Dr. Joanne Liu, International President of Médecins Sans Frontières/Doctors Without Borders (MSF), says her organization warned the World Health Organization (WHO) in April 2014 of the potential for catastrophe with the West African Ebola outbreak. She says the WHO’s reaction was largely shrugs and indifference. In mid-October, the WHO cautioned that West Africa could be seeing a tenfold increase in Ebola infections to 10,000 new cases a week by December and now calls the pandemic the “most severe acute health emergency in modern times.” Now, the WHO and other agencies are scrambling to deal with a calamity that might have been brought under control if swifter action had been taken earlier.
The world has been caught flatfooted in its attempts to deal with the deadly Ebola outbreak
Is Quarantine the Answer?
Some people have suggested closing the borders of Guinea, Liberia, and Sierra Leone to all travel
In a letter to the U.S. State Department and Homeland Security Congressman Alan Grayson has urged a travel ban on all people coming from the affected areas.
Some countries – South Africa, Kenya, Zambia, Saudi Arabia are examples – have banned travellers from countries in the hot zone from entering. Some regional and international airlines have shut down their operations in West Africa.
In late September, Sierra Leone quarantined more than a million of its own citizens for a week in an effort to control the spread of Ebola.
But, sealing off millions of people in the effected countries, even if it was possible to do this, would condemn large numbers to death. WHO assistant director-general Dr. Bruce Aylward says such draconian measures as quarantining entire nations “would be horrifically unethical.”
Early and Decisive Action Needed
Critics say the Ebola pandemic could have been contained if those who were sick had been identified and isolated promply
The template for how to deal with Ebola can be found in Uganda. The central African country has been hit with four outbreaks of Ebola and they have all been treated swiftly and effectively.
First, the population has been well educated about Ebola and its symptoms to demystify the disease and deal with superstitions surrounding it. The result is that Ugandans are very open about reporting Ebola-like symptoms.
Early detection of an outbreak is essential so a laboratory has been set up in Uganda so that samples can be tested and results known within 24 hours. A positive test triggers the sending of a team to the patient’s location to identify all who had contact with him or her. These people are tested as the entire chain of transmission is revealed. Those found to be infected are immediately isolated and treated.
An Ebola outbreak started in Uganda late in July 2014. All those in direct contact with patients were isolated for 42 days and their belongings burned. They received proper care and their possessions were replaced. Just 24 people were infected of who 17 died, but the Ebola outbreak was snuffed out before it took hold.
Unfortunately, it’s too late for these measures to be effective in the West African pandemic.
The 2014 Outbreak Explained
The Response Now
The United Nations Envoy on Ebola, David Nabarro, says the global response to the crisis needs to be ramped up by a factor of 20
The countries mainly affected – Guinea, Liberia, and Sierra Leone – had only rudimentary health care systems when the first Ebola cases appeared. Hospitals and their staff were quickly completely overwhelmed and outside help has been slow in arriving. This has allowed the disease to gain a firm base in the population.
The mortality rate in West Africa is 70 percent. In comparison, an influenza pandemic usually kills about two percent of its victims.
Dr. Nabarro says that with a massive effort the rising curve of new cases can be stalled: “The epidemiologists, the people who study disease, say that when 70 percent of those who have got the virus are enabled to avoid spreading it to others then the epidemic curve will come down and that’s our target for the next 90 days.”
Slum in Conakry, Guinea
Containment is difficult in such conditions.
Containing the Spread
U.S. National Security Adviser Susan Rice says “The goal has to be to contain this epidemic in the three countries … in West Africa and to give appropriate care to those that need it”
Public health officials in developed nations seem to have been caught asleep at the wheel so that months after the Ebola pandemic struck West Africa authorities are still scrambling to contain it.
The first cases have been traced to December 2013 in village in Guinea but not until October 2014 has airport screening been put in place in countries outside the region in a belated attempt to keep the virus at bay. Even then, experts say airport screening of incoming passengers is only partially effective.
Isolated cases of Ebola have appeared in the United States, Spain, and other countries; there will be more as health care workers from Western nations become infected and return home for treatment.
However, with sophisticated medical systems in place and the ability to track contacts quickly it should be possible for stop Ebola from breaking out into the general population in developed nations.
For the people living in West Africa the immediate future looks bleak.
“The Ebola Crisis Prompts some Health Care Workers to Call for a NATO-like Rapid Reaction Force to Tackle Outbreaks.” Canadian Broadcasting Corporation, October 14, 2014.
“Congressman: Close Border to Ebola Countries.” Steven Nelson, U.S. News & World Report, July 30, 2014.
“Expert: We Can Control Ebola Spread.” Press Association, October 12, 2014.
“Susan Rice: The World Has Not Done Enough to Contain Ebola.” NBC News, October 11, 2014.