WASHINGTON (AP) — Republicans in competitive races are treading gingerly around climate change this campaign season, often saying they are not in a good position to make a judgment on the issue, then pivoting quickly to express concern for the environment, the economy or both.
"I am not a scientist," Senate Republican Leader Mitch McConnell of Kentucky has said numerous times, a response that other members of his party have employed when asked if human activity is causing the earth to warm.
Former Rep. Frank Guinta of New Hampshire, running to reclaim a House seat he once held, says, "I think the science is not complete on this issue."
Senate hopeful Joni Ernst of Iowa, said recently, "I don't know the science behind climate change. ... I can't say one way or another what is the direct impact from whether it's man-made or not." She prefaced her comments by saying she believes in protecting the environment, offering as evidence, "I drive a hybrid car, and my family recycles everything."
Polls routinely find that climate change is far down the list of voter concerns, particularly in an era of slow economic growth.
Yet the issue has come up persistently in the fall campaign, including in debates and interviews as well as political commercials.
Surveys suggest there may be political safety for Republicans in straddling the issue, since doing otherwise could anger conservative GOP voters who deny climate change's existence or offend the majority of the country that says it is an established fact.
A year-old survey by Pew Research showed that only 25 percent of tea party supporters believe global warming is occurring, compared with 67 percent for the nation as a whole. Nationally, 44 percent said the earth is warming mostly because of human activity, a view held by only 9 percent of tea party backers — a group that Republican candidates hope will turn out in large numbers this fall.
More recently, a New York Times poll said 42 percent of Republicans say global warming won't have a serious impact, a view held by 12 percent of Democrats and 22 percent of independents.
Global Climate Change, a WebSite of the nation's space agency, says, "Ninety-seven percent of climate scientists agree that climate-warming trends over the past century are very likely due to human activities, and most of the leading scientific organizations worldwide have issued public statements endorsing this position."
But that consensus is hotly disputed by critics, including some office-holders.
One high-profile doubter, Sen. James Inhofe of Oklahoma, published a 2012 book, "The Greatest Hoax: How the Global Warming Conspiracy Threatens Your Future."
Among Democratic candidates, there is a strong consensus that global warming is a fact.
Sen. Mary Landrieu, running for a new term in oil and gas-producing Louisiana, said during a recent debate, "I do believe our climate is changing, and I do believe humans contribute."
Sen. Mark Udall, another energy-state Democrat in a tough race, says on his campaign website, "Climate change threatens our special way of life in Colorado."
Yet many Republicans in this year's campaign appear highly reluctant to stake out an unequivocal position.
"Well, I am not a scientist," Florida Gov. Rick Scott said last spring.
More recently he expressed no opinion whether human behavior is affecting the climate. Instead, he said in a debate he focuses on solving problems.
"We've spent $350 million to deal with sea level rise; we spent $100 million to deal with protecting our coral reef; we've increased the funding by 45 percent for beach re-nourishment" and spent $880 million on the Everglades, he said.
Rep. Bill Cassidy of Louisiana, a physician, likewise avoided taking a definitive position.
"Global temperatures have not risen in 15 years," he said in a debate with Landrieu and Bob Maness, a third candidate.
"There might be climate change, but we are not seeing that reflected in temperatures. We are losing our coastline, but that's relative sea level rise. ... That's related to our levees on our river, taking needed sediment from restoring our coast as well as other factors that cause the land to sink as much as water rising."
McConnell, recently interviewed by The Cincinnati Enquirer, said, "I am not a scientist. All I can tell you is that country after country after country, given a choice between pursuing this goal (of curbing carbon emissions) and their own economic growth, are choosing economic growth." Kentucky is heavy producer of coal, which gives off carbon emissions.
Rep. Cory Gardner, challenging Udall in Colorado, took no position on the existence of global warming in a debate, and said talk of a scientific consensus is itself overrated. It doesn't exist "to the extent that has been reported in the news," he said. "I think there is disagreement as to that."
ONCUPINAR, Turkey (AP) — The Turkish border crossing of Oncupinar, an hour's drive from the embattled Syrian city of Aleppo, is a chaotic buzz of people waiting to pass into one of the most violent regions in the world. Border guards stand by with machine guns to prevent Islamic militants from joining the flow, but within their sight smugglers offer to take travelers across for a surprisingly small fee.
