H5N1

Fire in an Ebola vaccination center: 'It was a soldier who instigated it'

Via Guineematin.com: Fire in an Ebola vaccination center: "it was a soldier who instigated it" (Gouécké SP). This is a confusing report: the soldier has a woman's name, but the translation mostly uses male pronouns (which I've changed for the sake of consistency). I hope future reports will clarify the matter. The Google translation and then a comment:

We know a little more about the fire of the Ebola vaccination facilities that occurred yesterday, Friday March 5, 2021, in the sub-prefecture of Gouécké (N'Zérékoré), the epicenter of the disease. Reached by phone by the correspondent of Guineematin.com in N'Zérékoré, the sub-prefect of Gouécké, Ibrahima Koné, gave details of this situation. According to him, it is an angry soldier who is the instigator of this violence. 

“It is a soldier named Alice Haba, in service at Dabola, who is at the origin of this act. Her sister, who was sick with Ebola, died this morning in N'Zérékoré. Now she says that she was not officially informed of her sister's death, and that it was the hospital and the sub-prefect who caused her sister's death. That is why she decided to come and burn down the premises of the sub-prefecture and the installations that are here. She mobilized children and took gasoline to come to the sub-prefecture. When they arrived, I was arrested in front of the sub-prefecture with a friend. They put gasoline on the tent (where the Ebola vaccination is done) and set it on fire. When we came to them, they fled to return to the neighborhoods,” explained Mr. Ibrahima Koné. 

For the time being, there have been no arrests following the fire at these facilities which house the vaccination against the Ebola epidemic. According to the sub-prefect of Gouécké, the soldier who is identified is a contact subject. It would therefore be necessary to wait until the security agents were vaccinated so that they could proceed to her arrest.

Alice Haba appears to be the sister of Lucie Haba, who died on February 12. Several other members of her family also contracted Ebola, and two of her brothers died.

The USA's response to the 2014 Ebola outbreak could have informed its COVID-19 response

Correspondence from Syra Madad and Craig Spencer in The Lancet: The USA's response to the 2014 Ebola outbreak could have informed its COVID-19 response. Excerpt:

There are foundational elements in epidemic preparedness that should have been gleaned from the USA's previous outbreak responses and subsequently applied to all future health threats, including COVID-19. Five lessons learned from the USA's response to the 2014 Ebola outbreak should have informed the country's COVID-19 response, given its roles in responding to both epidemics previously and currently. 

First, infectious disease outbreaks expose the shortcomings in health-care systems. The Ebola outbreak pointed to gaps in training and resources as not all US hospitals were ready and equipped to manage a patient with suspected or confirmed Ebola. With COVID-19, all 6090 US hospitals became battlegrounds. Given that pandemic preparedness has not been part of routine health-care delivery, nor has there been an incentive to build a better infrastructure, there must be specific federal funding allocated that is sustained in perpetuity to ensure biopreparedness. A return to pre-pandemic normal is what got us here in the first place. Americans must invest in long-term solutions, build back better, invest in preparedness, and sustain the gains. Regardless of the cost, this investment will pay massive dividends during the next pandemic. 

Second, health-care worker safety must be prioritised. Protecting the health-care workforce should always be a top priority. Simply put, there is no patient care without providers. Health-care facilities that were caring for patients with Ebola had a provider-centred approach, containing the virus within a dedicated unit and with a limited number of health-care personnel as part of the care team. With COVID-19, nearly every provider is on the front line and must be supported, and the strategy must be shifted from containment to community risk mitigation. Health-care worker safety goes beyond just physical safety. It must also encompass psychological and mental health support. 

Third, a coherent national plan is vital to combat a pandemic, and collaboration with national and international partners, including the US Centers for Disease Control and Prevention, the US Agency for International Development, and WHO—all of whom collaborated at the forefront of the fight against Ebola in 2014—is necessary. That collaboration was two-fold: to work together in mitigation and containment of the contagion, and to share knowledge, best practices, and lessons learned that would better inform processes, public health guidance, and health-care responses. Responding to pandemics by prioritising nationalistic tendencies over global goodwill is doubly damaging—it undermines the USA's important leadership role in global health, but also makes the USA less safe for Americans. 

