Ebola: Will Doc be Stigmatized?

In a joyful and emotional public appearance this morning, New York City officials, staff at city-run Bellevue Hospital System, and Craig Spencer, MD celebrated his release.

But throughout the event at the hospital this morning speakers stressed that Ebola stigmatization is an ongoing problem, one that could hamper efforts to end the outbreaks in West Africa..

Spencer is is now free to go out, though his fiancée remains under quarantine until Nov. 14, a period 21 days after her last contact with Spencer.

The event at Bellevue had three themes: the public hospital system is vital; Ebola should not carry a stigma; and first world medicine with the latest therapies and unlimited resources for supportive care could end Ebola if it is made available in West Africa.

Introduced to cheers by New York City Mayor Bill de Blasio as “a true American hero” Spencer thanked his caregivers, and supporters—a long list, including he said, “complete strangers”.

Looking a bit gaunt after his three-week ordeal, Spencer sipped water, nodded vigorously as others spoke, and asked for privacy for himself and his family. He read from a prepared statement also posted on Doctors Without Borders website

He recounted his time in Guinea, when he “cried as I held children who were not strong enough to survive the virus,” But he added, “I also experienced immense joy when patients I treated were cured and invited me into their family as a brother upon discharge.” When news reached Guinea that he was ill, he got calls from colleagues there asking what they could do to help.

He asked the media to “focus attention your attention where it is most urgently needed at the source of the Ebola outbreak in West Africa.” and said “I will not be commenting beyond this.”

The successful management of his case however still leaves the challenge of fighting the Ebola stigma, which has been a problem for Bellevue employees. It could also hamper efforts to get more volunteers to go the West Africa.

Likely with that in mind, the news conference was also occasion for some very public embraces. Spencer got hugs from the mayor; New York City Health and Hospitals Corp. President Ram Raju, MD; Sophie Delaunay, executive director of Doctors Withput Borders-USA,; NYC Health Commissioner Mary Bassett, MD; his physician Laura Evans, and just about everyone on the crowded platform.

“As you can see, he’s a very huggable guy, in addition to his medical skill,” de Blasio quipped.

Later though, HHC’s Raju said “There is a lot of stigma around him [Spencer] and it was very unhelpful for his treatment.” In answer to a reporter’s question Raju said discussions about paying for Spencer's care are underway with city, state and federal agencies.

No new details about that care were released, though Evans, who as director of critical care at Bellevue was the lead physician in Spencer’s care, said it involved the University of Nebraska, the US Centers for Disease Control and Prevention, Emory University in Atlanta, GA, and city and state health departments.

Officials would not talk about what drugs he got, or whether he intended to donate plasma as another survivor did for him.

Beyond that, it was a day for congratulations.

Spencer’s parents were in the audience, and de Blasio singled them out saying “Thank you for bringing him up right.”

And Raju said it was a triumph for the public hospital system he heads—one that the administration of Mayor Rudolph Giuliani had once tried to dismantle and sell off to private bidders.

“The message is here is clear,” Raju said, “this public health system will care for you—if you ever have a misfortune, we got your back.”