The War Against Ebola is Still Not On the Fast Track

Two months ago, United Nations Emergency Response Mission (UNMEER) announced ambitious plans to curb the Ebola virus spread by December 1st. Unfortunately, those objectives have not been met in the worst affected countries of Sierra Leone, Guinea and Liberia.The plans challenged health workers to isolate 70 percent of those sick with the deadly virus and to inter  70 percent of  the bodies of those deceased from the disease buried in a manner that would not allow their corpses to further infect others.

According to the most recent status update from WHO, the only area in which this goal has been reached is Guinea. Sierra Leone and Liberia are still far behind target, with a large number of those suffering from the Ebola virus in conditions of non-isolation, and many unregulated burial practices still taking place.

Liberia hasn’t even come close to the 70 percent isolation goal, with only 23 percent of known cases of the disease having been isolated. In order to insure that  burial rituals are conducted in a manner that is safe for mourners to attend without coming into physical contact with an Ebola-infected corpse, trained burial teams have to be present. Liberia has only  57 burial teams, 26 percent of the estimated required number of burial teams are actually available, resulting in a large number of unregulated burials being performed under conditions that could spread the infection further

Tradition and ritual work against the recommended practice of not touching the bodies of the dead in these areas of West Africa. Without the burial teams in place, there is a high possibility that mourners will touch infected corpses putting themselves at great risk of becoming infected, and further spreading the disease which has already killed 5,689 people. In Sierra Leone, only 40 percent of known cases of the virus have been isolated and only 24 burial teams are in place. 27 percent of the number required/

Dr Bruce Aylward from WHO said in October that the system would be very hard pressed to reach the December 1st deadlines. Aylward, wh0 is directing the Ebola response for WHO,  explains that if the deadline was not met, the consequences in terms of loss of life consequences would be even greater and the manpower needed in order to fight the disease would increase significantly.

Reports indicate that there has been a decline of the number of new cases in Liberia and Guinea in recent weeks. Sierra Leone, however, has seen a surge in the spread of infection. According to Anthony Banbury, who heads the Ebola response on behalf of UNMEER, the isolation and burial team targets were met in some areas, but not in others. Banbury warns that there are going to be many more deaths from the virus in the coming months.

While some people consider a 70 percent isolation rate a steep goal to reach, others think that anything less than 100 percent containment is insignificant. Sebastian Funk, director of London School of Hygiene and Tropical Medicine’s Centre for the Mathematical Modelling of Infectious Diseases says that aiming for anything other than 100 percent regulated burials and 100 percent isolation of infected patients “doesn’t really mean very much.”

Indeed, WHO did have a goal of 100 percent in mind, but that target was set to be reached by January 1st 2015. Banbury says that ending Ebola will be a long hard fight but that things are heading in the right direction, even though the target goals for December 1st have not yet been met.

(Editor’s Note:  We see these kinds of disagreements over and over again among organizations attempting to deal with various epidemics around the world. Since both organizations clearly believe that a 100% interdiction of infected persons and infected corpses is necessary to beat back this epidemic, the establishment of intermediate goals – a perfectly normal management convention – becomes a point of contention between different stake-holders.  While it is obvious that missing the December 1st goals was a not a good thing, that was only a step toward achieving the 100% interdiction goals on January 15. The problem is that, if the December goals have not been met, there is little likelihood that the January 15 goals will be met either. Along with the proliferation of the epidemic, there also appears to be a proliferation of stake-holders. The question is whether they clear the waters, or muddy them further. AMM)

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