I think people are most at risk of catching ebola when the prior patient is in the terminal stages of the disease- the body becomes a "viral bomb", as Richard Preston puts it in The Hot Zone. Basically whole portions of the body are being converted into ebola virus, cells become viral "bricks" that then explode, etc.
Of course our medical protocols expect heroic attempts at life-saving measures when patients hit these near-terminal levels. I suspect it is likely that the combination of the late stage of the disease combined with the heroic measures undoubtedly taken to save Duncan's life, contributed to the infection of the two nurses.
I think if we are serious about planning on dealing with a steady stream of continual ebola importations from W Africa- and the fact that the administration continues to refuse to consider any from or restrictions on visa holders means we most inevitably will- then I think our care facilities need to have a serious, difficult, and potentially harsh conversation about the potential of heroic measures to realistically save the life of any ebola patient whose infection is that far along - pretty unrealistic, I think, once the virus has taken over that much of the body there is very little hope for the patient - versus the high risk those heroic measures will pose to the attending health care personnel.
It goes against standard medical ethics, which say to throw everything plus the kitchen sink at someone who is about to die- and under normal ethical constraints that would be the way to go, morally. But this disease may call for different approaches. It is possible that once an ebola patient passes a certain threshold the best thing to do is to manage their pain and isolate them as much as possible.
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