Via The New York Times: Better Staffing Seen as Crucial to Ebola Treatment in Africa. Excerpt:
Dr. Rick Sacra, a missionary who contracted Ebola in Liberia this August, was first treated there. Each nurse on the ward cared for 15 or 20 patients, and none could work for more than an hour at a time because the protective gear was so suffocatingly hot. They never drew his blood for lab tests. There was no lab.
“A nurse makes rounds maybe once every eight hours,” Dr. Sacra said. A doctor came by once a day. “The staff is so few.”
After he was evacuated to Nebraska Medical Center, a nurse stayed in his room all the time, and dozens of people were involved in his care. He had daily blood tests to monitor his electrolytes, blood count, liver and kidneys, and doctors used the results to adjust what went into his intravenous lines.
The stark difference in the care available in West Africa and the United States is reflected in the outcomes, as well. In West Africa, 70 percent of people with Ebola are dying, while seven of the first eight Ebola patients treated in the United States have walked out of the hospital in good health. Only one died: Thomas Eric Duncan, a Liberian, whose treatment was delayed when a Dallas hospital initially misdiagnosed his illness.
The survival gap can and should be narrowed, experts say, and they agreed that the single most important missing element is enough trained health workers to provide the kind of meticulous intensive care that saved Dr. Sacra and the others treated here. West Africa is starved of doctors, nurses, hospitals and equipment, so more outside help is urgently needed, they said.
"There is no reason we can't turn this around," said Dr. Paul Farmer, a Harvard professor and co-founder of the aid group Partners in Health, which is setting up treatment centers in Liberia and Sierra Leone for 500 patients each. "You need the four S's," he said. "Staff, stuff, space, systems."
