Ebola news 11/8

[Buster's Uncle]

Empty Ebola beds in Liberia pose riddle for health workers
Reuters
By Derick Snyder and Joe Bavier  23 hours ago



A burial team wearing protective clothing, remove a body of a person suspected of having died of the Ebola virus, in Freetown September 28, 2014. REUTERS/Christopher Black/WHO/Handout via Reuters



MONROVIA/ABIDJAN (Reuters) - Health workers in Liberia are struggling to tell whether a growing number of empty beds at Ebola treatment centres is a sign that the country's ramped up response to the disease is working - or just a lull in the epidemic.

Of the West African countries hit by the 11-month outbreak, Liberia has suffered the most deaths. The virus has killed nearly 5,000 people there and in neighbouring Sierra Leone and Guinea - though numbers could be far higher owing to under-reporting of cases, the World Health Organisation (WHO) warned.

Nonetheless President Ellen Johnson Sirleaf suggested in an interview with Reuters last month that the first signs of a decline in the epidemic were showing. The government has launched a huge public awareness campaign - sticking posters up and installing chlorine hand washing stations at the entrances to main buildings - that it says is stemming infection rates.

As of Sunday this week, two-thirds of the 696 beds in Liberia's Ebola treatment centres were empty, according to the health ministry. New admissions and the number of dead bodies being picked up by burial teams are both falling.

"The key indicators.. are telling us that things are improving and slowing down," Deputy Health Minister Towan Nyenswah, who heads the country's efforts to fight the disease, told Reuters.

Yet international partners, including the U.S. military, are pressing ahead with plans to build up to 20 new Ebola treatment units (ETUs) in Liberia after dire predictions in September that hundreds of thousands more people could be infected by the virus.

And health officials and aid workers caution against declaring a premature victory over an outbreak that has already shown signs of retreat only to rage back with ferocity.

"It's almost impossible to tell, epidemiologically, what's happening when you're in it," said Sean Casey, who runs International Medical Corps' ETU in Bong County. Of the 52 beds at his site, 37 are empty, according to health ministry figures.

"There could be a legitimate decline, but there could be a blip down, or previously there could have been a blip up."

In remote southeastern Guinea, health officials also claimed the disease was all but contained, one month after the outbreak was detected and had killed just over 100 people. Within weeks of that claim - in April - the number had boomed.

Experts blamed the resurgence on superstition, denial, and mass paranoia that led many sick to hide due to fear that the treatment centres themselves were spreading the illness.

Now when doctors in Liberia look at their empty beds, they wonder which scenario is playing out.


FEWER BODIES

From his small shack next to an Ebola treatment centre in Monrovia, Lepoe Kunkar watched for months as the epidemic ravaged Liberia's seaside capital, home to 3 million people.

The treatment centre - run by medical charity Medecins Sans Frontieres (MSF) - quickly filled up after it opened in August. People unable to get in died outside on the street, he said.

Now however, Kunkar is convinced the tide is turning. Ambulances scream past his front door less often and people in his community no longer live in constant fear of falling ill.

"A few months ago, we used to see bodies lying around here but now the rate is going down," he said.

MSF acknowledges that new admissions to the centre have fallen - as of Sunday, the 250-bed facility was treating just 61 patients, according to health ministry data - but adds it is too soon to draw conclusions.

Health authorities - overwhelmed by their growing case loads and hampered by an international community that was slow to act - have focused almost entirely on the patients who got to them.

"We still don't have a very clear picture of what's going on outside our treatment units," said Natasha Reyes, MSF's medical coordinator in Liberia.

In fact, under-reporting of cases likely means that the real number of Ebola cases in Liberia is two and a half times higher than figures show, the WHO said last month.

With so many cases thought to be unreported, attempting to track the epidemic is tough. Some doctors, looking at Guinea, fear that sick people are simply being hidden, perhaps due to alarm over the non-traditional burials given to Ebola victims.

"How much of this is happening right now, we still don't know," Reyes said.


DESPERATE FOR GOOD NEWS

Dr. Bernice Dahn, Liberia's chief medical officer, hopes the respite at treatment centres can allow for a reallocation of staff to a nationwide case search. But she worries that officials, desperate for good news, may read too much into the recent figures.

