Via allAfrica.com, a fascinating interview with Dr. Thomas Frieden: West Africa: If Ebola Response Had Been Adequate 'Outbreak Would Be Over' - CDC's Frieden. Click through for the full article. Excerpt:
At a U.S. Congressional hearing on 7 August, you said CDC and your partners must "surge" to deliver resources. Can you be more specific about what that means?
The bottom line is that this is an unprecedented, overwhelming, crisis. It needs an unprecedented global response. You've seen the case numbers. They're horrific, and we know there are many more cases that haven't been diagnosed.
We know that Ebola is not just killing people. It's also undermining the public health and healthcare systems, particularly in Liberia. That will result in more deaths from malaria, diarrhea, pneumonia, other things.
It's different in different places. The Guineans have made a lot more progress than the others. In Lagos [Nigeria], they were slow initially, but now have had an exemplary response. They have additional cases diagnosed in the past 24 hours [as of the afternoon of 22 August]. It shows just how hard it is to control this. You need a meticulous and comprehensive approach.
The second key bottom line about Ebola is that we know how to stop it. We can stop this. It really comes down to finding, responding, and preventing.First you find. You find patients, get a lab test done. Next, you respond: you isolate patients safely; you elicit the names of their contacts; you trace their contacts; and you speak with them every day for 21 days. If they get fever, you begin that process again.
There are two main ways that Ebola is spread. If we turn off these two taps – when we turn off these two taps – we will stop the outbreak.
The first [way] is through health care – not primarily healthcare in Ebola treatment units but among people who come in with fever and end up having Ebola. That means we need to improve infection control throughout the entire healthcare system in the Ebola affected areas.
The second is through burial practices. I know that this is a very sensitive topic, but unfortunately and tragically, many cases are being spread, in certain regions, by traditional practices involving burial and sending off the dead. At least until the outbreak is over for good, we need to work with communities, community leaders, and religious leaders to have safer ways of burying the dead. I'm sure that the dead person would not want one of their loved ones, or someone who is trying to pay respects to them, to die as a result of that process. That really highlights the importance of communication.
What we're doing there is extensive. We've got mobile labs deploying in the region. We're working with many international partners – South African, Canadian, German, French, the European Union…there's a lot of global partners. Even within the U.S. government, we've got both the defense department and CDC helping with testing and NIH [National Institutes of Health] helping with testing.
It's really a coalition. We have epidemiologists – disease detectives. We have laboratory experts. We have analytics experts helping to understand what's happened. We have infection control experts. We have communications experts. We have emergency response experts – how to organize the work.
The two most urgent things to get right are how we organize the response. In an emergency like this, it's very difficult to make sure that our activities are strategic and effective. So we have an emergency response system that will facilitate control.
The second is the need for more treatment beds, isolation treatment beds. Currently there are not nearly enough.
The gap is enormous. And it's very difficult to get the staff trained. There's a real challenge here. Looking to the future, I'm confident that if we do have this global response, Ebola can be stopped.
What we hope is that it will not only stop Ebola, but put in place the laboratories, people who are trained, emergency response capacity that will stop the next Ebola – or other health threat – before it spreads like this. I am 100% certain that if systems like this had been in place, the outbreak could be over already.