One of the men, who claimed to be a former officer for Syrian intelligence, said he charged just over $20 — but was willing to bargain. Abdul-Rauf, who gave only his first name for fear of prosecution for his illegal profession, said he could take clients within an hour and even help them carry their bags a few hundred meters (yards) into Syria.
Abdul-Rauf, a thin man in his thirties with a close-cropped beard, asked whether the travelers were headed for territory controlled by pro-Western rebels or by the Islamic State group. When told the latter, he shook his head disapprovingly.
"Why would you want to go?" he asked, drawing a finger across his throat.
Interviews with a half dozen a smugglers at Oncupinar and other border crossings indicate that foreign militants approach them regularly — and that the border is porous, with areas near Oncupinar and the adjacent city of Kilis as the primary illegal crossing points. All spoke to The Associated Press on condition of anonymity because they feared arrest or violence from criminals and militants they help cross.
Some of the smugglers said they avoid people they suspect might be foreign fighters, while others said they don't ask questions.
Turkey, under pressure from its Western allies, stepped up its efforts to disrupt the flow of foreign fighters into Syria to join the Islamic State group, mainly with surveillance of travelers at airports and bus stations. Officials say their primary objective is to prevent foreign fighters from gaining entry to Turkey, with a secondary one stopping those who might want to leave.
They have established special investigative units and have deported hundreds of suspected foreign militants in recent months. But they said the more than 1,250-kilometer (800-mile) border with Iraq and Syria is often rugged and hard to patrol — and that the smugglers often know the contours better than they do.
"The measures that have been active right now will probably decrease all these activities, but bringing it to zero level — that is almost impossible," said Cemalettin Hasimi, an adviser to the Turkish prime minister's office.
Aaron Stein, associate fellow at the Royal United Services Institute, a London-based think tank, said Turkey has done much to stop the flow of foreign fighters into the country: "They are tracking people to the best of their ability."
But he said the efforts are more lackluster at the border.
"You can still get yourself across the border for about 10 bucks and nobody can understand why," he said. "It seems clear that they could be arresting more people."
The smugglers say a crackdown by authorities over the last year has made their work more dangerous, but the border remains porous because of their knowledge of its vulnerabilities and the complicity of some border guards, who can be bribed.
The smugglers told stories about being approached by foreigners they suspect to be Islamic militants. Some said they avoid helping people who are not Syrian or Turkish, for fear of attention by authorities watching for foreign fighters. The stories could not be verified, but the accounts were consistent with one another. All of those interviewed said they had seen foreigners, including Westerners, trying to cross; it was impossible to tell how many were trying to join IS and how many other rebel groups.
One ex-smuggler, who now makes a living exchanging currency and asked to be identified only by his first name, Mustafa, said that late last month, he saw three tall blond men wandering around and approached them to ask if he could help.
Mustafa, an earnest 25-year-old Syrian who wore jeans and a Levi's shirt, said the men were dressed in shorts, sneakers and long shirts and apparently did not speak Arabic. One of them addressed him in English and asked how to get to Islamic State group territory.
"The accent was 100 percent American," he recalled. "I watch movies. His accent wasn't British or anything else."
He told the men about a nearby crossing to Islamic State territory and offered to take them there. They set an appointment to meet, but he said the three men never showed up.
Other smugglers backed his account of an the Islamic State group crossing point close to a refugee camp in Kilis, and also mentioned one further east near the Syrian city of Jarablus. The AP was able to verify separately a crossing point within a kilometer (half-mile) of the Oncupinar border gate, where there is an unmonitored gap in the border fence leading to territory controlled by the Western-backed Free Syrian Army.
Sipping tea in a black leather jacket, sandals and baseball cap in a cafe in Kilis, a smuggler who identified himself as Abu Mohammed said that he avoids foreign clients because undercover Turkish police officers have been leading a crackdown.
Early this month, he said, a Frenchman, his wife and two children approached him. The woman was wearing a hijab, but he could see blond eyebrows and blue eyes. One of the kids was about three; the other a baby.
"He told me he wanted to go to the Islamic State. I turned him away," said Abu Mohammed, a former house painter from Idlib province in Syria. "If you want to smuggle, you only smuggle Syrians."
Abu Mohammed said he also witnessed Turkish police detain two Uzbeks with their wives near the border crossing.
"It was clear that they were Daish," he said, using an Arabic term for the Islamic State group.
He gave his fee as 20 Turkish lira — just under $9. He splits that with a driver, who brings the travelers to a hole cut in the fence. Nothing stops them from bringing light weapons through.