Fourth, health experts must be placed at the forefront to educate the public. Science and risk communication during a public health crisis is crucial. With every epidemic comes the contagion of misinformation. Health experts, such as those in public health and health-care services have a central role in addressing misconceptions, risk behaviours, preventive measures, and providing the latest science-based information. Although the risk of Ebola transmission within the community in the USA was low in 2014–16, the public perceived the threat as much greater, requiring a coherent, one-voice approach from the federal government to better inform the public. COVID-19 is, however, a substantial public health threat with ongoing community transmission in the USA. Sharing conflicting information and largely politicising the pandemic has led to greater loss of trust in science and life-saving public health measures with constant undermining of public health professionals. 

Finally, training and hands-on experience are critical. During the 2014–16 Ebola outbreak in west Africa, academic (medical and public health) institutions across the world contributed faculty and staff to aid the response. This global assistance was crucial to ending the outbreak and provided unparalleled real-world and hands-on experience to thousands of health professionals who would subsequently use those skills to lead future responses at home and abroad. Although case studies and simulated exercises are helpful didactic tools in preparedness and response, they do not reliably mimic the on-the-ground complexity of response activities during a disease outbreak. Compared with their counterparts across the globe, the academic institutions and public health schools in the USA were more restrictive and less likely to send faculty and staff, often for logistic or legal reasons. This situation meant that the USA had fewer front-line providers with real-life experience in a rapidly changing disease outbreak. Had more Ebola-experienced providers been on the front lines during the early stages of the COVID-19 pandemic, we would have responded better, faster, and more efficiently.

Fight against Ebola and Covid-19: Alpha Condé announces directives for greater Conakry and N'Zérékoré

Via guineenews.org: Fight against Ebola and Covid-19: Alpha Condé announces directives for greater Conakry and N'Zérékoré. The Google translation:

As part of the fight against covid-19 and Ebola virus disease, the President of the Republic Alpha Condé has taken measures to supplement those already in force within the framework of the state of health emergency. 

The Head of State motivated his directive read on national television this Thursday, March 4 by the recent evolution of the epidemiological situation and on the proposal of the interministerial response committee in consultation with the scientific council. 

These are the suspension of all cultural and artistic activities, the ban on public and private mass gathering activities, the ban on baptism, marriage and funeral ceremonies, the closure of performance venues, discotheques and nightclubs in the greater Conakry area (Conakry-Dubréka-Coyah) and the Nzérékoré region. 

“These measures complement those already in force in the context of the state of health emergency. As such, the celebration of the International Women's Day scheduled for March 8 is postponed to a later date. The health authorities and the security services are requested to take all measures to guarantee the strict application of this directive,” we learned.

Africa CDC Outbreak Brief 2: Ebola virus disease (EVD) outbreak

Via Africa CDC: Outbreak Brief 2: Ebola virus disease (EVD) Outbreak.

• Outbreak Update: Since the last brief (23 February 2021), 11 new confirmed cases, one new death, and two new recoveries of Ebola virus disease (EVD) have been reported in Nzérékoré, Guinea and North Kivu, Democratic Republic of Congo (DR Congo). This represents a 47% increase in the total number of cases reported this week compared to the last brief. Cumulatively, 28 EVD cases, 11 deaths (CFR: 39%), and two recoveries have been reported from DR Congo (11 cases; 4 deaths; 2 recoveries) and Guinea (17; 6; 2). Seven healthcare workers are amongst the confirmed cases: DR Congo (2) and Guinea (5). 

• DR Congo updates: Since the last brief, one new health zone (Butembo) is reporting three cases; additionally, two new recoveries have been reported this week. Cumulatively, 11 confirmed cases with four deaths (CFR: 36%) have been reported in four health zones: Biena (5; 3), Butembo (3; 0), Katwa (2; 1) and Musienene (1; 0). 

• Guinea updates: Since the last brief, eight new confirmed cases, one new death and two new recoveries have been reported in Nzérékoré. Cumulatively, 17 cases (13 confirmed and 4 probable) with seven deaths and two recoveries have been reported in Nzérékoré (12 cases; 7 deaths; 1 recovery) and Conakry (1; 0; 1) regions.1 

• Cross-border updates: Between 15 – 28 February 2021, Sierra Leone investigated 13 EVD-related alerts. All persons under investigation tested negative for EVD by Polymerase Chain Reaction (PCR) test. As of today, no confirmed case has been reported from Sierra Leone.

