Ebola and other Epidemics, Inadequate Healthcare Threatens Millions

[Baron von Schtinkenbutt]

UN Secretary General Ban Ki-moon says he will hold a meeting on the international response to the Ebola crisis on the sidelines of the UN General Assembly this month.

Is that a joke?  Hold a meeting sometime this month?  Oh FFS.

That's just the meeting to set the agenda for the meeting to decide where the meeting will take place.

[mongers]

Good to see the Gates Foundation is chipping in 50 million, well done Bill and his forceful wife. 

[Caliga]

Is that a joke?  Hold a meeting sometime this month?  Oh FFS.

That's what high muckeymucks do... hold meetings and then yell at other people to take care of shit.

[jimmy olsen]

[Caliga]

I'm jealous of Tim's time machine.

[jimmy olsen]

Looks like the government will collapse sooner rather than later.

www.frontpageafricaonline.com/index.php/news/2974-ebola-hits-seat-of-liberian-presidency-1-dead-1-quarantined

Ebola Hits Seat of Liberian Presidency; 1 Dead; 1 Quarantined

    Written by Rodney D. Sieh, [email protected]
    Published: 10 September 2014

Monrovia - Liberia's Ministry of Foreign Affairs, which is also the seat of the Liberian presidency, has been hit by the deadly Ebola virus, FrontPageAfrica has learned.

On Monday, the Administrative Assistant to Foreign Minister Augustine Ngafuan reportedly died from what sources say is a suspected case of the deadly virus. Her husband, a staffer in the office of President Ellen Johnson-Sirleaf, is currently under quarantine.

FrontPageAfrica is withholding the names of the officials because the government has not officially notified the public about the cases, so close to the Liberian presidency. Minister Ngafuan's office is two floors below the floor now being used as the President's office.

The wife of the President's office staffer reportedly died on Monday and may have gotten the virus from a sister, who had previously died. A praying woman who reportedly had sessions and laid hands on the sister of the deceased Administrative Assistant, has also died.

Sources within the Executive Mansion informed FrontPageAfrica Wednesday that both the deceased Administrative Assistant in Minister Ngafuan's office and her husband had been told not to return to the office until after 21 days.

" They had not been coming to work for more than 21 days now," the source, speaking on condition of anonymity because they were not clothed with the authority to speak on the matter.

Minister Ngafuan is currently in Addis Ababa, Ethiopia attending an Emergency Meeting of the African Union's Executive Council on the Ebola Virus Disease Outbreak.  Attempts to reach the minister and his press aide have been unsuccessful. The AU members are recommending the urgent lifting of all travel bans imposed on countries affected by the Ebola outbreak in Africa.

The Ministry has been the seat of the presidency since 2006 when fire gutted the fourth floor during celebrations marking the 159th Independence Day celebrations in the presence of three West African leaders, who had come to witness the then newly-elected President Ellen Johnson-Sirleaf switch on electricity to reach limited parts of the capital city.

South African forensic scientists brought in to probe the cause of the fire said it was an electrical fault. Following the fire outbreak at the Executive Mansion, the Government of Liberia announced a closure of the Mansion, and President Johnson-Sirleaf relocated to the Ministry of Foreign Affairs, where the president has for the past eight years been performing official state functions.

The mansion was constructed in 1964 under the regime of the late Liberian President William Vacanarat Shadrach Tubman by 2,000 workers, including about a fifth of Monrovia's labor force, and 150 foreign technicians. The eight-storey Executive Mansion building, which costs US$20 million, has an atomic-bomb shelter, an underground swimming pool, a private chapel, a trophy room, a cinema, an emergency power plant, water supply and sewage system, among others.

The report comes just 24 hours after Defense Minister Brownie Samukai told the U.N. Security Council that the outbreak poses a "serious threat" to the war-torn nation's very existence. Samukai's words were echoed by the U.N. Secretary-General's special representative Karin Landgren, who said Liberia is facing its gravest threat since its decade-long civil war ended in 2003. She deemed the outbreak a "latter-day plague" and its spread "merciless."