"You can take over, say, five AK-47s in a bag like this," he said, motioning with his hands the size of a normal duffel bag.
As he spoke, another smuggler stood on a terrace with three men sealing a deal to cross the border.
Abu Mohammed said business has become more dangerous because border guards have stepped up their patrols and undercover work — but that the gap in the fence remains open and business continues because some of the border guard officers are corrupt.
"The officer will call the smuggler to tell him that if he has people, now is the time to cross," Abu Mohammed said.
DALLAS (AP) — In a land of lawsuits, this case seems made for litigation: A doctor appears to miss a red flag, an Ebola diagnosis is delayed, and a patient dies. But this is Texas.
It may not matter much that Texas Health Presbyterian Hospital Dallas apologized for initially misdiagnosing Thomas Eric Duncan, who was sent home from the ER but later returned sicker and farther along on a painful decline to death. Insulated by Texas tort reform that gives an extra layer of protection to emergency room doctors and nurses, not only is the very feasibility of winning complicated, but the potential payout is severely capped.
"Emergency room health care providers in Texas have virtual immunity," said Steve Laird, a personal injury lawyer in Fort Worth. "The Duncan family's chances of prevailing would be slim to none."
Trial lawyers and health care providers squared off when Proposition 12 went before Texas voters in 2003, with Gov. Rick Perry cheerleading the constitutional amendment he said was aimed at quelling a loss of doctors and a surge of frivolous lawsuits. Millions were pumped into the most expensive ballot measure campaign in the state's history, and it narrowly passed.
The law puts a $250,000 limit on noneconomic damages related to pain and suffering in almost all cases. Additional economic damages are still possible to recoup lost wages on behalf of a parent, legal or common-law spouse or children. But because Duncan was a chauffeur from a poor, war-torn country who had just arrived in the U.S. and was not working, the hurdles may be higher and the payout lower.
Duncan's sister and nephew say they are considering a lawsuit. Any potential litigation would likely point to the drumbeat of warnings and publicity about Ebola prior to his arrival at Presbyterian as evidence a reasonable person should have known about the threat.
Many states have instituted malpractice caps. But the facility where Duncan was given a diagnosis of sinusitis and sent home happened to be the emergency room, which is especially shielded under Texas law. Instead of simply requiring proof of negligence to win, plaintiffs must demonstrate that any negligence in the ER was "willful and wanton."
"You have to show that they basically knew what they were doing was going to cause harm," said Brent Walker, a Dallas personal injury lawyer. "It's something a whole lot more than 'Oops, I shouldn't have done that.'"
The state Department of Insurance said Thursday that the number of medical malpractice claims fell by 64 percent between 2003 and 2012, and the average payout dropped by one-third. Walker says his law firm now turns down dozens of medical malpractice cases a month that would have otherwise been considered legally viable.
"The emergency room claims have virtually disappeared," he said. "There have been vanishingly few."
Central to any case over Duncan's death would be what the caregivers knew. In Duncan's first ER visit, a nurse logged the fact that he had recently traveled from Africa, where the largest outbreak of Ebola ever recorded is occurring. But there's no indication in his medical records — which his family provided to The Associated Press — that the treating physician received that information.
Presbyterian said the fact "was not communicated effectively among the care team." A hospital spokesman said changes have been implemented to make sure travel histories are captured upon the patient's arrival in the ER and that the electronic record system better documents and displays the information. The hospital has acknowledged its training on the virus also "had not been fully deployed."
Some attorneys say a lack of ample preparation given the warnings and the initial dismissal of Duncan might be enough to at least convince the hospital to settle.
"What they did may meet the most basic standard of recklessness," said Stewart Weltman, a Chicago attorney who has tried malpractice cases.
Duncan's second visit to Presbyterian ended with his death on Oct. 8. Dozens of medical professionals cared for him, and two of his nurses contracted Ebola. Those women, Nina Pham and Amber Vinson, could also pursue lawsuits, claiming they were not kept safe by their employer.
Vinson's family has hired high-profile attorney Billy Martin, who previously represented NFL player Michael Vick. Walker said any potential lawsuit on behalf of Vinson or Pham would likely have to seek a payout through the state worker's compensation system. But if the women fully recover and eventually are able to return to normal lives, he said, any settlement likely would be limited.
Tarm reported from Chicago.