North Kivu: Two patients cured of Ebola in Butembo

Via 7sur7.cd: North Kivu: Two patients cured of Ebola in Butembo. The Google translation:

The provincial minister of health in North Kivu, Doctor Nzanzu Salita Eugène, presided over this Wednesday March 3, 2021, the unloading ceremonies of 2 patients cured of the Ebola epidemic, which resurfaced in the province since February 7. They were unloaded from the Katwa Ebola Treatment Center (CTE).  

Doctor Nzanzu Salita urges the population to believe in the existence of the virus in the region and not to stigmatize these Ebola winners. 

“I am happy because it was not easy. From the first day, we came, we were able to install something to receive our patients. And here it is, they are healed. They are there. That is to say, on behalf of the government of the DRC and the province of North Kivu represented by Governor Carly Nzanzu, I would like to thank the entire population of Butembo (…). At the beginning, we were told that it is a made-up story. But here are our people coming back among us. I ask that we take them like other citizens. They are like us,” said Dr. Nzanzu Salita. 

He also specified that these two recovered will adhere to the program for monitoring Ebola winners for a period of 2 years.   

“The follow-up program for the cured is there for 24 months. So 2 years. They will be welcome to join this program so that this follow-up goes smoothly. We have a monitoring site here in Butembo. It is to tell the population that Ebola is there,” he added.  

Until Monday March 01, the cumulative number of cases was 11. Since the reappearance of the Ebola virus disease in North Kivu, more precisely in the health zones of Biena, Katwa and Musienene, 4 people are already deceased. 

Reluctance to vaccination against Ebola: Only 24% of contacts vaccinated in N'Zérékoré

Via guineenews.org: Reluctance to vaccination against Ebola: only 24% of contacts vaccinated in N'Zérékoré. The Google translation:

The populations of the regional capital of Forest Guinea continue to observe reluctance against Ebola vaccination. As proof, only 193 contact cases were vaccinated in the urban municipality, or only 24%. Today's statistics bring the number of deaths to 9 deaths in N'Zérékoré with 13 confirmed cases, 

For the time being, foci of reluctance have been reported in the Gonia and Gbangana districts of the urban commune of N'Zérékoré. Where the populations contacted, do not adhere to the vaccination. This sufficiently demonstrates that there is still a long way to go to eradicate the epidemic.

Ebola: United States restricts arrivals of travelers from Guinea

Via guineenews.org: Ebola - United States restricts arrivals of travelers from Guinea. Excerpt from the Google translation:

Starting next week, the US government will route all travelers who have stayed in Congo and Guinea to six airports designated for Ebola virus health inspection before being allowed to re-enter US territory. 

Airlines are also required to collect and report passenger information to the Center for Disease Control (CDC) for follow-up and public health response for all passengers aboard a flight to the United States who may have stayed in the DRC or Guinea during the previous 21 days. 

This information will be shared with U.S. states and local health departments in order to adequately monitor arrivals in their jurisdiction, the CDC said in a statement to air carriers. Although the CDC has not specified which airports it plans to use, according to several sources, John F. Kennedy in New York, Dulles near Washington, DC, O'Hare in Chicago, Hartsfield-Jackson in Atlanta, Los Angeles International Airport and Newark Liberty near New York. All of these airports are considered “watch points” for border control purposes. 

Tens of thousands of Guineans have taken up residence in the United States and have settled across the country, especially on the east coast in the Boston-Washington axis.

North Kivu: The installation of control and prevention points against Ebola is gradually being done in the Butembo-Lubero region

Via Radio Okapi: North Kivu: the installation of control and prevention points against Ebola is gradually being done in the Butembo-Lubero region. Excerpt from the Google translation:

The installation of control and prevention points against Ebola is being done gradually in the Butembo-Lubero region. It was the provincial minister of health of North Kivu who said it on Wednesday February 24 to Radio Okapi in Butembo, in reaction to the concern expressed by civil society actors. 

