Dr. Daniel Bausch thought they had whipped Ebola again.
It was May, and Bausch, a doctor at Tulane University’s School of Public Health and Tropical Medicine, was leaving Guinea after fighting the deadly virus there for three weeks.
But by June, it was clear that Ebola had spread in dangerous ways. Bausch returned to West Africa, this time to Sierra Leone. For three more weeks, he donned a biohazard suit each morning and treated people suffering from the scourge well into the evening.
One day, the nurses went on strike to protest the terrible conditions, and he and another doctor were left to treat 55 patients. Blood, vomit and feces littered the floor.
On the day he left, Sierra Leone’s foremost Ebola doctor got infected. Bausch had worked by his side. The African doctor died, as have another 10 doctors and nurses with whom he has worked.
Despite the deadly menace, Bausch continues to believe the virus must be fought at the source.
“If there’s a raging fire 3 miles from you, the best way to combat it is not to stay home with a bucket of water in your hand,” he said. “You need to go in and fight the fire. … The more Ebola in Africa, the more risk to the rest of the world.”
That’s one reason Bausch was critical of recent calls by Gov. Bobby Jindal and other politicians for banning flights to the United States from the affected West African countries.
For one thing, “it’s not reasonable or possible,” he said. “There are no direct flights from these countries to the United States. I’ve been working there for 20 years. There are no flights to ban. That’s one thing very few people talk about or realize. People who would come” to the United States “come through Belgium, France or the United Kingdom.”
More important, he added, “the same flights that bring people out are the flights that bring people in. That’s how we get people into combat.”
Bausch likewise has little patience with calls to quarantine doctors and nurses after they return from treating Ebola patients. It’s already a major challenge to find medical professionals willing to go to West Africa for three or four weeks. An additional three-week quarantine makes the prospect even less appealing, Bausch said.
Besides, he added, “It’s not evidence-based, and it doesn’t need to be done.”
Bausch is particularly dismayed by the Jindal administration’s controversial decision to discourage anyone who has been to any Ebola-stricken country over the past three weeks from attending the American Society of Tropical Medicine and Hygiene conference in New Orleans, which runs from Sunday to Thursday. If they do come, state health officials are insisting they be quarantined in their hotel for three weeks, a policy that goes far beyond what the federal Centers for Disease Control and Prevention requires.
“People are not able to come to the meeting because of the draconian law,” said Bausch, who planned to arrive in New Orleans for the conference Saturday. “These are people who will move forward with solutions to deal with the outbreak.”
A familiar enemy
Ebola may be new to most people, but it is a familiar enemy for Bausch.
“Dan is a leader in this whole field,” said Dr. John Schieffelin, another Tulane faculty member who has treated Ebola patients in Sierra Leone. (Three other Tulane doctors — Lina Moses, John Carlson and Susan McLellan — also have worked there recently.)
Few doctors in the world have Bausch’s level of experience with Ebola. He began fighting the virus in 1996 when he joined the staff at the CDC. In the following years, he treated Ebola patients in Uganda, Gabon, the Democratic Republic of the Congo and the Republic of the Congo. Each time, he and the other doctors and nurses snuffed out the outbreak.
But Ebola has retained an ability to reappear, especially in areas with few doctors and little medicine. “It’s by no coincidence that it’s happening (today) in the poorest countries in the world,” he said.
Bausch has spent the past three years based in Lima, Peru, heading the Virology and Emerging Infections Department at a U.S. Naval Medical Research lab there, while remaining on Tulane’s faculty.
His work in Peru doesn’t generate public attention. But given the sensitivity of his Ebola work — which has no direct relation to his work in Peru — the U.S. Embassy there must approve interview requests for him. The Advocate interviewed him at lunch on Monday across a busy street from the embassy.
Bausch, 53, said he didn’t originally intend to be a doctor. When he entered Northwestern University as an undergraduate, he planned to study art but switched to psychology. He chose to attend medical school once he decided his real passion was improving health care and human rights for the underserved.
He came to Tulane in 1992, but he has repeatedly taken leave to work elsewhere, including in El Salvador, Cameroon and Mexico, where he met his wife, Frederique Jacquerioz, who also is a Tulane doctor. She’ll be traveling to Liberia in a week to train people to treat Ebola patients.
Bausch didn’t initially expect to stay long at Tulane. But the institution has been a good fit for him because of its expertise in tropical medicine and infectious diseases and its willingness to allow him to work overseas.
Also, New Orleans “just kind of got under my skin,” he said. “When I go back, I feel like it’s home.”
He and his wife and their two children will move back in July after his stint in Peru ends.
Answering the bell
Given his previous work against Ebola in Africa, it was no surprise that the World Health Organization asked Bausch to go to Guinea in April. When he had completed his work there, only a few patients remained at isolation and treatment centers.
“But unbeknownst to us, there were areas where transmission was occurring,” he said. “That’s how it goes with these outbreaks. You get to the point where you think you’ve controlled it, but you can’t have surveillance with every person of every village.
“Sometimes you wait four or five or six more days, and somebody knocks on the door and tells you about 10 cases where eight more people are dying and two more people are sick in some village you’ve never even heard of. And you realize you put out only 98 percent of the fire. There are still some embers burning somewhere. Obviously, it came back with a vengeance.”
News of the virus has spread fear and even panic throughout the world among people far from the disease. But Bausch said he didn’t hesitate when the WHO asked him to go to Sierra Leone in June to combat Ebola again.
“I’m very careful when I’m around it,” he said. “I have done this before. I feel like I know how to handle it. I know the science around it. I’m scared enough to be extremely careful, extremely cautious and to follow the rules that I do believe work.”
That’s not to say Bausch hasn’t felt uneasy.
“There’s always a time when anybody who is honest about it — you work like crazy, you’re really tired, you’re trying to do a million things,” he said. “There’s a moment when you feel a little feverish that day. You ask yourself: ‘Am I just hot and tired, or is this the first inkling of the disease?’ I don’t dwell on that. A person who is inclined to dwell on that would have already gotten a different job a long time ago because it would have been too stressful.”
As fear has spread, Bausch understands some people may not want to shake his hand, even though weeks have passed since he left Sierra Leone, and in any case, the virus cannot be passed through casual contact.
He said friends at Case Western Reserve University told him that school officials discussed whether to rescind a planned invitation for him to speak there two weeks ago. The talk ended up going off without a hitch.
Fear of Ebola has not spread to his children’s lives. They are 7 and 9 and have only a general sense of his work, he said, though his son did ask one day if Ebola would come to Peru.
Since leaving Sierra Leone, Bausch has played a leading role in helping the WHO plot strategy, especially in ensuring that doctors and nurses have the best available biohazard suits.
He expects he’ll return to West Africa sometime soon to rejoin the fight.
“This is what I do,” he said. “This is why I became a doctor, to improve people’s health. This is my opportunity to do that and do what I know.”