Associated Press writers Will Weissert in Austin and Emily Schmall in Fort Worth contributed to this report.
MANILA, Philippines (AP) — American forces are guarding Marine Pfc. Joseph Scott Pemberton, yet a ring of Filipino troops surrounds them. The seemingly redundant security effort around the suspect in a Philippine murder case reflects Manila's uneasy ties with Washington, its former colonial master.
Pemberton, 19, is accused of killing Jennifer Laude, a 26-year-old transgender Filipino, in a motel room Oct. 11 in the city of Olongapo. He was initially held on a U.S. Navy warship at the Subic Bay Freeport, northwest of Manila, but on Wednesday he was transferred to the Philippine military's main camp, where Filipino troops and two of his fellow Marines continue to guard him.
Here are some questions and answers about the tensions that result when U.S. troops are accused of serious crimes in the Philippines, whose love-hate relationship with Washington has been shaped over the decades by war, terrorism and now, jitters over China's rise:
Q: WHAT ARE THE RULES WHEN A U.S. SERVICE MEMBER IS ACCUSED OF A CRIME IN THE PHILIPPINES?
A: Under the Visiting Forces Agreement, which the treaty allies signed in 1998, the Philippines can prosecute U.S. troops accused of crimes there. But the accord grants the U.S. custody over those troops "from the commission of the offense until completion of all judicial proceedings."
Left-wing groups and nationalists have demanded that the Philippine government take immediate custody of Pemberton, saying Americans continue to impinge on their country's sovereignty nearly 70 years after it gained independence. In a compromise between the two countries, the U.S. transferred Pemberton to Philippine soil but continues to guard him and officially has not given up custody.
Q: HOW DID THE AGREEMENT COME ABOUT?
A: After World War II, the U.S. maintained huge military bases in the Philippines for nearly a half-century, but those were shuttered in the early 1990s amid rising nationalism, virtually freezing military ties.
China's 1995 seizure of a contested reef, however, prompted Manila to reach out to Washington again. Three years later, the allies signed the Visiting Forces Agreement, allowing large-scale military exercises to resume in the country. It also gave the Philippines a clear right to prosecute U.S. troops who commit crimes, something it lacked previously.
Territorial disputes continue to simmer between China and the Philippines over islands in the South China Sea, and occasionally spark direct confrontations. In April, Manila and Washington signed a 10-year defense accord that will give American forces greater access to Philippine military camps.
With its anemic military, the Philippines aims to bolster ties with the U.S. to try to deter China. Washington, meanwhile, is strengthening its military in Asia after years of heavy engagement in the Middle East and Afghanistan.
Q: WHAT ROLE HAS THE VISITING FORCES AGREEMENT PLAYED IN PAST CASES?
A: The highest-profile, and to many Filipinos most infamous, case was against Lance Cpl. Daniel Smith, who was found guilty and sentenced to life in prison on charges of raping a Filipino woman in 2005. He was held at the U.S. Embassy in Manila until a Philippine appeals court overturned his conviction in 2009, allowing him to leave the country amid anti-U.S. protests.
In 2009, then-U.S. Ambassador Kristie Kenney advised Washington about the dilemma Smith's case created.
"It is imperative that we recognize that more than a legal case, the accusation against LCpl Smith struck at the very heart of Philippine historical animus toward its colonial past," Kenney wrote in a confidential diplomatic cable published by WikiLeaks. "For the last three years, no story ... matched the headlines in column inches devoted to the sordid details" of his case, she wrote.
With Philippine officials dead set against a repeat of the circumstances of the Smith case, they reached a deal with the U.S. that allows both sides to say they have control over Pemberton.
Foreign Secretary Albert del Rosario said Wednesday that Washington "is fully aware that for the Philippine government, it will be totally unacceptable for them to detain Pemberton within the premises of the U.S. Embassy, as was done in the Lance Cpl. Daniel Smith case."
Q: HOW ELSE DOES HISTORY AFFECT THE U.S. MILITARY'S RELATIONSHIP WITH THE PHILIPPINES?
A: America's foray into the Philippines started when it defeated the Spanish fleet in the Battle of Manila Bay in 1898, ending more than three centuries of Spanish colonization. But the Philippines was ceded shortly after to the United States and only gained independence in 1946, a colonization that was disrupted by the Japanese imperial army's invasion.
