NEW YORK -- New York City health officials updated Ebola patient Dr. Craig Spencer's condition Saturday night, saying he is "awake and communicating" and "entering the next phase of his illness, as anticipated with the appearance of gastrointestinal symptoms."
The emergency room doctor was admitted to Bellevue Hospital, a specialized Ebola treatment center, on Thursday and tested positive for the virus. His is the first case of the deadly virus diagnosed in the city.
Spencer is receiving antiviral medication and plasma, according to a statement issued by the New York City Health and Hospitals Corporation and the city's Department of Health and Mental Hygiene.
"A large CDC team has been actively involved in advising the Bellevue staff and we are very appreciative of the additional guidance," the statement read, adding that doctors are also receiving input from Emory University Hospital and the Nebraska Medical Center, two facilities that successfully treated Ebola patients.
Morgan Dixon, Spencer's fiancée, left Bellevue Saturday night but will remain in quarantine at the Harlem apartment she shares with Spencer.
Two of the couple's friends are also being quarantine as a precaution. The quarantine for Dixon and the two others will be lifted on Nov. 14 after the maximum 21-day Ebola incubation period has passed, New York Mayor Bill de Blasio said Saturday.
Spencer arrived in New York on Oct. 17 after treating Ebola patients in Guinea with the aid group Doctors Without Borders.
"The phase ahead will be a tough one. By definition, the days ahead will be tough for Dr. Spencer," de Blasio said. "His situation will become worse before it gets better," he added.
The mayor spoke after eating lunch at a Greenwich Village restaurant where Spencer ate earlier this week. Also Saturday, Brooklyn Borough President Eric Adams bowled the first frames at the Williamsburg bowling alley Spencer, Dixon and their friends visited a day before he became ill, CBS New York reported.
In his weekly address Saturday, President Obama noted that every American who has been treated for the virus thus far has recovered.
"It's important to remember that of the seven Americans treated so far for Ebola -- the five who contracted it in West Africa, plus the two nurses from Dallas -- all seven have survived," he said. "Let me say that again: seven Americans treated; all seven survived."
"Sadly," a Liberian man treated for the virus in the U.S., Thomas Eric Duncan, "did not survive," the president said, "and we continue to keep his family in our prayers."
Neither the U.S. Centers for Disease Control nor Doctors Without Borders ask health care workers returning from the Ebola hot zone to quarantine themselves, but they do recommend that they self-monitor their temperature at least twice a day.
Spencer was complying with that guidance, officials have said. International aid groups have warned that such restrictions could deter health care volunteers from traveling to West Africa.
People who worked with Spencer described him as the kind of globe-trotting do-gooder who could walk into a small village in Africa and, even though he didn't know the language, win people over through hugs alone, according to people who worked with him.
Even before leaving for Guinea this, the 33-year-old had amassed an ordinary man's lifetime worth of world travel, much of which was in the service of the poor.
In the past three years alone, Spencer, an attending physician at New York-Presbyterian Hospital/Columbia University Medical Center, had been to Rwanda to work on an emergency care teaching curriculum, volunteered at a health clinic in Burundi, helped investigate an infectious parasitic disease in the Democratic Republic of Congo and traveled to 32 villages in Indonesia to do a public health survey.
"He was never afraid of getting his hands dirty or his feet dirty," said Dr. Deogratias Niyizonkiza, founder of Village Health Works, the aid group that brought him to Burundi for four months in 2012.
"He went into this environment, a country that is truly off the mark, without knowing the language and he would make everyone feel so comfortable. It's really a daunting task and yet he helped the people immensely," Niyizonkiza said. "He talked to everyone, including the people working in the lab ... Their language was just to hug each other and smile."
Ebola survivor Ashoka Mukpo, who was successfully treated after contracting the virus while working in Liberia as a freelance cameraman for NBC, said Saturday that Spencer is a hero.
In an interview with The Associated Press, Mukpo took issue with those who would criticize the doctor for going out in public after returning from West Africa and said there's no evidence Spencer exposed anyone in New York to any risk.
"Dr. Spencer risked his life to treat and lend a hand to people who have very little ability to take care of this problem themselves," Mukpo said from his family's home in Rhode Island. "Before we look at what the implications of this case are, I think we need to honor what he did in West Africa and give him the respect he deserves."
New York Gov. Andrew Cuomo has criticized Spencer, saying he should have stayed home until any danger period for the disease had passed.
"Dr. Spencer is a valued fellow and was a volunteer and did great work, but that was a voluntary quarantine situation for 21 days. He's a doctor and even he didn't follow the voluntary quarantine, let's be honest," Cuomo said.
Experts have repeatedly assured the public that there is little chance that Spencer spread the virus prior to developing symptoms, but his case prompted Cuomo and New Jersey Gov. Chris Christie on Friday to establish new, stricter guidelines for people returning to the area from Ebola-stricken countries.
A nurse who arrived Friday at Newark Liberty International Airport after recently treating Ebola patients in Sierra Leone was quarantined at a New Jersey hospital, the first traveler isolated under the new protocols.
Kaci Hickox tested negative for Ebola in a preliminary screening, state health officials said Saturday, but she remains in isolation at University Hospital in Newark. Like Spencer, Hickox had been working with Doctors Without Borders.
In a first-person account given to the Dallas Morning News on Saturday, Hickox sharply criticized the way her case has been handled.
"This is not a situation I would wish on anyone, and I am scared for those who will follow me," Hickox wrote.
Under the new protocols for travelers, health officials in New York and New Jersey will establish a risk level by considering the countries that people have visited and their level of possible exposure to Ebola.
The patients with the highest level of possible exposure will be automatically quarantined for 21 days at a government-regulated facility. Those with a lower risk will be monitored for temperature and symptoms, Cuomo explained.
The governor of Illinois, Pat Quinn, has implemented similar guidelines. Florida Gov. Rick Scott issued an order Saturday that requires health care workers to self-monitor.