New York Ebola patient's movements tracked to trains, taxis and the High Line
Craig Spencer was halfway through the recommended 21-day self-monitoring period for those at risk from the Ebola virus when he went bowling in Brooklyn.
The 33-year-old physician had been working with Doctors Without Borders on the Ebola outbreak in Guinea, one of the three west African countries worst affected by the virus. He finished his work there on 12 October and left the country on 14 October, flying home to John F Kennedy airport in New York via Europe. He arrived in New York on 17 October.
In the days since returning to his apartment in Harlem, he was careful to check his temperature twice a day as part of his monitoring process.
But at some point between returning home from Guinea and experiencing symptoms, officials said, Spencer took a three-mile jog, despite being on a self-imposed limited-contact regime.
Certainly, it seems likely that he thought he was in the clear by Wednesday evening, when he decided to go with friends to Gutter, a bowling alley in Williamsburg.
He did, authorities confirmed at a press conference on Thursday, bowl.
During the day on Wednesday, he may have walked on the High Line a popular tourist attraction on the west side of Manhattan built on a former elevated railway and may have also eaten at a restaurant near there, according to officials.
It is known for sure that he travelled on three subway lines the 1-train, the A-train and the L-train as well as an Uber taxi. Epidemiologists were using information gathered from Spencers New York Metrocard which records the entry points to subway journeys and his credit cards, to determine his movements around the city.
Uber confirmed that Spencer had been given a ride Wednesday evening, and told the Guardian that it had contacted the federal Centers for Disease Control and Prevention and the New York department of health, who had told it that neither the driver nor any of his subsequent passengers were at risk.
Spencer had no fever when he left his apartment on Wednesday, and continued to check his temperature. He told health authorities that began to experience fatigue on Wednesday night, but was otherwise feeling well.
A fever on Thursday morning was the first time Spencer displayed symptoms which indicated Ebola, authorities said, and emphasised that it was unlikely he would have been infectious before that time. Humans are not infectious until they develop symptoms.
It was between 10am and 11am on Thursday, when he developed both a fever and gastro-enterital symptoms, that he contacted Doctors Without Borders, who in turn contacted the New York health authorities.
An emergency medical crew arrived in full protective gear and took him to Bellevue in an ambulance surrounded by police squad cars.
This triggered a series of responses that had been exhaustively rehearsed over the weeks that had passed since Americas first Ebola patient, Thomas Duncan, was diagnosed with the virus at a hospital in Dallas.
Spencer was brought to New Yorks Bellevue Hospital, one of five hospitals in the state which have been designated to handle patients with the disease, by a team of specially-trained paramedics in full hazmat suits.
A meticulous individual, he was careful to make sure his apartment was locked behind him.
Spencer is currently in an isolation ward unit at Bellevue hospital that was built during the Aids epidemic in the 1990s, when it was designed to deal with immuno-compromised patients suffering from tuberculosis.
Since returning from Guinea, it is confirmed that he had been in contact with his fiancee - who is currently under supervision and in isolation also at Bellevue hospital, where she is currently showing no symptoms that would indicate Ebola.
Two other friends have been given the option of home quarantine. All three are said to currently be healthy, but will be monitored until they clear the 21-day incubation period.
At the press conference, the governor of New York, Andrew Cuomo, compared New Yorks preparedness favourably with the response in Dallas, saying it was the exact opposite of what happened there.
Dallas unfortunately was caught before they could prepare, before they knew what they were dealing with, and we had the advantage of learning from the Dallas experience, he said.
Thomas Duncan, the Dallas patient, was at first sent home from Texas Health Presbyterian hospital and was later left in open waiting rooms, according to reports by the nurses union, which also alleged that healthcare personnel were forced to seal gaps in their protective equipment with surgical tape.
Two nurses in Dallas contracted the disease from Duncan.
Cuomo said that New York had been fortunate that the affected was a doctor who was familiar with the possibility and the symptoms, and handled himself accordingly.
This is New York, people fly in and out every day, said Cuomo. We cant say that this is an unexpected circumstance.
As soon as the diagnosis was suspected, a team from the federal Centers for Disease Control and Prevention was dispatched to New York to assist with Spencers treatment and the public health response.
Out of what officials called an abundance of caution, the bowling alley Spencer attended will be closed on Friday for a full inspection by health authorities.
