Ebola is spreading exponentially in Liberia, with thousands of new cases expected in the next three weeks, the World Health Organization (WHO) says.
Conventional methods to control the outbreak were “not having an adequate impact”, the UN’s health agency added.
At least 2,100 people infected with Ebola have died so far in the West African states of Guinea, Liberia, Sierra Leone and Nigeria this year.
The WHO and many others have really been slow in reacting to the Ebola crisis, it seems. As recently as a week ago, I read several articles containing remarks by supposed experts in emergency medicine who were criticizing Medecins Sans Frontieres (Doctors without Borders) for being alarmist about the situation in Liberia. (MSF leaders had been calling for Western governments to send in military support, and were claiming that an 800 bed Ebola facility was needed in Monrovia) Some scoffed. (here’s an example: http://bostonherald.com/news_opinion/local_coverage/2014/09/docs_doubt_dire_ebola_prognosis_but_call_for_help)
Now 7 – 10 days later, WHO is calling for similar things…. Sigh. Anyone looking at the data 3 or 4 weeks ago could see that Ebola was starting to increase exponentially in Liberia.
As the chart the elves posted a few days ago [ http://new.kendallharmon.net/wp-content/uploads/index.php/t19/article/56129 ] shows so clearly,
Ebola cases in Liberia have been increasing at rates of 250% – 300% per month. At this rate there will have been about 4200 cases in Liberia alone by the end of September… (and probably the REAL total is double that amount or more given the number of hidden cases not being counted). Add to that all the other deaths that will occur from other illnesses, childbirth etc. because the entire health system has collapsed… It is truly terrifying.
I did a bit of internet digging, and found links to some articles that back on June 20 MSF was already saying that Ebola was “out of control”
http://rt.com/news/167404-ebola-africa-out-of-control/
WHO held emergency meetings in the first week of July. But then it seemed very little progress or effective mobilization happened for the last two months (at least in Liberia and Sierra Leone). I think WHO has been more effective in responding in Nigeria.
I wonder if the WHO is like the US Embassy in Cairo when I was there. They warned us of a danger on the border with Gaza by email. I had been reading about that situation on the BBC for a week before the official warning came.
Because of the three-week incubation period the situation in [url=http://af.reuters.com/article/topNews/idAFKBN0H414B20140909?sp=true]Senegal[/url] is still of concern. A student from Guinea traveled 600 miles to Dakar in crowded bush taxis and has been reluctant to cooperate fully with contact tracing. His Dakar family are in isolation and so far they show no sign of ebola. But evidence of how volatile this disease outbreak can become is this comment, from a neighbor in Dakar: [blockquote]”There was no Ebola in Senegal. It was a Guinean and we should have killed him,” said Talla Dieye, who runs a small coffee stand in the Parcelles neighbourhood.[/blockquote]
A really helpful website for following the latest news and the numbers from each country is here:
https://www.internationalsos.com/ebola/index.cfm?content_id=394&language_id=ENG
I can’t resist one more link. The US Military plans to set up a field hospital in Liberia. Cost: $22 million for a 25 bed facility.
http://tinyurl.com/lntl5ta
Hmmmm. I wonder how much it would cost an NGO like MSF to open a 25 bed facility?
This is not meant to knock our military! And I’m glad they’re responding as I think this could become a major security threat as well as a health threat.
I’m not even knocking the WHO, they do excellent and invaluable work on many levels (research, promoting needed health policy changes in various countries…) but trying to mobilize bureaucracies to respond to such a challenge is slow and expensive. Unfortunately now the outbreak is beyond the level at which NGOs like MSF and Samaritan’s Purse can respond. It’s gotten too big and complex.
Yes but then there is this from WHO director Dr Margaret Chan saying that it is a ‘fantasy’ (her word) to think of WHO as a first responder to epidemic:
http://www.nytimes.com/2014/09/04/world/africa/cuts-at-who-hurt-response-to-ebola-crisis.html?module=Search&mabReward=relbias:s,{“1″:”RI:9”}
Excellent article at Foreign Policy:
http://www.foreignpolicy.com/articles/2014/09/05/we_could_have_stopped_this_ebola_virus_world_health_organization
Key excerpts:
As I wrote last month, the world simply didn’t get it. And it still doesn’t. The WHO doesn’t have a giant SWAT team of disease-fighting soldiers ready to swoop into a beleaguered area on an agency-owned transport jet, armed with lifesaving drugs and vaccines. In reality, the WHO begs airlines for tickets in coach, pleads with drug companies and protective gear manufacturers for free handouts, and has only the expertise on hand that governments are prepared to payroll and donate, such as scientists from the U.S. Centers for Disease Control and Prevention (CDC).
And now the epidemic is skyrocketing — nearly half of the cumulative case burden of Ebola in the three countries has occurred in just the last 21 days, according to the WHO. This week CDC Director Tom Frieden returned from Liberia visibly stunned, flabbergasted by what he had witnessed, warning that “There is a window of opportunity to tamp this down, but that window is closing.”
