US Ebola 'blunder' stokes anger

Mr Duncan's apartment was cleaned on Friday, three days after his admission to hospital

Until Tuesday the US plan for responding to the presence of the Ebola virus on its soil existed only on paper. When Thomas Eric Duncan ended his journey from Liberia in Dallas, Texas, last week that hypothetical situation became a reality.

What happened next has left many US commentators wondering if there are glaring holes in the government's game-planning and outbreak preparedness.

"More than six months after an outbreak of Ebola began its rampage through West Africa, local and federal health officials have displayed an uneven and flawed response to the first case diagnosed in the United States," write Kevin Sack and Manny Fernandez for the New York Times.

Much of the controversy has centred around the chain of events after Mr Duncan first displayed symptoms after his arrival in the US.

He visited a local hospital and was sent home with antibiotics, despite informing health care practitioners that he had recently returned from an Ebola "hot zone".

Given all the recent attention the Ebola outbreak in western Africa has garnered, the fact that a medical facility in a major US city did not appear vigilant for signs of the disease - including flagging the results of background screening for patients displaying Ebola-like symptoms - has many commentators concerned.

"If Texas medical facilities truly were on top of this, as were the Centers for Disease Control, then asking the recent travel history of every patient should have been as routine for all medical personnel as taking blood pressure or asking whether the patient is allergic to penicillin," writes Tod Robberson of the Dallas Morning News.

"When the world is on high alert, this is no time to be learning from mistakes on the fly."

Are Texas and US officials paying attention now that there has been an Ebola case in the US?

He says that government handling of the situation so far has people in Dallas worried:

"Thousands of parents are no doubt freaking out and wondering whether their children are safe. Thousands more Dallas residents are probably nervously looking around them and wondering what's going to happen next. This is no way to stop people from panicking. In fact, if I were to write a script for how to build slow, mass panic, it would unfold a lot like this."

Mr Duncan's case presented "everything hospitals have been warned to watch for", write the editors of USA Today.

Although the "breathtaking blunder" in this case has been now been remedied, they write, the US public health system needs to learn from these mistakes - and fast.

"Impressive-sounding federal strategies to fight Ebola won't mean much if front-line health professionals don't follow them," they write. They warn that public trust in medical authorities will waver if there are further lapses.

"The US healthcare system is the most sophisticated in the world," writes Celine Gounder, an infectious disease specialist, for Reuters. "It is also byzantine and inefficient, and those systemic flaws may have allowed a patient with a deadly virus to slip through the cracks."

She says one of these flaws is that modern healthcare practitioners are enamoured with technology and don't take the time to talk with their patients or conduct basic physical exams.

Food and other supplies have been delivered to the apartment, where four people have been ordered to stay indoors until 19 October

Criticism of the response to the first US case of Ebola hasn't stopped at the hospital doors, either.

As Sack and Fernandez note in the Times, four days after Mr Duncan was quarantined in a hospital, the apartment where he stayed when he first became ill still had not been properly sanitised and the possibly contaminated sheets and towels from his bed had yet to be disposed of.

"County officials visited the apartment without protection Wednesday night," they note.

Texas public health officers said they were having difficultly finding contractors willing to perform the cleanup tasks - the sort of task that would seem an essential part of any emergency response plan.

"The failure to sanitise his sheets and towels also revealed a broader problem in handling materials possible infected with the virus," they write.

"Hospitals say they face a major challenge disposing of waste generated in the care of Ebola patients because two federal agencies have issued conflicting guidance on what they should do."

On Thursday the Times website published a series of short opinion pieces detailing what the US could be doing better to confront the potentially deadly disease. Advice ranged from a thorough screening of all individuals entering the country from at-risk areas to an outright ban on entry for all such non-US citizens.

Meanwhile Tom Frieden, director of the US Centers for Disease Control and Prevention, took to the pages of CNN.com to assure Americans that there is no need to panic.

A hazardous materials crew arrived on Thursday

The US government anticipated that an infected patient would eventual make it to US soil, he says.

"The fact is that CDC has been preparing for this day, working around the clock with local and state health departments to enhance surveillance and laboratory testing capacity, provide recommendations for healthcare infection control and other measures to prevent disease spread, and deliver guidance and tools for health departments to conduct public health investigations," he writes.

While the CDC may not be able to contain this outbreak at just one case, he says, the US will "stop Ebola in its tracks".

Recent commentary indicates it may be too late to prevent at least some damage to public confidence in the adequacy of the US preparedness, however.