Ebola- Where Are We? What Can We Do?

The Ebola virus epidemic is not close to being brought under control in West Africa, where the number of reported cases is doubling every three weeks. Liberia and Sierra Leone have a real need for more hospital beds. The US troops in Liberia are building 17 buildings with 100 beds each, to be ready in November. But the two countries currently have only 924 beds between them, while they need 4,078, according to the World Health Organization. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told the Washington Post that : “The virus is moving on virus time; we’re moving on bureaucracy or program time. The virus is actually picking up the pace. Even as we add resources, we get farther behind." ~~~~~ WHO warned BBC that Ebola is "now entrenched in the capital cities of all three worst-affected countries and is accelerating in almost all settings." According to WHO deputy head Bruce Aylward, the world's response is not keeping up with the disease in Guinea, Liberia and Sierra Leone. The three countries have appealed for more aid to help fight the disease that has killed more than 3,860 people, mainly in West Africa. More than 200 health workers are among the victims. On Thursday, Mr Aylward said the situation was worse than it was 12 days ago : "...70% of the people affected are definitely dying from this disease, and it is accelerating in almost all of the settings," he said. The medical charity Medecins Sans Frontieres (MSF) has reported a sharp increase of Ebola cases in the Guinean capital, Conakry, ending hopes that that the disease was being stabilized there. Speaking to the BBC on Friday, MSF President Joanna Liu called for urgent international action : "We're not winning the battle...To get ahead of the game we're going to need to deploy much more massively." ~~~~~ In Liberia, the UN peacekeeping mission has placed 41 staff members, including 20 military personnel, under "close medical observation" after an international member of its medical team was diagnosed with Ebola this week - the second mission member to test positive for the deadly disease. The mission said Friday that the observation is "meant to ensure no possible further transmission of the disease....None of the personnel who are contacts have shown any symptoms but will be observed for the full 21-day possible incubation period." WHO says the 41 staff members under observation may have come into contact with the member of the medical team who has Ebola, but whose name and nationality are being withheld. The patient tested positive Monday and was sent to Leipzig on Thursday. St. Georg Hospital in Leipzig said the patient would be placed in a special isolation unit. Meanwhile, all 209 people who work at the UN mission in Liberia will be subject to some control measures, including daily temperature checks and screening at a military facility where they work. The first UN staffer in Liberia to come down with Ebola died September 26. Liberia has recorded 2,316 confirmed deaths from Ebola, far more than any other nation. More than 400 health care workers have contracted Ebola, and 233 of those have died, according to the World Health Organization. Liberia and Sierra Leone have both recorded 95 health worker deaths. ~~~~~ One in twenty of those killed in the current Ebola epidemic are medical workers, and the US troops deployed to Liberia are going to help affected medical workers. In addirion, more than 1,300 Nigerian peacekeeping troops have been quarantined in Liberia after coming into contact with a Sudanese man who later died of the disease. In Liberia, senate elections due next week have been postponed to help reduce the risk of voters spreading the virus. And in Europe, Spain is at the epicenter, where seven more people are being monitored in hospital for Ebola. They include two hairdressers who had contact with Teresa Romero, the Madrid nurse who cared for an Ebola patient repatriated from West Africa. Romero is now very ill and reported to likely be dying. ~~~~~ In addition, while the Ebola epidemic widens, some experts believe ISIS may be thinking of using human carriers to infect its enemies with the Ebola virus. Retired Captain Al Shimkus, a professor of national security affairs at the US Naval War College, told Forbes : "In the context of terrorist activity, it doesn't take much sophistication to go that next step to use a human being as a carrier....the individual exposed to the Ebola virus would be the carrier, and with West Africa in an open epidemic, it would not be difficult for terrorists to steal infected bodily fluids to use elsewhere." Shimkus said that ISIS or another terror group could also send some operatives into an outbreak region so they could intentionally expose themselves to the virus, and once exposed, they could head to a target city or country. But Amanda Teckman, who holds a master's degree in diplomacy and international relations from Seton Hall University in New Jersey, told Forbes that ISIS, however, does not need to go to the extreme of using Ebola to get the West's attention. Its other actions, including beheadings, are proving to be enough. "But just because this is not probable for ISIS, I do believe others will at least contemplate using such suicide infectors." ~~~~~ Dear readers, I wouldn't presume to suggest how to stop the spread of Ebola into a real pandemic. But, let's reflect on what has happened -- *Ebola appeared in West Africa, far from its usual Bush habitat, suggesting a mutation. *As the cases grew, UN and MSF medical personnel intervened using disinfectant and special infectiuos disease suits. *The US promised to send 4,000 mitary personnel, many of whom are now there. *No quarantine was imposed on West Africa, so that the virus was free to travel to the rest of the world. *The now-begun temperature check at key West African, European and US airports are useless because Ebola carriers will test normal if they are still in the incubation period. *Aid workers stricken have been repatriated for treatment, even though there is no proven effective treatment, so the only result is to spread the virus. *The US Centers for Disease Control argues that refusing to send medical workers or quaranting West Africa will seriously impact the region economically. ~~~ The only conclusion I can draw is that the international and US public health communities are risking an uncontrolled pandemic of a 70% deadly virus for which there is no known treatment. And we, the possible victims, are being exposed in our home countries without even having a voice or vote in the matter. Something is very out of joint. Can we demand changes? What about a quarantine on travel to and from Liberia, Sierra Leone and Guinea effective immediately -- and a 21-day quarantine in a safe zone before any medical or aid worker can leave those countries to return home -- and a world class medical center in West Africa to treat any medical or aid worker who contracts Ebola -- and the rapid installation of proper cremation and burial facilities in West Africa for those who die of Ebola. Will the world be saved from a pandemic with these actions? It surely would be better than the international hydra-headed semi-chaotic approach we are witnessing today.