TB traveler moved up flight; says he wasn't on the run

~ The CDC has begun revamping its own leased aircraft to allow quarantine-style transport.

WASHINGTON -- The globe-trotting tuberculosis patient moved up his flight to Europe after health officials urged him to stay put -- but the Atlanta lawyer, in defiant testimony from his hospital room Wednesday, insisted he wasn't ducking anyone.

"I didn't go running off or hide from people. It's a complete fallacy; it's a lie," Andrew Speaker told a Senate subcommittee by telephone from the Denver hospital where he remains in government-ordered isolation with an exceptionally dangerous form of TB.

But U.S. doctors painted a picture of a man on the run from the start, revealing that Speaker left for his wedding and honeymoon two days earlier than planned -- and saying they were blocked by Georgia law from stopping him and thus preventing what turned into an international health scare.

Then when Speaker turned up in Rome, the government hesitated to ask Italian authorities to quarantine him in favor of offering him a second chance to cooperate. Instead, Speaker fled, slipping back across a U.S. border that was supposed to be closed to him when a border agent disregarded instructions and waved him through.

"We gave the patient the benefit of the doubt, and in retrospect we made a mistake," said Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention, in highlighting several times "we failed to take the aggressive actions we could have."

Added Ralph Basham, chief of U.S. Customs and Border Protection: "I can offer no defense for what happened that day at the Champlain port of entry. ... I'm not going to sit here and say the system worked."

If anything, Wednesday's dramatic sparring before Congress raised new questions about government authority to intervene before someone with an airborne infection takes steps that endanger others. Gerberding called for more authority for states to restrict such patients' movements.

On May 10, Fulton County, Ga., officials told Speaker he had a drug-resistant form of TB and that, "No, you should not travel," testified health department chief Dr. Steven Katkowsky. "Was he ordered not to travel? The answer to that was no. The local health department does not have the authority to prohibit or order somebody not to travel."

Speaker would have had to demonstrate he was a danger before the county could get a court order restricting his movements, Katkowsky said.

But Speaker, 31, told senators that in face-to-face meetings to discuss his treatment options, no doctors even wore masks.

"I was repeatedly told I was not contagious, that I was not a threat to anyone," Speaker said.

Not so, Katkowsky countered: His medical chart says he was told that "he was not highly contagious."

Why did Speaker leave for Europe early? He told senators he saw no reason not to escape a stressful situation and spend more time with family already gathering abroad for the wedding -- and that it actually was his then-fiancee's idea.

"She said, 'Why don't you just go on over? Once you get over there, you're not going to be worried about things. You're not going to be stressed about things and when we come back, we'll worry about it then,'" Speaker said.

CDC laboratory testing didn't conclude until May 22 that Speaker actually had the rare and particularly dangerous "extensively drug-resistant" form of TB, one untreatable by most medications. Then the agency tracked him down in Rome -- only to encounter what Gerberding called a major gap in public health defense: The CDC couldn't find an airplane with the separate air ventilation required to transport Speaker home without endangering the pilot. While officials debated options, Speaker was advised to hire a private jet -- which he said would cost $140,000 -- or go to an Italian hospital. Instead, he boarded another commercial flight for home, via Canada.

The CDC has begun revamping its own leased aircraft to allow quarantine-style transport, Gerberding said.

But at a separate House hearing, lawmakers heaped criticism on both the runaway patient and federal authorities' failure to catch him.

"Mr. Speaker obviously wanted to have his wedding cake and eat it, too, and that is unfortunate because he put a lot of people at risk," said Rep. Al Green, D-Texas.

The CDC did alert Homeland Security officials in time to put out an alert to border agents to detain him if he tried to re-enter the country. Instead, an agent identified Wednesday as an 18-year veteran, now on administrative leave while he is investigated, waved Speaker across the border. To prevent a similar incident, Homeland Security officials said Wednesday that new rules require officers to get a supervisor's approval before they override such border warnings.

"I hope you'll consider firing this person and anyone else involved," said Rep. Dan Lungren, R-Calif.

Customs officials did not defend the unidentified officer, and indicated at least one other worker is also under investigation, since the computer alert about Speaker should have appeared on more than one officer's computer screen.

"I've got 12 grandchildren, congressman. I do not know any one of them that would not know what to do in that situation," said Customs' Basham.