[…]
This week the WHO finally came out of its somnambulant state and infuriating claims of being just a “normative agency,” as Director-General Margaret Chan has repeatedly put it. The WHO’s Chan and Keiji Fukuda, who oversees the agency’s responses to outbreaks, held a blitzkrieg of meetings in Washington this week hoping to raise hundreds of millions of dollars and instill confidence in United Nations leadership. With them was David Nabarro from the United Nations’ Secretary-General’s Office, who was recently appointed to coordinate Ebola responses across the entire U.N. system. They touted the WHO’s “road map,” a 12-point set of principles and needs for Ebola response that was released in August. When the road map was originally released, the WHO said its implementation might stop Ebola in nine months’ time, at a cost of $490 million and some additional 20,000 human cases. But days later, at their Sept. 3 Washington press conference, Nabarro put the cost at “at least $600 million” and said that “it may cost even more,”
[…]
All that coordinating will presumably be executed from an “Ebola Crisis Center” created on Sept. 5, and located in the U.N.’s New York headquarters. But here is what WHO and U.N. leaders have not said or explained to date.
First, where is the bank account to which donors, both public and private, can make out their checks? Surely the logical location is the World Bank, but months after the epidemic commenced there is still no account to which a corporation like Goodyear (which has huge rubber operations in Liberia) or Rio Tinto (mining in Guinea) or Titanium Resources Group (Sierra Leone) can donate millions. …
Second, nearly all commercial airlines and air delivery companies have stopped flights to and from the three Ebola-stricken nations, and many have halted services across all of West Africa. As a result, personnel and supplies cannot get into the area, …
Happily, the government of Ghana has agreed to make Kotoka International Airport in Accra an air bridge for Ebola responses, allowing large aircraft from all over the world to land at Kotoka, and smaller planes to shuttle personnel and supplies in and out of areas of need in the region. The WHO will assure that screening is in place at all of the region’s airports to ensure that no ailing individuals fly to Ghana.
While this is a long-overdue beginning, the air bridge — if it is to come close to meeting the needs in the Ebola-stricken areas — will require military-scale logistics and support. […] To get a sense of the scale of the necessary Kotoka operations, Fukuda has calculated that for every 80 patients in care in Liberia, for example, 200 to 250 health and logistics personnel are required. […] Simple math based on the number of cases currently estimated and the joint Fukuda/MSF calculus shows that more than 11,000 health care workers are needed now, with exigencies destined to soar with expansion of the epidemic. No matter where these people come from, most will need to use the Kotoka air bridge.
But also not stated in the road map or WHO/U.N. briefings is who will pilot and crew the planes in that air bridge? Chan said that her team has been meeting with airline executives, trying to convince them that the safety of their personnel can be assured. But it seems unlikely that hundreds of commercial pilots, cargo handlers, and flight crew will volunteer to fly in and out of Liberia, Sierra Leone, Guinea, and even, if conditions worsen, Nigeria. Military pilots and crew, in contrast, often volunteer for dangerous missions.
Supplies of everything from basic food for the people of Monrovia’s slums to advanced medical equipment are desperately needed, and demand for everything will grow in tandem with the size of the epidemic. If the Ebola RO in Liberia = 3.0 right now — and it might — then the expansion rate of personnel and supplies needs to grow threefold simply to keep pace, or fourfold to get ahead of the virus. The logistics and warehousing scale of need is mind-boggling […] But WHO and U.N. leaders have nothing to say about staging grounds, warehousing, and accountability for the movement (versus theft and black-marketing) of supplies.
Thanks for the Foreign Policy excerpts, Karen B. The WHO indeed is not a first responder to epidemics. What we are seeing is that local governments and societies which are not prepared to respond to medical crises can and will be overwhelmed. The cited logistics of getting supplies into the areas are devastating, and I am beginning to worry about how people in other areas of West Africa will get out if they decide to leave. People in Guinea, Sierra Leone and Liberia seem pretty much stuck except for the ambulance airlifts of selected Western missionaries.
The only good news is that Ebola patients in American isolation wards seem to do pretty well, given the care which is not available to those dying in West Africa, even in MSF, SIM and Samaritan clinics. They just don’t have the facilities and supplies to do it.
Lord, have mercy.
Katharine, your closing line “Lord have mercy” is about all I’ve really been able to pray for this crisis the past few days. My job has required me to immerse myself in the details of the risk of the spread of Ebola in W. Africa, and so I’ve been feeling a bit overwhelmed by how this is spreading… reading lots of articles but not praying as much as I should.
I realize most of my comments make me sound like the Epidemiology geek that I sometimes am (Epidemiology was just about my favorite course in my grad school training in International Health & Development)… I’ve not been sounding much like the person who founded Lent & Beyond and turns to God in prayer for this crisis.
Jill Woodliff has been posting prayers re: Ebola at Lent & Beyond:
http://anglicanprayer.wordpress.com/tag/ebola-crisis-prayers/
[I’ve actually not even posted on Ebola at Lent & Beyond (yet?) because it is almost too personal… for various reasons my blogging at L&B is usually totally separate and distinct from my work overseas, and this crisis is too close to my life and work here in Africa…]
I’m finding the words of Ps 62 coming to mind tonight: ONLY in God is our salvation….
5Yes, my soul, find rest in God;
my hope comes from him.
6Truly he is my rock and my salvation;
he is my fortress, I will not be shaken.
7My salvation and my honor depend on God ;
he is my mighty rock, my refuge.
8Trust in him at all times, you people;
pour out your hearts to him,
for God is our refuge.
Karen B., I hope you and your colleagues have an evacuation route in mind if it came to that. I hope and pray it won’t. Our hope is in the Lord, at all times and in all places. Others will pray for you. Do your job; it’s what God is calling you to do now.