Copyright Françoise Herrmann
**Maybe, it’s time to
start thinking about evacuating those people still healthy and willing to leave
from the uncontrolled Ebola infected areas, in Sierra Leone, Liberia and Guinea. I know this is what I would
like rescue efforts to do for me and my family, if it were our situation..
-----
Today, October 16, 2014 (almost two months later), WHO
reports 4493 deaths and a total of total of 8897 confirmed, probable and
suspected infections [WHO 1]. That is a fourfold increase in deaths, and a
similar increase in infections.
At this uncontrolled rate alone, the number of deaths in
December 2014 will be 20,000 people, and the number of infected people 350000 (and these are far from science-based epidemiological calculations))
This is no longer an outbreak or even an epidemic. With
deaths and infections in 7 countries (Sierra Leon, Liberia, Guinea, Senegal,
Nigeria, Spain and the US), this is already a pandemic.
-----
A panel of speakers, back from the field in Sierra Leon and
Liberia, reported the following, extracted from my notes. The panel included: Dr.
P. Farmer (Partners in Health; Brigham and Harvard U.), Dr. Raj Panjabi
(LastMileHealth.org in Liberia, Brigham and Harvard U.), Dr. Dan Kelly
(WellBodyAlliance.org non Profit in Sierra Leone and UCSF), Ambassador Dr.
Eric. O. Goosby (UCSF, and US Global Fund HIV/TB/Malaria) and interviewer Roy
Eisenhardt (Interviewer for City Arts and Lectures and the Commonwealth Club):
- 10 years of civil war in Liberia left the country with no
infrastructure for public health, and just
41 physicians, 4 of whom died this year in the Ebola epidemic. This
amounts to 8 physicians for a city like San Francisco.
- The first case of Ebola was reported in February 2014 when
it had already crossed borders from Liberia to Nigeria.
- The estimated toll is 1.4 million by January 2015 if there
is no control. Figures are based on known cases, multiplied by 2.5 for all the
unknown cases. The ability to find the cases, to treat in isolation, and to
take appropriate measures to sanitize, will determine the capacity to control
the spread** But finding the sick is contingent upon restoring hope in the
medical response, which so far offers no cure rate. And protection measures are
inadequate because not enough is known about how the virus spreads from human
to human or even from objects contaminated by humans (such as clothes or taxi
seats…).
- Stopping the Ebola pandemic implies setting up a long term
healthcare system in addition to the ER response with US Troops and 17 MASH
units. A long term healthcare system able to prevent any future epidemics or
outbreaks.
- Setting up a healthcare system in low income, deprived and
underserved places like Sierra Leone, Liberia and Guinea, for example, subsumes
having: 1 community worker per village, supervised by 1 nurse at a local
dispensary, in communication with a regional hospital or healthcare center,
with capacity for transportation of patients with ambulances or vehicles, or
planes etc.. This is a model system set up in Haiti that works for low income
settings. The system has to involve/mobilize the country in their own destiny.
With sufficient funds the system also should have its own teaching hospitals to
train local medical personnel. This is now the case in Haiti, and Haiti is
sending many volunteer healthcare workers to West Africa. (Cheers to Haiti!)
- Most importantly, the medical response has to restore hope,
as it is currently unable to offer care. So the population refuses to go to the
ER health centers or isolation wards to die.
- Major players are the UN, WHO and CDCs, already on location.
- The bottom line, however, is that the medical response has
to deliver a cure rate, instead of a 90% death rate. This is possible according
to Dr. P. Farmer. The virus is not invincible. Care cannot only be palliative. It
has to be curative too.
----
Sorry the news is not any better… Indeed there are not
even any IV supplies or beds out there… never mind patented ....
But perhaps there is hope is airlifting everyone who is still healthy to safety, to stop the spread, reduce the burden of care on site. ... I have two spare rooms in my house and I would truly welcome a family from Liberia or Sierra Leone… before the worse scenarios play out, and until they can return to their beloved country.
References
Farmer, P. Dr. Partners in Health www.pih.org
Kelly, D. Dr. Well Body
Alliance http://wellbodyalliance.org/
Panjabi, R. Dr. Last Mile Health http://lastmilehealth.org/
WHO1 WHO: Ebola response roadmap situation report – Oct 15,
2014.
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