NEW YORK – As the World Health Organization unveiled a proposal Thursday to stop the spread of the Ebola virus in West Africa, a field nurse for the French organization Doctors Without Borders confirmed the conclusion of experts who contend the outbreak is “out of control.”
Anja Wolz, a registered nurse serving as an emergency coordinator at the organization’s Ebola case-management center in Sierra Leone, wrote a first-person report published Wednesday on the website of the New England Journal of Medicine.
The Ebola outbreak, Wolz wrote, “has been out of control for months, but the global health community has taken a long time to react.”
“The current international Ebola response remains dangerously inadequate,” she said.
Last week, Wolz explained, 250 infected persons were identified for “contact tracing,” but there should have been more than 1,500, which is the number of confirmed cases.
“The alert system – whereby an investigation team (and, if needed, an ambulance) is sent to a village when a suspected case or death is reported – is not functioning properly, and the Ministry of Health has only four ambulances in a district with about 470,000 people,” Wolz wrote.
The conclusion that the Ebola outbreak is out of control in West Africa is shared by the co-discoverer of the virus.
Belgian microbiologist Dr. Peter Piot said in an interview published Tuesday he believes the efforts to contain the outbreak in West Africa are doomed to failure.
“The Ebola outbreak has exploded in West African nations where the health services, ravaged by decades of war, simply do not function,” Piot told the French publication Libération.
Meanwhile, the WHO announced Thursday its new “WHO Ebola Response Roadmap.” But in a telephone interview with WND, Fadela Chaib, a WHO spokeswoman in Geneva, acknowledged the plan will work only if the international community follows every step precisely.
Wolz said the international resources available to combat the Ebola outbreak in West Africa are woefully inadequate:
“Our health promotion teams are still visiting villages where no other health care provider has been,” she wrote. “Every day sees deaths in the community that are surely caused by Ebola, but they are not counted by the Ministry of Health because the cause has not been confirmed by laboratory testing. The epidemiologic surveillance system is nonfunctional. We need to define the chains of Ebola transmission to interrupt them, but we lack key data.”
In an email Wednesday to WND, World Health Organization spokeswoman Margaret Ann Harris in Geneva said the United Nations agency is unable to provide accurate numbers of the Ebola cases currently under quarantine in “hot districts” in Guinea, Sierra Leone and Liberia.
“Unfortunately we cannot give you the number of Ebola cases in the zones under quarantine as numbers change from day to day as cases are confirmed or proven to be something else – so basically no such count can ever be scientifically ‘accurate,’” Harris wrote.
The Belgian microbiologist Piot explained the cultural impediments to controlling the outbreak
“The exposed populations in West Africa have no confidence in the health system, preferring instead to cling to cultural habits such as touching the corpse in the funeral process, when the body is most infectious, and physical contact with the bodily fluids of a contaminated person are a major way the virus spreads,” he said.
Piot also lamented that the WHO began major health operations to combat Ebola in West Africa only in July, while the outbreak began in January.
“In recent years, many treatments and vaccines have been developed thanks to American financing in the war to combat bio-terrorism,” he noted. “Now it’s time we make the products available to the affected countries.”
WHO’s Chaib explained to WND the “roadmap” has a chance of stopping the Ebola outbreak in West Africa within the next six to nine months only if the international community follows it precisely, step by step.
“If we don’t put in place the measures called for in the WHO roadmap, we will not be able to stop the spread of Ebola,” Chaib said.
She affirmed the WHO doesn’t have accurate numbers of the people infected with Ebola in the quarantine areas in West Africa.
“We do not have adequate numbers of health workers to follow all the cases being reported,” she said. “We lack information about the scale of the disease not only within the quarantine zones but outside them. We lack information about how many people are living around the quarantine zones and also how many infected people may be hiding within the quarantine zones.”
WND reported Wednesday that Air France is suspending all flights to Sierra Leone, following a recommendation by the French government council of ministers.
The airline already had revealed Aug. 19 that some employees had refused to board flights to West African countries where the Ebola outbreak is raging, including Sierra Leone. The Air France employee’s union, Syndicat National Du Groupe, previously called for “an immediate end” to service in the Ebola-affected region.
Already, some African-based airlines, including Kenya Airways, have suspend flights to Liberia, Guinea and Sierra Leone.
WHO: Don’t stop flights
Chaib explained to WND that commercial flights to West Africa are needed to stop the disease.
“We must be able to rely on commercial flights to West Africa to move medical experts in and out of the region as well as to transport medical supplies,” Chaib explained.
She said the WHO is in discussions with international airlines to address their concerns.
“It is not a good public health measure to ban or restrict air travel into an affected area,” she said. “Ebola cannot be stopped because you cut flights from West Africa.”
She contended the risks to aircrews and passengers of contacting Ebola in flight are minimal.
“Ebola is not an airborne disease,” she said. “People can travel safely. The only people who should not be allowed to travel are those sick with Ebola already exhibiting symptoms of the disease. Restricting travel is not contributing to the WHO fight against Ebola.”
Chaib admitted that because the incubation period for Ebola is 21 days, someone infected but not yet exhibiting symptoms would be allowed to travel.
But she insisted any such case could be handled.
“If we have someone traveling who gets sick with Ebola only after they arrive at their destination, there are many countries that have adequate health facilities to treat the Ebola case locally and to track those the sick person may have infected by contact after arriving in the destination country,” she said.
She pointed to Nigeria, where there is a single chain of transmission traced to a man who brought the disease via an international air flight from Liberia and contacted others in Nigeria.
“This is good news in that no second chain of transmission has been found so far in Nigeria,” she said.
However, the physician coordinating the United Nations response to the outbreak, Dr. David Nabarro, contends suspending flights to West Africa has hindered international efforts to combat the virus.
“The understandable decisions made by certain airlines to cease flights serving Freetown, Monrovia and Conakry has had an enormous impact on the capacity of the United Nations to transport health workers and equipment,” Nabarro said Wednesday, the Paris paper Le Monde reported.
WND reported Tuesday the WHO has scheduled a closed-door conference with some 100 health care experts to consider alternative medical treatments and experimental drugs available for treating Ebola and make recommendations.
The Japanese company Toyama Chemical, a pharmaceutical subsidiary of the photo giant Fujifilm, already has promised to deliver to the WHO at no cost a quantity of the experimental drug Favipiravir. Fujifilm is in talks with the U.S. Food and Drug administration through a U.S. partner, Boston-based MediVector, to clinically test the drug in the U.S, the Associated Press reported Monday.