'In 1976 I discovered Ebola, now I fear an unimaginable tragedy'

[cali]

<snip>

After Yambuku, you spent the next 30 years of your professional life devoted to combating Aids. But now Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?

No, not at all. On the contrary, I always thought that Ebola, in comparison to Aids or malaria, didn't present much of a problem because the outbreaks were always brief and local. Around June it became clear to me that there was something fundamentally different about this outbreak. At about the same time, the aid organisation Médecins Sans Frontières sounded the alarm. We Flemish tend to be rather unemotional, but it was at that point that I began to get really worried.

Why did WHO react so late?

On the one hand, it was because their African regional office isn't staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for haemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard. But since August WHO has regained a leadership role.

There is actually a well-established procedure for curtailing Ebola outbreaks: isolating those infected and closely monitoring those who had contact with them. How could a catastrophe such as the one we are now seeing even happen?

I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic there were many factors that were disadvantageous from the very beginning. Some of the countries involved were just emerging from terrible civil wars, many of their doctors had fled and their healthcare systems had collapsed. In all of Liberia, for example, there were only 51 doctors in 2010, and many of them have since died of Ebola.

The fact that the outbreak began in the densely populated border region between Guinea, Sierra Leone and Liberia ...

… also contributed to the catastrophe. Because the people there are extremely mobile, it was much more difficult than usual to track down those who had had contact with the infected people. Because the dead in this region are traditionally buried in the towns and villages they were born in, there were highly contagious Ebola corpses travelling back and forth across the borders in pickups and taxis. The result was that the epidemic kept flaring up in different places.

For the first time in its history, the virus also reached metropolises such as Monrovia and Freetown. Is that the worst thing that can happen?

In large cities – particularly in chaotic slums – it is virtually impossible to find those who had contact with patients, no matter how great the effort. That is why I am so worried about Nigeria as well. The country is home to mega-cities like Lagos and Port Harcourt, and if the Ebola virus lodges there and begins to spread, it would be an unimaginable catastrophe.

<snip>

http://www.theguardian.com/world/2014/oct/04/ebola-zaire-peter-piot-outbreak?CMP=twt_gu

[kestrel91316]

1. I'm frankly astonished that they seem to have stopped things in Nigeria after it got into Lagos.

Clock still has a few more days on that to make it official, I think.

[Fred Sanders]

4. After 40 days Nigeria seems no more at risk than any other country, it really is a model of how

easily this virus can be contained.

[kestrel91316]

9. Nothing easy about it. Two more days and they are officially in the clear. I applaud them.

All that oil money finally did them some good.

[Fred Sanders]

13. Nothing to do with oil money, to do with basic epidemiology, oil money in Texas also.....

[uppityperson]

2. "This isn't just an epidemic any more. This is a humanitarian catastrophe"

My heart breaks for west Africa's people

[Louisiana1976]

3. I'm surprised Duncan's family hasn't gotten infected after being in that contaminated apartment for

several days.

[SickOfTheOnePct]

5. They may have

I would think that the 21 day observation clock they started last Sunday or Monday would be reset to yesterday, when they moved out of the infected apartment and into a clean home.

[kestrel91316]

11. That's what I said. I do, however, think that nobody is going to let their guard down until the

42 day mark, just to be safe. I bet PH or CDC stays in touch with the contacts for the full 42 days as a precaution. I would support that completely.

[SickOfTheOnePct]

17. Same here

It needs to be done right, even if it means longer observation times.

[MineralMan]

6. We wont know for some days to come.

I will be very surprised if at least one of them does not contract the disease. However, it will probably end there.

[cwydro]

8. And I wonder of we'll even know.

Somehow I think the CDC doesn't want us to know everything they know.

[kestrel91316]

12. Of course we will no. No purpose would be served by hiding a case of EVD, and it's is a legally

reportable disease, and any physician who diagnoses and reports it wants that feather in their cap (diagnosing rare diseases carries some prestige within the profession).

CDC aren't spooks. And they all like the public to know how valuable their services are, so it is totally in their interests to report all Ebola cases and show how they function.

[cwydro]

14. My only thought

was they don't want anyone to realize how badly they screwed up on this first case.

Otherwise, I agree with what you're saying.

[kestrel91316]

16. CDC didn't screw up. Physicians in that hospital screwed up. CDC moved heaven and

earth to provide hospitals and doctors and nurses with guidance in advance of this. Some of them chose to ignore it.

[kestrel91316]

10. Give it time. They yet may. Hence the 21 day isolation period.

[sendero]

15. It hasn't been....

.... anywhere near long enough to tell. We aren't remotely out of the woods yet.

[AngryAmish]

7. The WHO reacted poorly because at it's core it is corrupt and mismanaged

WHO is UN organization. The UN is corrupt and mismanaged. Ergo, WHO will act corruptly and be mismanaged.