By Delia M. Arias De Leon
UNITED NATIONS – Lacking a medical solution to the worst Ebola outbreak in history, governments and organizations in West Africa are resorting to a medieval tactic that would radically affect the lives of more than 1 million people, according to the World Health Organization.
The method popularized in the era of the Black Death plague in the 14th century, the “cordon sanitaire,” draws a line around the geographic area where the infections are taking place, allowing no one to exit. It hasn’t been used since the end of World War I.
Plans to cordon off a triangular area that includes parts of Guinea, Sierra Leone and Liberia were discussed as early as Aug. 1, and troops began closing roads last week in the effort to prevent the deadly virus from spreading further.
The WHO is supporting the move. Dr. Margaret Chan, the WHO’s director-general, remarked in a briefing in Geneva that the decisions “to seal off the hot zone of disease transmission, that is, the area where the borders of Guinea, Liberia and Sierra Leone intersect, are critical for stopping the re-infection of areas via the cross-border movement of people.”
WHO admits, however, sealing off the hot zone is not without consequences, with more than 1 million people affected who “need daily material support, including food.”
“The isolation of this zone has made it even more difficult for agencies, like Doctors Without Borders, to bring in staff and supplies,” WHO said.
There is also the question of how to manage doctors and health workers trying to save patients’ lives. Would they be trapped along with the rest of the population or allowed to leave, potentially carrying with them a life-threatening disease? Or should the affected population be left to its own?
In ancient times, the cordon sanitaire was used as a last-ditch effort to contain a disease, and the citizens of the trapped area were usually left to their own devices. While in this case the WHO has committed to provide food to the million people affected by the quarantine, there is little else it can do.
As WND reported, even though the WHO has approved the use of experimental treatments to cure Ebola, there are no readily available supplies, making the disease untreatable for the foreseeable future, with a mortality rate of well over half the people it infects
Dr. Martin S. Cetron, quarantine expert for the Centers for Disease Control, has expressed hope that the cordon will work. But he admits there is “a lot of potential for it to go poorly if it’s not done with an ethical approach.”
“Just letting the disease burn out and considering that the price of controlling it – we don’t live in that era anymore,” he said.
Early on Thursday, the WHO announced on its website it was “scaling up the international response, marshaling support from individual countries, disease control agencies, agencies within the United Nations system, and others.”
All of this in an effort to provide the “extraordinary measures needed, on a massive scale, to contain the outbreak in settings characterized by extreme poverty, dysfunctional health systems, a severe shortage of doctors, and rampant fear.”
The organization also admitted the numbers of reported cases and deaths “vastly underestimate the magnitude of the outbreak.”
The entire U.N. body apparently realizes the epidemic is far more dangerous than initially thought and is now lending its full support to the WHO’s containment strategy.
On Wednesday, the U.N. secretary-general, Ban Ki-Moon, chaired a system-wide meeting in which “he stressed the need for the entire U.N. system to support the WHO’s efforts in combating the outbreak.”
The meeting followed WHO Director-General Margaret Chan’s bleak admittance to U.N. member states in Geneva that, not only is every city with an international airport at risk of unwittingly bringing an Ebola-infected person into their country, but an end to the outbreak is nowhere in sight.
The U.N. health agency has stressed that in the past, standard measures, such as early detection and isolation of cases, as well as rigorous procedures for infection control, have stopped Ebola outbreaks.
What makes the current crisis different is fear. The U.N. has warned “fear causes contacts of cases to escape from the surveillance system, families to hide symptomatic loved ones, and patients to flee treatment centers.”
Delia M. Arias De Leon writes for WND and is stationed at the United Nations in New York City. For breaking news about the U.N. follow her on twitter @deliaADL