Liberia is worst hit among the nations affected by the current Ebola epidemic with at least 1,200 recorded deaths. Over the past three weeks, the country has experienced a 68% bump in infections and the World Health Organization estimates the surge will continue to accelerate in coming weeks.

Humanitarian groups in the country have been complaining that there simply aren't enough beds and suspected victims of Ebola are reportedly turned back to their communities or left waiting outside medical facilities, aggravating the risk of further contagion.

At least 160 health workers have been infected with the virus and 79 have died, in a nation that counted a paltry single doctor per 100,000 inhabitants at its onset. Landgren pointed out that the challenge also goes beyond the medical response.

"The enormous task of addressing Ebola has revealed persistent and profound institutional weaknesses, including in the security sector," she said. "As the demands pile on, the police face monumental challenges in planning and implementing large scale operations."

Good Lord, it's even worse than I thought. This is as bad as virgin field smallpox epidemic.

[jimmy olsen]

It's true. 

http://www.dw.de/virologist-fight-against-ebola-in-sierra-leone-and-liberia-is-lost/a-17915090

Virologist: Fight against Ebola in Sierra Leone and Liberia is lost

The killer virus is spreading like wildfire, Liberia's defense minister said on Tuesdayas he pleaded for UN assistance. A German Ebola expert tells DW the virus must "burn itself out" in that part of the world.

His statement might alarm many people.

But Jonas Schmidt-Chanasit of the Bernhard Nocht Institute for Tropical Medicine in Hamburg told DW that he and his colleagues are losing hope for Sierra Leone and Liberia, two of the countries worst hit by the recent Ebola epidemic.

"The right time to get this epidemic under control in these countries has been missed," he said. That time was May and June. "Now it is too late."

Schmidt-Chanasit expects the virus will "burn itself out" in this part of the world.

With other words: It will more or less infect everybody and half of the population - in total about five million people - could die.

Stop the virus from spilling over to other countries

Schmidt-Chanasit knows that it is a hard thing to say.

He stresses that he doesn't want international help to stop. Quite the contrary: He demands "massive help".

For Sierra Leone and Liberia, though, he thinks "it is far from reality to bring enough help there to get a grip on the epidemic."

According to the virologist, the most important thing to do now is to prevent the virus from spreading to other countries, "and to help where it is still possible, in Nigeria and Senegal for example."

Moreover, much more money has to be put into evaluating suitable vaccines, he added.

Angry reactions

In the headquarters of Welthungerhilfe, a German non-governmental aid organization that is engaged in helping with the Ebola epidemic, Schmidt-Chanasit's statement causes much contempt.

Such declarations "are not very constructive," a spokeswoman said.

Jochen Moninger, Sierra Leone based coordinator of Welthungerhilfe, told DW, Schmidt-Chanasit's statement is "dangerous and moreover, not correct."

Moninger has been living in Sierra Leone for four years and has experienced the Ebola outbreak there from the beginning.

"The measures are beginning to show progress," he says. "The problem is solvable - the disease can be stemmed."

"If I had lost hope completely, I would pack my things and take my family out of here", Moninger adds. Instead, he and his family will stay.

In Sierra Leone, the government has ordered a quarantine of 21 days for every household in which an Ebola case occurred. Soldiers and police are guarding these houses preventing anyone who has come into contact with an Ebola patient from leaving.

According to Moninger, that is exactly the right thing to do: isolating sick people - should it be necessary, even with military force.

Creating hopelessness doesn't help

Moninger says he doesn't know much about the situation in Liberia. But indeed, he got the impression that "there seems to be happening something that is not good at all."

He grants that Schmidt-Chanasit's statement "might point a little bit into the right direction" regarding Liberia.

Liberia has not taken on the same quarantine measures as Sierra Leone. According to a WOrld HEalth Organization (WHO) report, Ebola-infected people are crisscrossing the capital in shared taxis, looking for a treatment place and returning home after finding none. This way the virus spreads.

"Distributing hopelessness", though, Moninger said, "is dangerous", adding that there are many human lives at risk, and "statements like these make the situation even worse".

