Out of Sight, Out of Mind

  Has anyone heard how containment and treatment of the Ebola epidemic is progressing? I haven’t seen anything mentioned in the newspaper or on television in some time now. Has the epidemic been arrested? Do we have a great treatment for the disease? Is a vaccine now being used to prevent the illness?

  When I first wrote about the Ebola epidemic in this space in August 2014, more than 1,300 people had contracted the disease and more than 700 had died from it.¹ I know the numbers got worse as more and more people contracted the disease. The disease spread in individual cases to the United States and Europe, but patients either died quickly or survived with treatment. By November 2014, there were more than 14,000 reported cases of Ebola with nearly 6,000 deaths.² Even the people reporting these numbers agreed they were a significant underestimation. We heard that nearly $1 billion in aid has been pledged, that supplies and equipment are being provided by many countries, and that the US military has sent 3,000 troops to build treatment centers in the most severely affected countries. With all that help, progress in containing and treating the disease must be going very well since we have not had any significant news reporting on it since early January 2015. Or is it just a case of out of sight, out of mind, since no more Americans or Europeans have contracted the disease?

  To be certain, the epidemic is not under control. It may be better, but as of February 22, 2015, the number of reported cases had risen to 23,729 and the number of deaths from the disease to 9,604.³ As of that date, 837 health care workers had contracted the disease, with 490 of them dying.³ There are 1,000 new cases being seen each week⁴ with 85 deaths per day still being reported.³ They may be making progress in reducing the number of cases but this still seems like a real epidemic to me!

  What about the support? Surely all the supplies and money that could possibly be needed have poured into these countries. Apparently there has been a mixed response with regard to the donations. The United States and other countries have responded with supplies and equipment, but the money is slow to appear. Of the 130 countries that pledged nearly 1 billion US dollars to the United Nations for the treatment of the Ebola epidemic, less than half of the money was donated or even committed as of November 2014.² The tragedy is that it takes more than just giving money to help people who are sick. The main countries affected, Sierra Leone, Liberia, and Guinea, have had their already under-resourced health care system devastated because of the volume of patients needing to be seen. They need more help from medical professionals. In October 2014, the President of Sierra Leone, Ernest Bai Koroma, said his country would need 750 more doctors and 3,000 more nurses to treat patients with Ebola.⁵ Few countries have sent help for the overworked local health care workers, missionary doctors and nurses, and providers from Doctors Without Borders. Those that have include the United Kingdom, Cuba, and China.² The United States has sent the military to do construction, and the Centers for Disease Control has sent epidemiologists and other teams, but people to help with direct patient care have been lacking. Those volunteers who have gone and selflessly put themselves in harm’s way to treat these desperate patients are the true heroes of this epidemic.

  One of the unintended consequences of this epidemic has been the failure of the health care system in general. Because of the fear of attracting patients with Ebola, many African facilities have closed, denying care to patients with non-Ebola medical problems. As a result, illnesses and diseases that are normally manageable, such as childhood diarrhea, diabetes, acute appendicitis, and obstetrical emergencies, have gone untreated resulting in many needless deaths.²

  It does appear that progress is being made in controlling the Ebola epidemic, but there is still a long way to go. The few doses of medication thought to have some effect in treating the disease have long been exhausted. There is still no vaccine for Ebola, although work continues on one. Many patients are still contracting the disease and continuing to die.

  We must not become complacent with just “improvement” in the situation. There must be a vaccine, treatments, and protocols in place to allow health care workers to quickly attack and contain the epidemic the next time it surfaces. Peter Piot, MD, PhD, FRCP, FMedSci, director of the London School of Hygiene and Tropical Medicine, and one of the group of researchers who discovered the Ebola virus in 1976, has said that “leaving too early, before those systems are firmly in place, would be hard to forgive.”²

  The Ebola epidemic may be off the front pages of the newspapers and off the news broadcasts, but do not think it has been conquered. There is still much work to be done before the disease is under control. This is important to you and me just as much as it is to those in West Africa. Remember, the Ebola virus is only an airplane ride from our front door.