Where Ebola Meets Concerns Over Race, Class and the Uninsured

As the condition of patient Thomas Eric Duncan in Dallas deteriorates, serious questions are being raised about why he was turned away from a hospital after his initial complaints of illness.

A hazardous-materials team member arrives Oct. 3, 2014, to clean a unit at the Ivy Apartments in Dallas where the confirmed Ebola virus patient Thomas Eric Duncan had been staying.
A hazardous-materials team member arrives Oct. 3, 2014, to clean a unit at the Ivy Apartments in Dallas where the confirmed Ebola virus patient Thomas Eric Duncan had been staying. Joe Raedle

It’s a question that’s left people scratching their heads: How does a fully equipped hospital send an Ebola-infected man home—right after he arrived from West Africa and complained about being sick?

Some observers and public health experts are beginning to wonder if there’s an elephant in the room that no one wants to talk about: race and the politics of health insurance. Texas Health Presbyterian Hospital Dallas, the private medical campus where Thomas Eric Duncan is currently under care and isolation, still can’t explain exactly how medical staff let the 42-year-old Liberian national go home with useless antibiotics. Hospital officials have only said that Duncan’s travel history wasn’t “communicated,” and now mainstream media reports are stuck on everything from malfunctions in Presbyterian Hospital’s electronic record system to Duncan being dishonest about the level of his Ebola exposure when he left Liberia.

But few want to touch the pointy eggshells of race and class in the frantic discussion over Ebola as it enters the United States. Did Duncan get initially turned away because he is black and, possibly, uninsured?

Would it have been different if Duncan had been white and insured?

We may never know for sure, and it’s unclear if Duncan had insurance (it’s unlikely, considering that he’s a Liberian national on a U.S. visa).

What we do know is that Ebola response in the U.S. is under enormous scrutiny as experts wonder if an already challenged health system—currently undergoing an Affordable Care Act renovation—is really all that prepared for something that is scaring us like a Contagion script. And the specter of race is lurking not too far behind: When white American aid doctors in West Africa showed signs of the virus, they were rushed back to the U.S. … stat. The same happened when a white freelance cameraman for NBC News in Liberia was immediately flagged for treatment.

But it’s been rough going for black Ebola sufferers—even when one manages to sneak into the U.S. and access one of the most advanced health care systems in the world.

Former District of Columbia Chief Medical Officer Dr. Ivan Walks, who led the response against Washington, D.C.’s first bioterrorism attack, believes it’s a question we need to start asking. “I was stunned,” Walks tells The Root. “You could put [Duncan’s] picture in the dictionary under what you look for when responding to Ebola. How do you miss that guy?”

That’s where factors such as Duncan’s race and level of insurance could have influenced the hospital’s first decision in either subtle or not-so-subtle ways. “There is a lot of research showing that different people get turned away in different places,” argues Walks. “So if they turned him away at first because he’s an African with no insurance, that would not be inconsistent with what we’ve seen over the years.”

Walks draws on lessons from a similar event in October 2001 when the D.C. area was struck by multiple anthrax attacks that hit postal facilities particularly hard. When two black Brentwood-facility postal workers—Thomas Morris Jr. and Joseph Curseen—dropped by Maryland hospitals complaining of anthrax-triggered symptoms, at the same time that news of the attack and Brentwood as a focus of investigation was plastered on every cable channel, they were sent home and died soon after.