Disastrous, but not without hope

The WHO in Geneva refuses to comment on Schmidt-Chanasit's statement.

WHO spokeswoman Fadéla Chaib, though, says that there is "of course" still hope for both countries.

"We can bring the situation under control in 6 to 9 months," she told DW.

She admits, though, that the situation especially in Liberia is "very intense".

The government is completely outstripped and as soon as a new Ebola treatment center has opened, it is overflowed by patients, she says, adding that Liberia has the highest number of cases and deaths in West Africa with a 60 percent case-fatality rate.

The situation is getting worse after 80 health workers, doctors and nurses, have died after contracting the disease.

The WHO even expects thousands of new cases of Ebola in Liberia over the next few weeks.

Winning together

Not only neighboring countries but also Europe and the US will have to support the fight against the epidemic, WHO's Chaib demands.

Then it might be possible to win this fight.

The key to getting a grip on the epidemic is to stop the transmission of Ebola, especially in healthcare workers, she says.

Creating Ebola centers in the communities themselves will stop Ebola patients and their family members moving around and infecting other people.

"We will do everything we can to stop this Ebola outbreak. We will not let down West Africa."

[mongers]

Tim, it's not as bad as you or the article make out, after all that quotes a 2nd expert, one actually on the ground who says there is hope.

Besides it's impossible for everyone to catch the disease in a country and only a given % of those will survive, there will be patches, even in the worse case analysis were no one is infected in some locations before it dies out in neighbouring areas, something that it's rapid killing actually aids.

[jimmy olsen]

Jesus. I can't even imagine.

http://www.theguardian.com/commentisfree/2014/sep/11/ebola-treatment-centre-liberia

I had to turn people away from an Ebola treatment centre. It's desperate work
Explaining to people pleading for their loved ones that we were full was almost impossible. Yet despite the horrors of the situation here in Liberia, there are moments of true joy

   
        Pierre Trbovic   
        theguardian.com, Thursday 11 September 2014 16.48 BST   


Soon after arriving in Monrovia, I realised that my colleagues were overwhelmed by the scale of the Ebola outbreak. Our treatment centre – the biggest Médecins Sans Frontières has ever run – was full, and Stefan, our field coordinator, was standing at the gate turning people away. This wasn't a job that we had planned for anyone to do, but somebody had to do it – and so I put myself forward.

For the first three days I stood there, it rained hard. People were drenched, but they carried on waiting because they had nowhere else to go.

The first person I had to turn away was a father who had brought his sick daughter in the trunk of his car. He was an educated man, and he pleaded with me to take his teenage daughter, saying that while he knew we couldn't save her life, at least we could save the rest of his family from her. At that point I had to go behind one of the tents to cry. I wasn't ashamed of my tears but I knew I had to stay strong for my colleagues – if we all started crying, we'd be in trouble.

Other families just pulled up in cars, let the sick person out and then drove off, abandoning them.

One mother tried to leave her baby on a chair, hoping that if she did, we would have no choice but to care for the child.

I had to turn away one couple who arrived with their young daughter. Two hours later the girl died in front of our gate, where she remained until the body removal team took her away. We regularly had ambulances turning up with suspected Ebola patients from other health facilities, but there was nothing we could do. We couldn't send them anywhere else – everywhere was, and still is, full.

Once I entered the high-risk zone, I understood why we couldn't admit any more patients. Everyone was completely overwhelmed. There are processes and procedures in an Ebola treatment centre to keep everyone safe, and if people don't have time to follow them, they can start making mistakes.

It can take 15 minutes to dress fully in the personal protective equipment and, once inside, you can only stay for an hour before you are exhausted and covered in sweat. You can't overstay or it starts getting dangerous. The patients are also really unwell, and it is a lot of work to keep the tents clean of human excrement, blood and vomit, and to remove the dead bodies.

There was no way of letting more patients in without putting everyone, and all of our work, at risk.

But explaining this to people who were pleading for their loved ones to be admitted, and assuring them that we were expanding the centre as fast as we could, was almost impossible. All we could do was give people home protection kits, containing gloves, gowns and masks, so that they could be cared for by their loved ones with less chance of infecting them.