The Biena health zone located in the northwestern part of the Lubero territory has so far been considered the focus of the 12th Ebola epidemic that is raging in the region. Among the cases already recorded since the start of the epidemic, the largest number have come from this health zone. The latter is connected to the city of Butembo from two main axes. These are the Butembo-Mangurejipa and Butembo-Butuhe axis. 

However, since the declaration of the epidemic, no measures to control and prevent the spread of the disease have been installed at these different points, worry civil society actors in the Bapere sector. The inhabitants therefore move freely without any precaution of checking their state of health, report our sources in the area. 

Aware of the situation, the Provincial Minister of Health of North Kivu, Dr Nzanzu Salita affirms that the installation of control and prevention points against Ebola is being done gradually.

Ebola in Guinea: 7 hospitalized patients, 465 people vaccinated

The Ebola outbreaks in Guinea and Ebola seem to have paused this week, and I've found very little news. Here's a Friday summary from guineematin.com: Ebola: 7 hospitalized patients, 465 people vaccinated (ANSS). The Google translation.

According to figures published this Friday, February 26, 2021, by the National Health Security Agency (ANSS), 7 confirmed cases of Ebola are currently hospitalized in Guinea. The number of confirmed cases since the resurgence of the disease is 11 and the number of confirmed deaths is 2,465 people have been vaccinated in Conakry and N'Zérékoré against this disease. 

Guineematin.com offers you below the situation of the day presented by the ANSS: 

Vaccination of 240 people including 60 in Conakry (2 in Dixinn and 58 in Ratoma) and 180 in N'Zérékoré; 

Total of 465 people vaccinated (98 contacts, 296 contacts of contacts and 71 probable contacts) from 23 to 25 February 2021; 

Six (6) confirmed cases including one (1) death recorded in N'Zérékoré on February 25, 2021; 

Cumulative eleven (11) confirmed cases and four (4) probable cases recorded as of February 25, 2021; 

No case of EVD hospitalized at the CT-Epi in Nongo (Conakry) as of February 25, 2021; 

No suspected case of EVD hospitalized at the CT-Epi in N'Zérékoré on February 25, 2021; 

Seven (7) confirmed cases were hospitalized at the CT-Epi in N'Zérékoré on February 25, 2021; 

Cumulative six (6) deaths including four (4) probable cases and two (2) confirmed cases as of February 25, 2021; 

Cumulative of 5 infected health workers including 2 deaths (1 confirmed case and 1 probable case) 

To date, 351 contacts are being followed up.

Butembo: Trial of alleged murderers of Dr Mouzoko begins

Via Radio Okapi: Butembo: trial of alleged murderers of Dr Mouzoko begins. The Google translation and then a comment:

The trial on the assassination of Doctor Richard Mouzoko opened on Monday February 22 in Butembo. This Cameroonian doctor was shot dead by armed men in April 2019.   

He was in full response to the tenth Ebola epidemic at the Graben university clinics in Butembo.    

Out of twenty-five people arrested in this case, only eight were present at the trial, including three Congolese doctors. 

All the defendants absent from this trial have been on the run since the recent massive escape of prisoners from Kangbayi to Beni. The president of the order of doctors of Butembo, Dr Kalima Nzanzu, who deplores the state of health of its members, hopes to wait for the true verdict:

“All 3 (doctors), at least those who are here in Butembo, are already hypertensive and even diabetic. However, these are people who were not really known to have these pathologies. So you feel it was the stress that made them uncomfortable. Our expectations: we want justice to say the true verdict. If there are any culprits, let them be condemned. If there are innocent people, let them be released. That's all we ask."    

For his part, the vice-president of the provincial coordination of civil society in North Kivu, Edgar Mateso. expresses some concerns about this trial:   

“The first concern is that some people who were arrested fled. The second concern is that we wanted this trial to be highly publicized. Many inhabitants of our region are not even informed, there are even some who do not know where the trial is being held. It is appropriate, for example, to broadcast this trial live on the radio, but at the same time we would like this trial to be quickly speeded up.”

The assassination of Dr. Mouzoko was an appalling outrage, and it's equally appalling that most of the accused have not just evaded justice for so long, but have escaped from prison.