Sunday, October 12, 2014

This week in Ebola: A Segbwema Blog Roundup

Thomas Eric Duncan
The most widely reported Ebola news this week was the death of a Liberian man Thomas Eric Duncan who became the first diagnosed case of Ebola in the United States of America. Mr. Duncan had entered USA on September 19th, reportedly to marry his fiancee who was a resident of Dallas, Texas. Five days after Mr Duncan arrived in USA, he had felt very sick and was taken to the Texas Health Presbyterian Hospital in Dallas with a Temp greater than 103F. Unfortunately the hospital had somehow not established a link between Duncan, his fever, Liberia and the Ebola infection in that country, and had sent him back home with a prescription for antibiotics. No lab tests were ordered or done. Three days later Eric Duncan presented again to the hospital violently sick with fever and vomiting. He was admitted to the hospital and only then diagnosed with the dreaded Ebola virus. In the following days, the hospital treated symptoms of the disease in Duncan and tried to stabilize his internal chemistry but made little effort to try the experimental treatments that had helped saved the lives of some other Americans who had contracted the disease in Africa and had been flown home. The hospital authorities reported that the experimental drug ZMapp that was used in some of the cases was no longer available. After some public outcry, Eric Duncan received some dose of another experimental drug, but it was apparently too late. Duncan died the next day on October 8th, 2014. His remains have since been cremated as a public health precaution. There had been plans underway to prosecute him in both Liberia and Texas for endangering public health if he had survived, but apparently the prosecutors were not so lucky.. Relatives who came in close contact with Duncan remain quarantined and under are under observation. A law enforcement officer who went to the apartment where Duncan lived and became sick caused a minor scare in Dallas, but he was later diagnosed as not having Ebola.
Ebola Airport Screening

Following the Duncan Ebola scare, the US Centers for Disease Control has decided to take extraordinary measures to screen all  passengers coming into the country from the Ebola infected West African countries of Liberia, Sierra Leone and Guinea. This increased monitoring of travelers will target the five airports through which 94% of travelers from West Africa enter the United States. The airports include New York's JFK International, Chicago's O' Hare International Airport, Atlanta's Hartsfield-Jackson International and New Jersey's Newark Liberty airport. Ebola screening started today Saturday October 11th at JFK and will expand to the other airports by Thursday. The screening process will involve temperature monitoring, assessing for visual signs such as bleeding, vomiting chills and nausea, and questions on health and Ebola exposure history. There have been calls mostly by conservative politicians and news outlets to ban all flights coming from Liberia, Guinea and Sierra Leone into the United States. However, the CDC believes that such travel will be counterproductive to the concerted international effort to stop the Ebola outbreak in these countries.
Liberia Ebola Training

In Liberia, the government has in collaboration with the WHO and the United States Agency for International Development (USAID) initiated an innovative Ebola training program for the country's health care workers. Real Ebola survivors have been integrated into the training program to make it   more realistic and effective. The goal is to train about 400 health care workers in Ebola management in order to staff the new Ebola treatment facilities that are being constructed around the country. The US military has deployed a substantial emergency response team to Liberia, but they are currently being slowed do by domestic supplies of needed construction equipment.
Ebola Burial Team in Waterloo

In Sierra Leone, Ebola burial teams in the capital downed their tools on Tuesday over nonpayment of their weekly wages and allowances. The members of the Ebola burial team had not been paid the previous Friday, due to what a government spokesman called bureaucratic delays. When questioned as to why they would decide to stop burying dead Ebola victims and clearly create a substantial public health hazard in the congested city of Freetown, a spokesman for the burial team said that they were doing their a hard job under very tough circumstances. Some of them, he said, had to keep their belonging to the burial team a secret from friends and relatives to avoid ostracization, as people were in mortal dread of members of the burial team. Some of those whose families members knew they were part of the burial team had been shunned and in some instances driven out of their own homes. Even in local food restaurants, they had to hide their identity otherwise people would not sell food to them. The spokesman said that they were doing an extremely dangerous job which nobody else wanted to do, and there was simply no excuse for them not to be receiving their pay as promised. The chairperson for the country's political parties Mohamed Bangura of the United Democratic Movement (UDM) who appeared on the scene to stage an intervention said that he understood the plight of members of the burial team and that there was simply no reason why they should not be paid, as he was aware that there was money available to pay them. He said that he would head straight to the President's office, believing that the nonpayment of the burial team's wages was the action of government saboteurs.
Umaru Fofanah Sierra Leone-BBC
"Outstanding reporter" NPR

On the Ebola infection front, this week was terribly bad for Sierra Leone, especially in the Western Area and the Northern Region of the country. On a single day Friday, Sierra Leone had 140 Ebola deaths, as reported by BBC's Umaru Fofana who has been described by America's National Public Radio (NPR) as the "most outstanding" reporter on the current Ebola infection in West Africa. As of Saturday, Sierra Leone had recorded a total cumulative number of 2700 diagnosed Ebola cases with a total of 904 deaths, 155 probable deaths and 97 suspected deaths. Umaru Fofanah who presents meticulous daily infection figures, has been noted by NPR for providing accurate reports free of sensationalism, unlike other reporters from reputable sources, many of who are reporting CDC worst case scenarios as Ebola news.

Before the three day lock down last month in Sierra Leone, many in the medical community were skeptical of the wisdom of keeping families huddled together in the same environment for three days, fearing that if there was an Ebola infected individual in one family, the probability of spreading the infection to other family members would be exponentially increased. After the lock down, a lot of people were quick to tout the success of the lock down. The Ebola teams had been able to discover over 50 dead individuals and take some suspected patients to treatment centers for monitoring. However, the fact that even in the absence of any infection, telling all 6 million Sierra Leoneans to stay at home for three days would result in finding approximately 50-100 deaths show the lack of statistical knowledge in the country, as a Sierra Leonean is born and another dies every hour in the country. After the initial euphoria about how successful the three day lock down was, the number of Ebola death in areas that were relatively Ebola free has now exponentially increased, somehow putting a severe dent in these initial claims of success. Even so there are reports that plans for an even longer shutdown are afoot.
Cuban Health Team in Freetown

Sierra Leone is now receiving substantial external assistance in combating the Ebola virus disease. Teams of Cuban, Chinese and British health and emergency workers are slowly deploying around the country complementing the effort of the country's overworked  health care workers. Even though all the foreign teams are reporting to the Emergency Operations Center, many are complaining of the lack of effective coordination and centralized authority, as there are just too many independent government entities and individuals with no clearly defined channels of authority. Clear communication channels are vital in an emergency crisis. The Emergency Operations Center has a lot of visibility but currently lacks much political authority. The role of the EOC and that of the country's health ministry in a lot of areas areas remain conflicting and undefined, creating some ambiguity.

By Sheku Sheriff
Segbwema Blogger


2 comments:

Anonymous said...

SB,
Now one of the nurses who treated the Ebola patient in Texas has tested positive.

http://www.cnn.com/2014/10/12/health/ebola/index.html?c=&page=1

Sheku Sheriff said...

Dangerous virus.