Preparing Airports for Communicable Diseases on Arriving Flights (2017)

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87 Ebola Time Line (Broom 2014a) Aug. 15 TSA employee with recent travel to Ivory Coast becomes ill in TSA office and is trans- ported to Baylor Medical Center Grapevine by DFW EMS. Conference call that night. Sept. 15 Mr. Duncan helps a neighbor get to the hospital. Neighbor later diagnosed with Ebola. Sept. 19 Mr. Duncan leaves Liberia. He is asymptomatic on exit screening. Sept. 20 Mr. Duncan arrives at EWR and takes a United domestic flight to DFW. Sept. 24 Mr. Duncan begins to have fever and GI symptoms. Sept. 25 Mr. Duncan presented to Texas Health Resources (THR) Presbyterian with symptoms, but his travel history was not fully appreciated by the entire care team. Sept. 28 Mr. Duncan returns to THR Presbyterian ER by Dallas Fire Rescue ambulance. CDC and DHHS are notified. Sept. 30 CDC passes unofficial warning that a diagnosed Ebola case will be announced. DFW has about two hours warning. 14:30 EVPs and Public Information office work most of the night in collaboration with Tarrant County Public Health and CDC to understand Mr. Duncan’s travel itinerary. CDC con- firms Duncan did not fly on Emirates. 17:00 Dallas County begins operating an EOC to manage the consequences of the diagnosis. 18:52 Tarrant County PH issues media statement. 19:19 Initial Board employee statement transmitted. Oct. 1 Dallas Fire reports that all its ambulance workers have tested negative for Ebola. They are sent home, to be monitored for 21 days. Dallas schools report that five children in four schools may have had contact with Mr. Duncan but are not showing symptoms. Schools stress to parents that there is “no imminent danger to your child.” Dallas County health officials say they are watching 10 to 18 people who had close contact with Mr. Duncan, mainly family and close friends, and would “not be shocked” if a second case surfaces. Emirates Airways begins A380 service to DFW Airport. Governor Perry holds noon press conference at THR Presbyterian. Tsunami of conference calls begins. Oct. 2 Mr. Duncan is listed in serious condition by the hospital. State health officials say they are looking at about 100 people who may have had contact with Duncan or his relatives. Dallas County says 80 people had contact either directly with Mr. Duncan or with people who had contact with Mr. Duncan. Duncan’s family is ordered by state health officials to stay home, with no visitors unless health officials give their approval, until Oct. 19. The hospital says a software flaw kept a physician from seeing that Mr. Duncan had recently traveled from Liberia, leading the hospital to initially send him home. United Airlines says it is trying to notify as many as 400 people who may have been on Mr. Duncan’s flights to the U.S., referring them to the CDC. Sanitation of Terminal E areas becomes an issue. PPE worn (or not) by employees becomes an issue. Appendix F ebola Time Line for dFW Cases

88 Oct. 3 Haz-mat crews decontaminate apartment where Mr. Duncan stayed before hospitalization. The quarantined family members of Mr. Duncan are transported from their apartment to an undisclosed location. Meanwhile, Mr. Duncan is in critical condition. CDC rep meets with DPS, EAD, Customer Service, ETAM. Oct. 4 Duncan receives an experimental drug called Brincidofovir, made by Chimerix, Inc. A Fort Worth doctor who was diagnosed with Ebola while in West Africa treating patients and later cured after traveling back to the U.S., says he attempted to donate plasma to help Duncan but their plasma types didn’t match. Mr. Duncan’s condition is downgraded from serious to critical. Oct. 6 Stericycle (waste handler) is given a permit to transport Ebola-contaminated materials for incineration. Parking begins frequent cleaning of buses. Oct. 8 Mr. Duncan pronounced dead at Texas Health Presbyterian Hospital Dallas. A sheriff’s deputy is transported from a Frisco clinic to Texas Health Presbyterian after experiencing stomach pains. The deputy went inside Duncan’s apartment days before his death with several other depu- ties and two health officials. False alarm on DFW-LAX flight which stopped in Midland, Texas. Oct. 9 The deputy’s Ebola test comes back negative. Message sent to Board employees. Infrared thermometer availability became an issue. Oct. 10 Patient #2, a 26-year-old nurse at Texas Health Presbyterian takes her temperature and reports having a fever. She drove herself to the hospital and was in isolation within 90 minutes. Patient #3 flies to Cleveland on Frontier Airlines. Parkland shares their training video on donning and doffing of PPE. House of Representatives Committee on Homeland Security holds a Field Hearing in Terminal D. Oct. 12 Patient #2 is diagnosed with Ebola. She’s the second person to be diagnosed within the United States and the first to contract the virus within the country. Three distinct messages sent for Fire/EMS, Police/Security, and admin DPS employees. Oct. 13 Patient #3, a 29-year-old nurse who also treated Duncan at Texas Health Presbyterian, travels from Cleveland to Dallas on Frontier Airlines with a low-grade fever. Crews transport Patient #2’s King Charles Spaniel, named Bentley, to an undisclosed location. The pet will be placed under monitoring for 21 days. Contamination of waste water became an issue. Oct. 14 Patient #3 reports and is admitted to Texas Health Presbyterian. DFW holds Pandemic Steering Committee meeting Oct. 15 Patient #3 is diagnosed with Ebola. Haz-mat crews clean out her apartment at Skillman Street and Lovers Lane. Patient #3 is the second person to contract the virus on U.S. soil. Texas Health Presbyterian announced she’ll be transferred to Emory Healthcare in Atlanta for treatment. Frontier is notified of Patient #3’s travel on their flights and posts press release. Subcontractor employee to Bombardier says he lives in same apartment complex as Patient #3 and has been ordered to DHHS for screening. Board employees increase questions after Frontier announcement. N-95 masks become an issue. Oct. 16 Patient #2 is transferred to NIH Bethesda, Maryland, for treatment. Border entry screening for Ebola concentrated at “the 5” airports. Employee (subcontractor) who was told to remove gloves and masks goes media. Message number 3 sent to all Board employees.

89 Oct. 17 Jail intake screening for Ebola set up. Center for Domestic Preparedness made initial contact about DFW hosting a PPE class at FTRC. First indication of enhanced screening possibility from Customs and Border Protection. Oct. 18 CBP indicates enhanced screening of those with travel history or passports begins immediately. Oct. 21 Conference call to polish the enhanced screening procedures and expectations was held. Oct. 23 CDP holds pilot course on PPE for biological events. Oct. 24 Patient #2 is Ebola-free and is discharged. Oct. 28 Patient #3 is Ebola-free and is discharged.