis, the company's vice president, said the man was the operation's medical safety coordinator, tasked with watching the procedure for any missteps by the hazmat-suited team, which handles the patient but cannot see or hear their surroundings well.
The coordinator keeps a distance from the patient and provides an external check on the transport. The company has used the same procedures for all of its Ebola transports — this was the 10th — and has never had a mishap or a crew member become infected, Davis said.
"We know our systems and our protocols and our procedures work, and we prove that over and over again," he said.
Harris acknowledges that the odds are slim that an American would become infected with Ebola, but said he also believes that a full or partial ban on commercial air travel from Liberia, Sierra Leone and Guinea to the United States would make sense.
"I think that alone would reassure Americans that the government is taking this seriously, and is taking what your average American would consider a common-sense step," Harris said.
He called on the Food and Drug Administration to speed the production of vaccines, treatments and diagnostic tests for Ebola. Some of those steps are underway but have been stalled, he said, including the development of the experimental drug ZMapp.
Medical professionals said the public would benefit from a better understanding of how the virus spreads: It is not airborne; it is not contagious if a patient is not showing symptoms; its transmission requires contact with bodily fluids such as vomit, tears or sweat.
"It makes sense that people get scared because this is a deadly disease. People hear the reports and watch the reports and they get scared," said Nancy Kass, a professor of bioethics and public health at the Johns Hopkins Bloomberg School of Public Health. "What is essential is continuing to do communication, calm communication, that continues to explain to the public who is at risk and who is not at risk, how transmission happens and how it doesn't happen. I think the response to panic is not to say to someone, 'You're so silly to panic,' but to continue to provide factual information."
At the port, work was scheduled to begin on the Silver Soul, a vessel owned by Dubai-based Sallaum Lines, at 8 a.m. Thursday, but didn't start until about 8:45 a.m. It is unclear who ordered the work stoppage. Riker "Rocky" McKenzie, ILA Local 333's president, could not be reached for comment.
In August, the ILA dedicated its quarterly safety bulletin to Ebola. The document played down the likelihood of a dockworker in the United States contracting the disease — saying that while longshoremen are part of an increasingly global trade, there were only "remote risks" for members not living or working in West Africa.
The Silver Soul had called in Jacksonville, Fla., prior to Baltimore with no issues. The roll-on/roll-off ship was in Baltimore to load used vehicles for sale in Africa's thriving secondhand market. It was not unloading cargo from West Africa, Scher said. After Baltimore, the vessel is bound for Bayonne, N.J., and Boston before returning to Africa.
Baltimore's port does not import any goods from the Ebola-affected nations of Liberia, Sierra Leone and Guinea, Scher said.
Lt. Krystyn Pecora, a spokeswoman for the 5th Coast Guard District, which is in charge of monitoring ships coming from the nations affected by Ebola, said the Silver Soul was not deemed a threat. The last time it was in a port outside the United States was more than 21 days ago, which is the incubation period for Ebola, she said.
In general, ships arriving in U.S. ports must notify the Coast Guard 96 hours in advance of arrival listing their cargo and their last five ports of call, Pecora said. Vessels that have been in Liberia, Sierra Leone or Guinea are being flagged, she said.
"For those vessels that may be coming from one of those locations, we're proactively reaching out and providing a questionnaire that is basically designed as a health survey for them to fill out," she said.
If a crew has experienced a recent death or illness, the Coast Guard will hold the ship off and notify the CDC, Pecora said.
In the past week, several ships with West Africa calls in their last five port visits have entered Baltimore, but none had been in West Africa within the past 21 days.
"Some hadn't been there for four months," Pecora said.
Understanding details such as Ebola's incubation period is critical to easing any panic. Dr. Tyler Cymet, president of MedChi, the state physicians society, said the best strategy is disseminating information about Ebola, "letting people rationalize what's going on and understand it, and understand they're likely to be safe."
"Their worries should be small unless they're in a situation with someone who's known to have it."
Baltimore Sun reporters Scott Dance and John Fritze contributed to this article.
An earlier version misstated that an American doctor was infected with Ebola and treated at NIH. The doctor was exposed to Ebola. The Baltimore Sun regrets the error.