A week ago, MSF's president spoke at the UN and called on states with biohazard response capability to urgently send teams to west Africa. To have any hope of getting the outbreak under control we need more treatment beds for Ebola patients and we need them yesterday. We are worried that if left to UN agencies and NGOs it will take too much time to respond – more lives will be lost and the virus will spread even further.

MSF is currently providing 160 beds in Monrovia, we will soon have 200, and we will carry on expanding as fast as we can. But we are stretched to capacity by our work elsewhere on the outbreak and through the rest of the world.

In Monrovia, we estimate that there needs to be more than 1,000 beds to treat every Ebola patient. There are currently just 240 in total. Until that gap is closed by treatment centres with hundreds, rather than the small numbers pledged so far, the misery of turning people away at our gates will continue.

After one week on the gate my colleagues told me to stop. They could see the emotional toll that it was taking on me. That same afternoon a nurse came to find me, saying there was something I had to see. Whenever people recover, we have a small ceremony for the patients who are discharged.

Seeing the staff gather to celebrate this exceptional moment, hearing the words of the discharged patients as they thank us for what we did, gives us all a good reason to be there. Looking around I saw tears in all of my colleagues' eyes. Sometimes there are good reasons to cry.

[jimmy olsen]

The NY Times freaking out about the possibility of mutation to an airborne strain.

http://www.nytimes.com/2014/09/12/opinion/what-were-afraid-to-say-about-ebola.html?_r=0

Wouldn't mutation to a mosquito borne vector be more likely? A lot of people carry malaria, and dengue fever is also edemic, if a carrier gets infected be ebola the possibility for some sloppy recombination and gene swapping is a possibility isn't it?

[CountDeMoney]

A blood-borne hemmoragic fever like Ebola mutating to the point of becoming aerosolized on its own is a long shot;  they haven't even reached that point in the laboratory, it's that difficult.  A cross-species jump requires a lot of molecular engineering as well.

[jimmy olsen]

A blood-borne hemmoragic fever like Ebola mutating to the point of becoming aerosolized on its own is a long shot;  they haven't even reached that point in the laboratory, it's that difficult.  A cross-species jump requires a lot of molecular engineering as well.

Ebola strains in pigs and monkeys have gone airborne. If it can go airborne in one species of primates, why not another.

I bet Soviet labs managed it.

EDIT: Apparently the NY Times is using out of date research

http://www.popsci.com/blog-network/under-microscope/pigs-and-primates-addressing-airborne-ebola-allegation

EDIT: 2 Extra Doom!
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20899

The exponential growth in case numbers during an outbreak also makes resource-intensive activities like contact tracing and surveillance increasingly difficult. Recent studies, including the one by Nishiura et al. in this issue, suggest that the reproduction number of Ebola (the average number of secondary cases generated by a typical case) is between 1.5–2 in some countries [8,9]. Based on the durations of incubation and infectiousness of EVD [3], it is plausible that the number of cases could therefore double every fortnight if the situation does not change. There are currently hundreds of new EVD cases reported each week; with the number of infections increasing exponentially, it could soon be thousands. Following up contacts and monitoring them for symptoms has already become unfeasible in areas where health authorities are stretched to the limit.

...
Ebola cannot be ignored in the hope it will burn itself out. It is true that outbreaks of acute infections will generally decline once a large number people have been infected, because there are no longer enough susceptible individuals to sustain transmission. But if Ebola indeed has a reproduction number of 2 in some locations as described by Nishiura et al. [8], the susceptible pool – which likely includes most individuals – would have to shrink by at least half before the outbreak declined of its own accord [17]. Given the vast populations in affected areas and the disease's high fatality rate, this is clearly not an acceptable scenario.[/

[CountDeMoney]

That's right, snot droplets still fall under blood/tissue/bodily fluid protocol.  Stop inciting panic, Timmay.

[jimmy olsen]

Then again, that doctor who wrote the Op-ed in the Times is the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, so maybe he knows what he's talking about.

[Caliga]

What were you told about relaxing?