Ebola

NEW YORK - Two months after the first U.S. Ebola patient died in Dallas, thousands of people have been screened at airports and tracked by health workers, and millions of dollars have been spent readying hospitals.

And just one new case has been diagnosed in America.

Of 10 patients treated for the disease in the U.S., most of whom were controlled medical evacuations from the outbreak in West Africa, eight have survived.

While the disease is still ravaging Sierra Leone, Liberia and Guinea, last week Congress allocated more than $800 million to prepare and compensate states for readying for Ebola in the U.S., more than a month after the last case was diagnosed in the country. Thirty-five hospitals nationwide are ready for an influx of contagious patients. At this rate, they may see only a handful, under highly controlled circumstances.

"There was a lot of panic and hysteria about where Ebola was going and what might happen," said Kamran Khan, an infectious disease professor at St. Michael's Hospital in Toronto. "Things have now cooled off a little bit, and we have a slightly more balanced approach to managing this outbreak."

As the effort to fight the disease in West Africa has increased, in the U.S. public concern has largely dissipated. Even some of the strict measures -- including airport checks -- ended up being effective more as a public reassurance than as a necessary containment method, said Jay Varma, deputy health commissioner at the New York City Department of Health and Mental Hygiene.

"One major benefit of this program is that it reassures people that government is doing everything it can to prevent Ebola transmission," Varma said in a phone interview. "We knew even before we started screening travelers that the risk of a case being imported into the U.S. was low."

Even as fears have quieted in the U.S., the disease in West Africa has continued virtually unabated, with about 18,460 cases diagnosed and 6,840 deaths, according to the World Health Organization.

While it's the largest Ebola outbreak in history, it's a fraction of the 550,000 or more cases the CDC projected in a worst-case scenario in September. The CDC projection had assumed no additional intervention by governments and relief agencies, which have mobilized to contain the outbreak.

The disease is spreading fastest in Sierra Leone, with three times as many new cases there in early December than in Liberia and Guinea combined. The WHO, the U.S. Centers for Disease Control and Prevention and local governments are focusing on building treatment centers and safely disposing of the dead bodies of infected people, which has slowed the virus's spread in Liberia. Earlier this month, the U.S. Defense Department said it may begin withdrawing some of 2,900 troops stationed in the region because the situation there had improved dramatically.

Congress has allocated $5.48 billion to fight Ebola, and most of those funds are aimed outside the U.S. The U.S. Agency for International Development will get $2.53 billion and the Defense Department $112 million. Some of the $800 million that's meant for U.S. hospitals and governments could also be spent internationally, according to the law.

The money comes long after the peak of the U.S. public's concern. On Sept. 16, President Barack Obama called the chance of an Ebola outbreak in the U.S. "extremely low." Less than a month later, after the first patient to be diagnosed in U.S. died in a Dallas hospital, Americans were far less sure. In a mid-October poll conducted by Pew, more than 40 percent said they worried they or a family member might be exposed to Ebola.

Focus on the virus peaked a month later, on Oct. 16, the day the U.S. began wide screening of international passengers, according to a Google analysis of American's online searches. That week Republican lawmakers also called for the resignation of Thomas Frieden, head of the CDC, and pressed Obama to institute a complete travel ban from the affected countries.

Since then, Ebola's place in the American mind has been in steady decline, according to the Google analysis.

While airport screening may have reassured the country, it was earlier steps taken by the CDC that may have actually prevented any influx of infected. In the first two weeks of August, the CDC sent teams to train local officials for Ebola screenings at airports in Liberia, Guinea and Sierra Leone, putting in place procedures to stop anyone with symptoms from flying.

That's not to say all risk of another case is gone, particularly if the situation in West Africa doesn't improve.

"The epidemic is still ongoing in West Africa, so the state of readiness, the need for readiness and vigilance continues," Mary Bassett, health commissioner at the New York City Department of Health and Mental Hygiene, said in a phone interview earlier this month. "We may have another imported case. So far there have only been two, but we never know where one will be. Who would've thought the first case would be diagnosed in Dallas, Texas?"

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