WASHINGTON -- On this day in 2014, the Centers for Disease Control and Prevention confirmed the first case of Ebola diagnosed in the United States.
The patient was in Dallas. A video of a press conference by then-Texas Gov. Rick Perry (R), set to theme music from a zombie apocalypse TV show, established the tone for what happened next. Louisiana Gov. Bobby Jindal (R) called for a travel ban from the three West African nations most badly afflicted by the virus, even though there were no direct flights from those nations to the United States. A Kentucky schoolteacher was chased out of her job. New Jersey Gov. Chris Christie (R) essentially imprisoned a nurse.
The country flipped its wig. The mere presence of Ebola in the U.S. convinced people that a biomedical nightmare was near.
"They would see pictures of West Africans, be they in Liberia, Sierra Leone or Guinea -- lying on the street, bodies there not getting picked up -- and they said, 'Oh my God, is this what's going to happen in the U.S.?'" Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, recalled in an interview.
And then the panic went away. After two nurses were infected treating the original patient Thomas Eric Duncan, nobody else developed Ebola within U.S. borders. By early November, the media had basically stopped talking about it.
The situation remained bad overseas, where more than 11,300 people have now died from the latest Ebola outbreak. But there too, progress has been made. The World Health Organization, which was universally criticized for its slow reaction, and the CDC, which was given similarly harsh treatment for its handling of that first fatal case in Dallas, have so successfully squelched Ebola that it's complicating clinical trials in vaccine development. (You need to test the vaccine's long-term resistance, after all.)
Still, a year removed, the people who found themselves in the heart of the madness in 2014 worry that it -- or a close variation -- could all happen again.
"You can't guarantee that if history repeats itself, it doesn't repeat itself in exactly the same way," Fauci said. "If it happens 10, 15 years from now, most of the people are going to forget what happened and what the response was early on."
Below is a look back at the autumn of Ebola panic in the United States.
And here are some reflections from Fauci and others on the Ebola crisis.
The 'Ebola Nurse'
New Jersey Gov. Christie temporarily detained a nurse named Kaci Hickox after she returned from fighting Ebola in Sierra Leone. Now 35 and living with her husband in Eugene, Oregon, Hickox looks back with worry that the panic that engulfed her life could repeat itself.
"If we have another outbreak of an infectious disease the general population doesn't know anything about, we're going to be at square one unless we have good leadership and strong risk communication," Hickox said.
Even though medical experts and epidemiologists at the time said there was no need to quarantine someone who didn't exhibit symptoms of Ebola, Christie and other politicians sided with public opinion, which favored quarantines.
"We really have a leadership and a stigma problem that hinders our ability to respond to any health issue, not just infectious disease," said Hickox.
Now a GOP presidential candidate, Christie has declined to second-guess his response. His spokesman Kevin Roberts said the governor and his New York counterpart, Andrew Cuomo, set up mandatory quarantines because the federal government failed to respond in a "robust" way that would calm the public.
"What can't be forgotten was that, at the time, this was especially important in the aftermath of the case of Craig Spencer in New York City that created public panic once his diagnosis was confirmed," Roberts said. "Even then, the federal government did not revise its protocols. Both governors worked together to assure citizens that New York and New Jersey were taking every possible precaution to be adequately prepared and responsive on this issue."
When Hickox finally returned home to Maine, she defied orders from Gov. Paul LePage (R) to stay in her home, going for a bike ride with the media in pursuit.
She was dubbed "the Ebola nurse" even though she didn't have the disease. Hickox wrote in The Guardian that people should cut it out: "I never had Ebola, so please stop calling me 'the Ebola Nurse' -- now!"
Ebola Attention Deficit Disorder
Sen. Chris Coons (D-Del.) actually went to the epicenter of the Ebola crisis in December to figure out how international institutions failed so spectacularly. He also hoped to remind people that even though Ebola had basically disappeared from American politics, people were still dying from it in West Africa.
Back home, Coons observed fundamental problems with America's preparedness. But they weren't institutional. Put simply, he said, the country suffers from severe attention deficit disorder.
"[Ebola] went from something that was completely off the radar screen of the average American to a huge national panic in a matter of weeks, back to being something most Americans were unaware of and unconcerned about," Coons said.
Congressional committees that were briefly consumed with fright over Ebola quickly forgot about it.
A year removed from the arrival of Ebola in the U.S., the senator worries not about its re-emergence but about the possibility of something worse.
"The next big human epidemic could just as easily come from a form of influenza as from Ebola," said Coons. "The cost of our investment in Ebola response will be pennies on the dollar compared to a renewed global influenza pandemic comparable to [the 1918 pandemic]."
Warnings Were Missed
Dr. Lance Plyler, the medical director of international disaster responses for Samaritan's Purse, was on the ground in Liberia fighting the Ebola outbreak. He, like Coons, saw the holes in the global response.
"We're underprepared for sure. There definitely needs to be much more work on a cohesive coordinating system that can respond internationally," Plyler said. "A lot of people showed up late to the party. There were a lot of warnings that went unnoticed."
Going forward, he said, the world community needs to prepare for an infectious disease like Ebola much like it would for a war. Plyler suggested that maybe all the panic over the 2014 outbreak wasn't so misplaced.
"The word everybody always uses still is 'unprecedented, it was so unprecedented.' I think there was some overreactions for sure. It was so novel and so fear-provoking that people may be imposed some of these real draconian quarantines that were an overstep," he said. "But in the context of the situation, there's some understanding there."
Preparing For Next Time
For Dr. Fauci, one of the most unfortunate side effects of Duncan's diagnosis in the United States was that it distracted attention from the real problem in Africa. From his office at the National Institutes of Health, he saw Americans become consumed with concern about Ebola spreading domestically, while ignoring the ongoing disaster in West Africa.
"That case was misconstrued as the potential of a real outbreak in the U.S., which never was really a risk, given the nature of our health care delivery system and our ability to isolate and do contact tracing," he explained.
In subsequent weeks, Fauci was thrust into the spotlight. In addition to a medical expert, he became a chief public soother, a TV personality and a critical conduit between the worlds of science and politics. All the while, he worked with an Ebola patient transferred to the NIH facility. His profile is much lower a year later, but the work isn't done.
Though Ebola vaccine trials have proceeded at "light speed," as he puts it, a vaccine is not yet ready. "We still have a lot more to learn about it, like how durable is the response. The only way you're gonna learn that is if you test it in the field," he said. "The good news is that there are no new infections out there. I wouldn't say the bad news, but the other side of the coin is, it's tough to test the vaccine right now."
With Congress having appropriated money to fight the Ebola epidemic, Fauci isn't panicked about a lack of resources. He is concerned. The NIH budget has lost about 25 percent of its purchasing power over the last 13 years. "That is not a good formula for preparedness for the next outbreak," he said.
As the panic of 2014 recedes into memory, Congress and the public may feel less driven to fund the research to prevent the next deadly outbreak, whenever it occurs.
"Part of what I need to worry about is the unexpected emerging," said Fauci. "That's the reason why when we do research now, we try to do it in a broader way that could be applicable even to the unexpected."