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Even Ebola treatment may be cheaper in Texas than in New York

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(Bloomberg) — New Yorkers are getting a bigger bill shock from Ebola than Texans.

In Texas, state, county and city spending on containment and clean-up after the first cases of the Ebola virus cropped up in the Dallas area this year added up to less than $3 million, according to data from local agencies. That even includes more than $26,000 to take care of an infected patient’s dog.

New York City estimates it has spent $21 million and counting to treat Ebola patient Craig Spencer, track down dozens of people he interacted with before his condition was diagnosed in October and monitor those people and hundreds of others who enter the city each day from West Africa.

New York’s estimate is part of the city’s appeal for reimbursement from the $6.2 billion fund President Barack Obama has requested to cover Ebola costs in the U.S. and to help fight the virus in West Africa and elsewhere. The city declined repeated requests to provide details of how it reached its estimate, making it impossible to tell how closely its figures compare with the spending figures in Texas.

See also: Ebola case raises questions about insurance coverage.

So is New York overspending? Are its officials overestimating the cost? Or does the city just have bigger needs than Dallas? Comparing the cities’ handling of the virus sheds some light.

Health officials in both New York and Dallas worked with the federal Centers for Disease Control and Prevention (CDC) to trace people who had contact with patients infected there. While patients in both cities moved around in public with infections in the time before they were admitted to hospitals for treatment, neither had a case of transmission outside of a hospital. In Dallas, two nurses contracted Ebola from contact with a patient.

Airport destination

Some of the difference in cost may be due to New York’s role in receiving people from West Africa, where most of the Ebola outbreak has been concentrated. Unlike Dallas, New York has one of the five U.S. airports designed by the Department of Homeland Security as a destination for passengers from Liberia, Sierra Leone and Guinea.

As of Dec. 2, the city’s health department was monitoring 222 people who had traveled to the city from West Africa in the previous 21 days, a precautionary measure. The department had also been keeping an eye on 114 health-care workers who treated Spencer until the monitoring period ended for the last one this week.

New York said it had 500 staffers working full time on Ebola. The city required police and disease detectives to spend hours finding individuals who needed to be monitored, and it hired substitute health-care workers to cover for the 100 medical staffers devoted to Spencer’s care.

First diagnosis

Dallas County officials calculate they spent $384,347, including items such as decontamination and payroll costs, in October and November after Thomas Eric Duncan became the first person diagnosed with the deadly disease in the U.S.

The city of Dallas, meanwhile, estimated it paid $155,000 tied to the Ebola outbreak, including costs for the fire department, police, animal services, utilities, equipment and emergency management services. The Texas Department of State Health Services estimates the expense will eventually total $1.28 million, covering staff costs, travel, supplies and incineration of waste. It isn’t clear whether the state’s total includes some of the city and county expenses.

Those price tags don’t include medical treatment for Duncan or the two Texas Health Presbyterian Hospital Dallas nurses who were infected while caring for him. While the hospital hasn’t disclosed its costs, its parent company, Texas Health Resources, attributed an $8.1 million drop in net revenue to the financial impact of the Ebola case, according to a regulatory filing.

Hospital costs

Texas Health Resources has absorbed all the costs associated with treating its Ebola patients, and its patient volumes have returned to normal except in the emergency department, Wendell Watson, a spokesman, said in an e-mail.

New York didn’t detail the specific costs of Spencer’s care at city-owned Bellevue Hospital Center. More than 100 people took care of him, and the costs include expenses for protective equipment, medicine, the treatment of hazardous materials and a special lab for blood tests, said Ram Raju, president of the city’s Health and Hospitals Corp.

The hospital agency’s costs are the biggest component in the $21 million total, followed by the health department, the fire department, the police and Office of Emergency Management, he said.

Spencer, who contracted Ebola while working as a volunteer with Doctors Without Borders in Guinea, didn’t respond to an interview request through a spokesman.

The University of Nebraska Medical Center, which has treated three Ebola patients, has estimated it costs $30,000 a day to care for each infected person. Spencer was at Bellevue from Oct. 23 to Nov. 11, or 20 days.

Bentley’s care

Dallas officials didn’t skimp when it came to came to Bentley, the Cavalier King Charles spaniel owned by Nina Pham, the first nurse to contract Ebola. The cost of sheltering, feeding and caring for Bentley alone totaled $26,884, according to the city, which included that amount in its total Ebola costs.

Some of Bentley’s expenses, about $19,000, were paid for by grants and donations, said Sana Syed, a city spokeswoman. The city is asking the state of Texas to reimburse some of the other costs, which included personal bills for Duncan’s family, hazardous materials response, salaries, supplies and security.

U.S. Senator Charles Schumer, the New York Democrat, called last month for the U.S. government to establish a permanent fund to cover any future costs for New York and other cities that find themselves grappling with Ebola. The need to contain the infectious disease is a nationwide imperative, as an inadequate response by an overburdened city could lead to the virus spreading nationwide, he said in a statement.

The situation should be handled like a natural disaster, which qualifies for federal relief, Schumer said.

Everyone affected

Nebraska Senator Mike Johanns, a Republican, has proposed federal funding to reimburse the hospital in his state for the expenses of its treatment of Ebola patients.

Representative Michael Burgess, a physician from Texas, said at a congressional hearing last month that the ramifications of an Ebola patient are substantial and hard to anticipate.

“Until you have this thing in your backyard it’s hard to predict how this will affect your life,” the Republican lawmaker said. “Trash collection, sewer treatment, school districts, everyone down the line was affected by this virus in our area.”

–With assistance from Doni Bloomfield in New York, Darrell Preston in Dallas and Anna Edney and Mark Drajem in Washington.


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