DALLAS — For Louise Troh, word of the death of her fiancé, Thomas Eric Duncan, unfolded Wednesday as everything else has since he was found to have Ebola — at a distance.
Dallas County's chief executive, Clay Jenkins, and the Rev. George Mason of Wilshire Baptist Church drove to the home where Troh, 54, has been under quarantine with her 13-year-old son and two other young men, all of whom had been living with Duncan during the time he first began to show symptoms of the Ebola virus. They have been under orders by state health officials not to leave the premises until the 21-day incubation period of the virus has passed.
"We never sat down," said Mason, who is the pastor of the church Troh attends. "We did not touch them. We kept about a three-foot distance from them at all times. This is simply a matter of extreme caution."
The death Wednesday morning of Duncan, 42, the Liberian man at the center of a widening public health scare and the first person with a case of Ebola to be diagnosed in the United States, heightened anxiety and fear here. It also renewed questions about whether a delay in receiving treatment could have played a role in his death and what role it played in the possibility of his spreading the disease to others.
His death came on a day when a sergeant with the Dallas County sheriff's office who had been in the apartment where Duncan had been staying was rushed to the hospital and monitored for possible exposure to Ebola.
Federal health officials said that they had not confirmed whether the sergeant, Michael Monnig, had definite contact with Ebola or definite symptoms of the virus, but that he was being assessed. Officials said it could take about 48 hours before they were certain of his condition. He was not one of the 48 people being monitored for the disease.
While there were condolences expressed throughout this city over Duncan's death, there were also renewed questions about the handling of Duncan's case by Texas Health Presbyterian Hospital in Dallas, and about whether Duncan would still be alive had he been admitted to the hospital when he first went to its emergency room on Sept. 25.
He was instead released, and returned three days later on Sept. 28 after his condition worsened.
"I trust a thorough examination will take place regarding all aspects of his care," Troh said in a statement.
Dr. Thomas R. Frieden, director of the federal Centers for Disease Control and Prevention, told reporters Wednesday that although Ebola is fatal in a high proportion of patients, it was important for the disease to be diagnosed early.
"The earlier someone is diagnosed, the more likely they will be able to survive," Frieden said.
He declined to speculate on whether the delay contributed to Duncan's death. But agency officials have said generally about treating Ebola patients that using basic interventions — including intravenous fluids and electrolytes, and maintaining blood pressure — can significantly improve the chances of survival.
Referring to the sheriff's sergeant being treated and monitored at Texas Health Presbyterian, Frieden said communities should be vigilant but prepared for false reports of the virus as fear of it spreads. "There will be rumors and concerns and potential cases, and that is how it should be," he said.
Duncan died at 7:51 a.m. Wednesday at Texas Health Presbyterian, eight days after the virus was detected in him on Sept. 30. State officials, following guidelines issued by the CDC on the safe handling of the remains of Ebola patients, recommended to Duncan's relatives that he be cremated, and the family agreed.
Texas Health Presbyterian at first blamed a problem with its electronic records system for Duncan's release after his first visit, but it later reversed itself and said the system had operated correctly. It remains unclear why, and how, the hospital did not view Duncan as a potential Ebola case during his first visit to its emergency room, since both the nurses and the doctor had access to the critical information that although his symptoms were not severe, he had recently traveled from Africa.
After the release of the statement by Troh, Mason said that when he and Jenkins broke the news to her, she had expressed frustration with the hospital's handling of Duncan's case. "She expressed all the 'What ifs,' " Mason said. " 'What if they had taken him right away? And what if they had been able to get the treatment to him earlier?' All of which of course is, as Jenkins says, rearview mirror sort of thinking at this point."