In Thursday morning’s chill, Dr. John Fankhauser stood outside his temporary home, an RV parked on the edge of the woods in south Charlotte, and stuck a thermometer in his mouth as public health nurse Carmel Clements watched.
She was there to make sure the medical missionary, who returned from Liberia two weeks ago, isn’t running a fever or showing other symptoms of Ebola.
After a few minutes, as they stood several feet apart, Fankhauser held out the thermometer so Clements could record his normal temperature – 97.4.
It’s all part of a Mecklenburg County Health Department quarantine that orders Fankhauser to remain secluded – for the second time in four months – because he was in contact with Ebola patients in Liberia, one of the West African countries where the epidemic has been raging.
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Fankhauser, 52, is not sick and is confident he wasn’t exposed to the often-deadly virus. When he last treated an Ebola patient on Nov. 3 in Liberia, he wore protective gear and felt no risk of being infected.
“I’m doing this to comply with a public health order, not because I think it’s a necessary restriction to keep the public safe,” Fankhauser said in an interview.
Even so, he and other officials with Charlotte-based SIM USA understand the need to allay public fears.
They’re well aware of the panic that arose last month after news broke that another medical missionary, Dr. Craig Spencer, rode the New York subway, ate in restaurants and went bowling before becoming ill with Ebola.
“From what I saw, Dr. Spencer really was responsible in that as soon as he had symptoms, he isolated himself,” Fankhauser said. “It’s important for people to be reminded that when people do not have symptoms, they’re not contagious. There’s really no medical reason to tell someone they can’t go bowling when they don’t have symptoms.”
Fankhauser’s quarantine began Nov. 8 when he arrived in Charlotte for a rest and reunion with his family. Monday marks the end of the order and of the 21-day incubation period, the time it takes for symptoms of Ebola infection to appear after an exposure.
On Tuesday, he’ll fly to California with his wife and two daughters to celebrate Thanksgiving with the Fankhausers’ son, a graduate student at UCLA. But the U.S. visit won’t be long. On Dec. 4, the missionary plans to return to Liberia for another two- or three-month stint.
“I’ll be spending Christmas in Liberia with my Liberian friends and family,” he said.
For now, Fankhauser and his wife and two daughters are living in two recreational vehicles on the SIM campus. He keeps a 3-foot distance between himself and others – except for his family.
The doctor is careful not to criticize, but he clearly believes he is no threat to anyone and that others who are willing to volunteer in West Africa should not be dissuaded because of unwarranted fear and misunderstanding.
“I’m not trying to object to my own situation,” Fankhauser said. “We need to be cautious to use quarantine to protect public safety but not to use quarantine where it’s not necessary.”
For now, quarantine decisions vary from state to state. Last month, after Spencer’s diagnosis, the governors of New York and New Jersey ordered mandatory, 21-day quarantines for medical workers and other arriving travelers who’d had contact with Ebola in West Africa. Soon after, nurse Kaci Hickox was detained at the Newark airport after returning from Sierra Leone. She complained about being held for hours with little to eat and being quarantined even though a test showed she didn’t have Ebola infection.
Unlike Hickox, Fankhauser said he was treated respectfully when he arrived at the Atlanta airport. But he said an “overly restrictive” response toward returning travelers could deter people from volunteering to help fight the Ebola epidemic in West Africa.
“The threat to America is really not going to go away until the epidemic is stemmed in West Africa,” Fankhauser said.
Mecklenburg County Health Director Marcus Plescia said Fankhauser has diplomatically raised “some legitimate issues” about the county’s quarantine order. “We could probably be a lot less intensive about how we monitor him, and we’re willing to look at some of that again,” Plescia said. “But part of our job is to manage public anxiety.”
For example, nurses who’ve been monitoring Fankhauser daily declined to be photographed or identified for this story because of “the potential for causing concern among their friends and family,” said Clements, who did the monitoring Thursday when the Observer was present. That isn’t typically part of her job as division director for community health.
“We know there is no need for excessive fear and stigma,” Clements said. “But you just have to watch the news to see that it’s real.”
‘A little pent up’
Fankhauser, who previously lived in California, has been on the front lines of Ebola since the outbreak began in Liberia in June. And he has been quarantined twice in Charlotte.
He and his family first arrived in Liberia in November 2013, because they “felt like God was calling us to do mission work in Africa.” He helped manage SIM’s ELWA hospital and start a medical residency program, and then the focus changed to Ebola.
In late July, fellow missionaries Nancy Writebol and Dr. Kent Brantly were the first Americans to be diagnosed with Ebola infection, and Fankhauser was part of the team that cared for them before they were airlifted to Atlanta.
About a week later, Fankhauser returned to Charlotte on a flight with Writebol’s husband, David. They were quarantined with several other missionaries on the SIM campus. They lived in RVs, some with their families. None became ill. “We had quite a little community up here for three weeks,” Fankhauser said. “We had campfires together and meals together.”
In early September, soon after his first quarantine ended, Fankhauser returned to Liberia to help care for another missionary colleague, Dr. Rick Sacra, who also contracted Ebola and was later airlifted to Nebraska Medical Center.
Needing another rest, Fankhauser returned this month to a second, quieter quarantine. It’s just him, his wife and two daughters, and three missionaries from Guinea who are not legally restricted.
Fankhauser said he’s not bored but feels “a little pent up.” He and his family have had some meals at SIM headquarters, seated at a table “away from the rest of the staff.” And they’ve been invited several times to the homes of SIM staffers for meals or coffee. He spends time working on reports and usually has one phone call a day to Africa.
“It’s hard to be away too long,” he said, referring to his responsibilities for running the SIM hospital and caring for patients in Liberia. He looks forward to the day when Ebola is under control and his family can join him again.
“That is where our family home is right now,” he said. “My home is in Liberia.”