Following U.S. forces' exit and return in the 1990s, the Sept. 11, 2001, attacks brought the two militaries closer. Filipino officials allowed hundreds of American counterterrorism troops to train Filipino forces fighting al-Qaida-linked militants in the south. U.S. counterterrorism forces began to scale down their presence in the south this year after helping weaken Abu Sayyaf extremists.
Q: COULD THE PHILIPPINES DECIDE TO SCRAP THE VISITING FORCES AGREEMENT?
A: The murder case has reignited calls, even among some Philippine senators, for the repeal of the agreement. But that is unlikely because of the security implications: Abrogating the deal could effectively halt current U.S. troop presence and large-scale exercises in the Philippines. President Benigno Aquino III has strongly opposed calls from left-wing activists to scrap the pact, but the government is open to a review of the agreement, including provisions on criminal jurisdiction and custody.
Q: WHERE DOES PEMBERTON'S CASE GO FROM HERE?
A: Laude's family has filed a murder complaint against Pemberton before prosecutors in Olongapo, the city northwest of Manila where she was killed. If prosecutors assess there is strong evidence, Pemberton will be indicted and face trial. Amid yells of "justice for Jennifer" by left-wing activists, Laude's remains were transported Friday by her family and dozens of mourners from a Roman Catholic church to a cemetery in Olongapo where she was laid to rest.
Meanwhile, the Marine will likely remain detained in an air-conditioned van, equipped with a sink and a cot, at a U.S.-Filipino compound in the Philippine military's Camp Aguinaldo in metropolitan Manila.
Jim Gomez, chief correspondent of The Associated Press in Manila, has focused on security and terrorism issues in the Philippines for the AP since 2001.
OTTAWA, Ontario (AP) — Authorities and ordinary Canadians sifted through confounding shards of a gunman's life seeking to understand what motivated the man to storm the nation's seat of power.
The emerging portrait of Michael Zehaf-Bibeau is a fragmented one: A misfit who went more than five years without seeing his mother. A crack cocaine user who once told a psychological evaluator he wanted to go to jail to beat his addiction. A committed Muslim who said he wanted to become a better man, but in recent weeks seemed to come unglued. A homeless shelter resident who talked about wanting to go to Libya — or Syria — and became upset when he couldn't get a passport.
A day after the 32-year-old Canadian launched what the prime minister called a terrorist attack, a top police official said Thursday that Zehaf-Bibeau — whose father was from Libya — may have lashed out in frustration over delays in getting his passport.
"I think it was central to what was driving him," said Royal Canadian Mounted Police Commissioner Bob Paulson on Thursday.
Bibeau shot a soldier to death at Canada's national war memorial Wednesday, then stormed the Parliament building, where he was gunned down by the sergeant-at-arms. Police said he was armed with a lever-action Winchester rifle, an old-fashioned, relatively slow-firing weapon.
The deadly attack was the second on Canadian soldiers in three days, forcing the country to confront the danger of radicalized citizens in its midst and exposing weak spots in security:
— During the attack, Prime Minister Stephen Harper hid in a closet-like space within a Parliament caucus room. The Mounties who are assigned to protect him were on the other side of the room's doors. The Mounties will now guard the prime minister around the clock, wherever he goes, Paulson said.
— After the tragedy, all members of the Canadian military were ordered to avoid wearing their uniforms in public while doing such things as shopping or eating at restaurants.
— Earlier this week, the Mounties said about 90 people nationwide are suspected of planning to join up with extremist fighters abroad or have returned from such activity. But Paulson said Thursday that Zehaf-Bibeau was not on that list and was not under surveillance, partly because it was not until after the shooting that authorities learned from his mother that he wanted to go Syria, where a host of militant groups such as Islamic State are fighting.
— Authorities are investigating how the gunman obtained the rifle, when he should been prohibited from possessing one because of his criminal record.
Zehaf-Bibeau's passport, meanwhile, hadn't been revoked or his application rejected, but authorities had been investigating whether to grant him one, Paulson said. That obstacle appeared to weigh heavily on Zehalf-Bibeau, a petty criminal with a long rap sheet, including drug and weapons offenses, assault and robbery.
Abubakir Abdelkareem, who often visited the Ottawa Mission, a homeless shelter downtown where Zehaf-Bibeau stayed in recent weeks, said Zehaf-Bibeau told him he had had a drug problem but had been clean for three months and was trying to steer clear of temptation by going to Libya.
