The Ebola-infected patients who were treated in isolation at Emory University Hospital have been released — Nancy Writebol on Tuesday and Dr. Kent Brantly on Thursday.
Emory doctors and government health officials are so sure the two are cured of Ebola and pose no threat to public health that they released Writebol without telling the public.
Brantly walked out of the isolation unit Thursday morning into a joyful phalanx of his doctors and nurses, receiving a hug from his wife, according to Dr. Richard Furman, who witnessed the scene; for two weeks the couple had only seen each other through a window. Later Brantly emerged from the hospital to address a press conference.
“Today is a miraculous day,” he said. “I am thrilled to be alive, to be well, and to be reunited with my family.”
He hugged each of his two dozen caregivers as he left the podium, a silent message to the world that the Ebola patients are now safe to face and to touch.
“He can return to his family, community and to his life, without concern for spreading this infection to others,” said Dr. Bruce Ribner, an infectious disease specialist at Emory who led the medical team.
Ribner said Emory had made the determination that the two patients represented “no public health threat” in conjunction with the U.S. Centers for Disease Control and Prevention and the public health departments of Georgia and North Carolina.
“It was the right decision to bring these patients back to Emory for treatment,” he said, even as corners of social media bubbled with comments like “Guy got over and is cured of Ebola that quick? ..here we go #genocide.”
The moment was a vindication for Ribner and all those involved in the decision to bring Brantly and Writebol to Emory — the first Ebola patients ever known to be in the United States.
Ribner had maintained that the simple provision of health care at the levels typically available in the U.S. would change the game for the two patients, and the broad smiles on the podium Thursday suggested that he’d been right.
Ribner said the team had learned enough to provide guidelines they hope will help the clinics dealing with the outbreak in West Africa. Clinics there mostly do not have the ability to monitor patients’ electrolytes, such as potassium, calcium and magnesium, he said, but Emory now knows that the levels can drop significantly and so can advise them to act accordingly.
As to the experimental treatments that Brantly and Writebol had received, there was less certainty.
“Experimental means exactly that,” Ribner said of the drug ZMapp, which the two received in Liberia even though it had never been tested on humans. “They are the first individuals to receive this agent. There is no prior experience with it, and frankly, we do not know whether it helped them, whether it made no difference — even theoretically if it delayed their recovery.”
Likewise, a transfusion Brantly received from a patient he had treated — the blood presumably contained antibodies — may or may not have helped, Ribner said. There's no evidence to support any conclusions about the impact of the transfusion, he said.
There has been discussion at Emory about other drugs that might be used in the outbreak. One drug, Gleevec, has already been approved for use in treating cancer, but an Emory study found it might be useful against Ebola as well. Ribner would not be specific about which drugs had been discussed, and because of patient confidentiality laws could not say what had been used to treat the two Ebola patients while they were at Emory.
Their Ebola journey is not finished. Brantly asked for time to recover not only physically but emotionally.
Physically, “there may be some recovery time because this is a fairly devastating disease,” Ribner said. “But we would anticipate that in general most patients if they have not had any substantial organ damage will make a complete recovery.”
In a statement released by the charity Writebol worked for, her husband said that “the lingering effects of the battle have left her in a significantly weakened condition.” However, like Brantly, she walked out of the hospital.
Emory doctors and other experts said there is no evidence of any patient infecting another patient after being cured — that is, after ceasing to show Ebola symptoms or any virus in blood tests for two to three days.
The research on Ebola is sparse. One man in the 1970s retained Ebola virus in his sperm for two months; out of caution, the CDC advises men to use protection during sex for three months afterward, and Ribner said the patients had been given that advice.
Brantly and Writebol have asked for privacy before they tell their stories. But it’s possible that Brantly could return to treat patients in Africa, said Dr. Richard Furman, a board member of Samaritan’s Purse, the North Carolina Christian charity that Brantly works for. Ribner said physically Brantly may be that hale once again, and in fact he should at least be immune to a strain of Ebola.
Furman said he had not discussed the issue with Brantly, but said, “That’s the plan.”
It’s been a rough journey for Brantly’s supporters, too. Furman was at an Alaska retreat with the Rev. Franklin Graham, the Christian mission founder and son of the Rev. Billy Graham, when they began receiving phone updates from a doctor there. “He said, ‘I don’t think he’s gonna make it,’” Furman said. Brantly’s temperature was “sky high” and his respiration abysmal.
“It was scary,” said Furman, who with Graham co-founded the medical mission arm of Samaritan’s Purse. “You realize, we sent them there, we set up this clinic. It was a tough time.”
Then Brantly got the experimental drug and improved, Furman recalled. And Emory took him in.
“For the first time, he said, ‘I think I’m gonna make it.’”
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