Via The New York Times: Short Staff Tries to Cope With Ebola. Excerpt:
Early this month at a hospital in Sierra Leone, Dr. Daniel Bausch and another physician found themselves alone in a ward with 55 patients infected with the deadly Ebola virus. The nurses had walked out in a dispute over extra pay to take care of the Ebola patients, and some were also staying away for fear of contracting the disease, which has killed health workers.
Dr. Bausch and his colleague, both working for the World Health Organization, did what they could.
“Even if you wanted to be the hero, you couldn’t take care of 55 people,” he said. “We tried to attend to the most important things we could attend to in terms of people who were the sickest. To be honest, it sounds terrible, not really the sickest, but the sickest who you think have chances of surviving. If you’ve seen cases of Ebola before, you can see when someone is on their last gasp and trying to treat them won’t save them.”
Guinea, Liberia and Sierra Leone have been struggling since March to stop what has become the largest Ebola outbreak ever, with 1,201 cases so far, including 672 deaths. The disease is causing widespread fear and disruption in West Africa, and shows no signs of being brought under control.
Liberia has closed many of its border crossings in an effort to contain the virus. Nigeria has shut down a hospital for decontamination, after a man from Liberia died there on Friday from Ebola. He had flown in from Liberia a few days earlier, and collapsed at the airport in Lagos. So far, 59 people who had contact with him are being monitored, but that figure does not include the passengers on the flight, who will also have to be tracked down.
That an infected person who may have been obviously ill managed to board a plane has stoked fears that other travelers could carry the disease to still more countries. So health officials in the region are considering the idea of monitoring people for signs of infection before allowing them to board flights leaving the affected countries, experts from the United States Centers for Disease Control and Prevention in Atlanta said on Monday.
Ebola is spread only by direct contact with bodily fluids — blood, vomit, saliva, urine, stool — from someone who is ill. People who are infected but do not yet have symptoms, which can include fever, diarrhea, vomiting and bleeding, are not contagious. American health officials said that they did not expect the disease to reach the United States, but that if it did, standard infection control procedures would almost certainly stop it from spreading.
Dr. Thomas R. Frieden, director of the disease centers, said in a statement, “We do not anticipate this will spread in the U.S. if an infected person is hospitalized here but we are taking action now by alerting health care workers in the U.S. and reminding them how to isolate and test suspected patients.”
In areas where the disease has been spreading, health workers need special training to avoid infection and must wear several layers of protective clothing — gowns, masks, goggles, boots, gloves and waterproof aprons or coveralls.
The gear is suffocatingly hot and people can tolerate it for only so long in the tropics. The masks can fog up, making a risky business of, say, inserting an intravenous line or drawing blood. Another peril can come from taking off the protective gear, which must be removed according to a strict protocol.