But in the three days before the rampage, "his personality changed completely," Abdelkareem said. He stopped being talkative and sociable and slept during the day, said Abdelkareem, who concluded Zehaf-Bibeau was back on drugs.
Lloyd Maxwell, a shelter resident, said that Zehaf-Bibeau had come to Ottawa specifically to try to get a passport, believing that would be more easily accomplished in the nation's capital.
"He didn't get it, and that made him very agitated," Maxwell said.
In an email to the AP expressing horror and sadness at what happened, Zehaf-Bibeau's mother, Susan Bibeau, said that her son seemed lost and "did not fit in," and that she hadn't seen him for more than five years until having lunch with him last week.
In a brief and tear-filled telephone interview with the AP, Bibeau said that she is crying for the victims of the shooting rampage, not her son.
"Can you ever explain something like this?" said Bibeau, who has homes in Montreal and Ottawa. "We are sorry."
While living in Vancouver in 2011, Zehaf-Bibeau was arrested on a robbery charge. During a court-ordered psychological evaluation, he said he committed the crime for the sole purpose of getting incarcerated.
"He wants to be in jail as he believes this is the only way he can overcome his addiction to crack cocaine," the evaluation report said. "He has been a devoted (Muslim) for seven years and he believes he must spend time in jail as a sacrifice to pay for his mistakes in the past and he hopes to be a better man when he is eventually released."
The evaluator said that while Zehaf-Bibeau was making "an unusual choice," he didn't appear to be mentally ill. He pleaded guilty to a lesser charge of making threats and was released after just over two months.
While in the Vancouver area in 2011, Zehaf-Bibeau went to a mosque and met a fellow attendee who hired him for a manual labor job at his family's landscaping business, said the fellow mosque-goer's father, John Bathurst. Zehaf-Bibeau quit after two days, and Bathurst said his son didn't see Zehaf-Bibeau again until six weeks ago and found "he was talking about the devil and talking about stuff that was pretty unhealthy. The real story here is mental illness."
The mosque released a statement saying members were concerned at hearing reports that the gunman might have attended.
After initially reporting that two or three assailants may have taken part in the shooting rampage, Canadian police conceded Thursday that Zehaf-Bibeau was the lone gunman.
The bloodshed raised fears that Canada is suffering reprisals — perhaps so-called lone-wolf attacks — for joining the U.S.-led air campaign against Islamic State extremists in Iraq and Syria.
On Monday, a man described as an "ISIL-inspired terrorist" ran over two soldiers in a parking lot in Quebec, killing one and injuring the other before being shot to death by police. Before the attack, Canadian authorities feared he had jihadist ambitions and seized his passport when he tried to travel to Turkey.
The prime minister noted Thursday that both attacks were carried out by citizens born in Canada.
Paulson said Zahef-Bibeau's history of crime, violence, drugs and "mental instability" contributed to his radicalization. Zehaf-Bibeau's email was found on the hard drive of someone charged with a terrorist-related offense, Paulson said. He didn't say who and described the connection as tenuous.
Associated Press writer Rob Gillies reported from Toronto. La Corte contributed from Vancouver and Associated Press writer Raphael Satter contributed from London.
NEW YORK (AP) — Officials tamped down New Yorkers' fears Friday after a doctor was diagnosed with Ebola in a city where millions of people squeeze into crowded subways, buses and elevators every day.
The warnings came as Dr. Craig Spencer remained in stable condition while isolated in a hospital, talking by cellphone to his family and assisting disease detectives who are accounting for his every movement since arriving in New York from Guinea via Europe on Oct. 17.
"I want to repeat what I said last night: There is no cause for alarm," by the doctor's diagnosis Thursday, said Mayor Bill de Blasio, even as officials described Spencer riding the subway, taking a cab, bowling, visiting a coffee shop and eating at a restaurant in the past week. "New Yorkers who have not been exposed to an infected person's bodily fluids are simply not at risk."
The Centers for Disease Control and Prevention confirmed the city's Ebola diagnosis for Spencer, said Dr. Mary Bassett, the city's health commissioner. And a company contracted to handle medical waste arrived at his Harlem apartment.
Heath officials have repeatedly given assurances that the disease is spread only by direct contact with bodily fluids such as saliva, blood, vomit and feces, and that the dried virus survives on surfaces for only a matter of hours.
But some in the nation's most populous city, with more than 8 million people, were not taking any chances.
Friday morning, a group of teenage girls in Catholic school uniforms riding the L subway train passed around a bottle of hand sanitizer. They said they were taking extra precautions because of the Ebola case. It was one of the subway lines the doctor rode after returning home.
The governor and health officials said Spencer, a member of Doctors Without Borders, sought treatment with diarrhea and a 100.3-degree fever — not 103 as officials initially reported Thursday night. The health department blamed a transcription error for the incorrect information. He was being treated in an isolation ward at Manhattan's Bellevue Hospital, a designated Ebola center.
Gov. Andrew Cuomo said Friday that the doctor "obviously felt he wasn't symptomatic" when he went out "in a limited way."
The governor, in an appearance on CNN's New Day, said there was no reason to fear riding the subway, and he would do so Friday.
But one commuter called riding the subway "a scary thing."
There are "a lot of germs in New York," said Chris Thompson who was riding the L train.
Another subway rider, 41-year-old construction worker T.J. DeMaso expressed concern.
"If the outbreaks get any more common, I'll be moving out of the city," he said. "You could catch it and not even know it. You could bring it home to your kids. That's not a chance I want to take."
Subway rider Alicia Clavell said she hoped it's "an isolated incident."
Health officials say the chances of the average New Yorker contracting Ebola are slim. Someone can't be infected just by being near someone who is sick with Ebola. Someone isn't contagious unless he is sick.
Bassett said the probability was "close to nil" that Spencer's subway rides would pose a risk. The bowling alley has been cleared to open, she said. Spencer's Harlem apartment is cordoned off but no other tenants are at risk, officials said.
Evageline Love also was unconcerned. "I saw the mayor and the governor. What they're saying, I believe, is true. There's no need for hysteria," she said as he rode the L train to work.
The CDC dispatched an Ebola response team to New York. President Barack Obama spoke to Cuomo and de Blasio on Thursday night and offered the federal government's support. He asked them to stay in close touch with Ron Klain, his "Ebola czar," and public health officials in Washington.
Spencer's fiancee and two friends had been quarantined, but showed no symptoms, officials said.
The epidemic in West Africa has killed about 4,800 people. In the United States, the first person diagnosed with the disease was a Liberian man, who fell ill days after arriving in Dallas and later died, becoming the only fatality. None of his relatives who had contact with him got sick. Two nurses who treated him were infected, but one was released from a hospital Friday. The other is still hospitalized.
In the days before Spencer fell ill, he went on a 3-mile jog, went to the High Line park, rode the subway, visited a meatball restaurant and coffee shop. On Wednesday night he took a taxi from a Brooklyn bowling alley. He felt tired starting Tuesday, and felt worse on Thursday morning when he and his fiancee made a joint call to authorities to detail his symptoms and his travels. EMTs in full Ebola gear arrived and took him to Bellevue in an ambulance surrounded by police squad cars.
Doctors Without Borders, an international humanitarian organization, said per the guidelines it provides its staff members on their return from Ebola assignments, "the individual engaged in regular health monitoring and reported this development immediately." Travelers from Guinea, Liberia and Sierra Leone must report in with health officials daily and take their temperature twice a day, as Spencer did. He also limited his direct contact with people, health officials said.
Spencer, 33, works at NewYork-Presbyterian/Columbia University Medical Center. He had not seen any patients or been to the hospital since his return, the hospital said in a statement, calling him a "dedicated humanitarian" who "went to an area of medical crisis to help a desperately underserved population."
Four American aid workers, including three doctors, were infected with Ebola while working in Africa and were transferred to the U.S. for treatment in recent months. All recovered. Health care workers are vulnerable because of close contact with patients when they are their sickest and most contagious.
In West Africa this year, more than 440 health workers have contracted Ebola and about half have died. But the Ebola virus is not very hardy. The CDC says bleach and other hospital disinfectants kill it.
Spencer is from Michigan and attended Wayne State University School of Medicine and Columbia's University Mailman School of Public Health.
According to his Facebook page, he left for West Africa via Brussels last month. A photo shows him in full protective gear. He returned to Brussels Oct. 16.
"Off to Guinea with Doctors Without Borders," he wrote. "Please support organizations that are sending support or personnel to West Africa, and help combat one of the worst public health and humanitarian disasters in recent history."
Associated Press writers Cara Anna, Cameron Young, Jake Pearson, Deepti Hajela, Ula Ilnytzky, Kiley Armstrong and Tom Hays and researcher Susan James contributed to this report.