"Now we're seeing a downward trend, there's actually discussion over whether some of these ETUs are needed or not," she said. "But you need to see the direction the disease is taking."

The epidemic as a whole is far from over. Just next door in Sierra Leone, Ebola is raging with renewed vigour - in the past three weeks 64 percent of all new cases of the disease have been recorded there and the United Nation's special Ebola mission in the region estimates that Sierra Leone will need 1,864 new beds by Dec.1.

The head of the U.N. mission Anthony Banbury warned this week that any celebration in Liberia was premature.

"As long there's one case of Ebola in any country, it's a threat not only to that country but to the region and the world," he said.

A giant roadside billboard in Monrovia's Paynesville neighbourhood put it another way: "Ebola is real. Ebola has no cure. Ebola has no boundary."

(Additional reporting by James Harding Giahyue and Alphonso Toweh in Monrovia, and Daniel Flynn in Dakar; Writing by Joe Bavier; Editing by Sophie Walker)


http://news.yahoo.com/empty-ebola-beds-liberia-pose-riddle-health-workers-153958467.html

[Buster's Uncle]

Ebola volunteers wrestle with quarantine mandates
Associated Press
By JENNIFER PELTZ  1 hour ago



In this Jan. 16, 2010 photo provided by the International Medical Corps, Dr. Robert Fuller provides medical care to an earthquake survivor in Port-au-Prince, Haiti. Three weeks of quarantine imposed on medical professionals who volunteer to go to West Africa to help care for Ebola patients adds to the complications of volunteering. It isn’t likely that Fuller will be able to participate if he is required to be away from the University of Connecticut Emergency Medical Department for nine straight weeks. (AP Photo/International Medical Corp, Margaret Aguirre)



NEW YORK (AP) — Dr. Robert Fuller didn't hesitate to go to Indonesia to treat survivors of the 2004 tsunami, to Haiti to help after the 2010 earthquake or to the Philippines after a devastating typhoon last year. But he's given up on going to West Africa to care for Ebola patients this winter.

He could make the six-week commitment sought by his go-to aid organization, International Medical Corps. But the possibility of a three-week quarantine afterward adds more time than he can take away from his job heading UConn Health Center's emergency department.

"I'm very sad that I can't go, at this point," said Fuller, who's helping instead by interviewing other prospective volunteers. Nine weeks or more "gets to be a pretty long time to think about being away from your family and being away from your job."

As Ebola-related quarantine policies have arisen around the United States, some health workers are reassessing whether, or how long, they can be among the hundreds that officials say are needed to fight the outbreak.

Potential volunteers are anxious about what they might come back to, especially after seeing new rules arise so rapidly that nurse Kaci Hickox was sequestered in a medical tent for days because New Jersey announced new regulations the day she flew back from Sierra Leone. Others are facing family qualms. And as the year winds down, some aid workers wonder whether they'll be able to go home for the holidays.

Aid organizations say it's too soon to tell whether quarantine rules are significantly shrinking the number of volunteers, but the measures are complicating an already challenging search for help treating a disease that has killed nearly 5,000 people, including about 310 health care workers.



In this Oct. 26, 2014 file photo provided by attorney Steven Hyman, nurse Kaci Hickox sits in an isolation tent at University Hospital in Newark, N.J., where she was quarantined after flying into Newark Liberty International Airport following her work in West Africa caring for Ebola patients. Hickox successfully fought her confinement in New Jersey as well as attempts by the governor of Maine to keep her sequestered in her home for three weeks. Three additional weeks of absence from their jobs, and possibly their families, could dissuade some potential health care professionals from volunteering in West Africa during the Ebola crisis. (AP Photo/Steven Hyman, File)


Some potential volunteers are wary of not only being quarantined but being seen as potential disease-carriers, rather than conscientious professionals.

"People are afraid what will happen when their kid goes back to school, what their family will think," said Dr. Joia Mukherjee, chief medical officer of aid organization Partners in Health.

Doctors and nurses still are offering to help, planning ahead to seclude themselves in settings ranging from medical "safe houses" to solo camping trips.

New Jersey nurse Andrew Wegoye volunteered last month to go to West Africa with AmeriCares after seeing earlier outbreaks strike his native Uganda. New Jersey set its quarantine rules shortly before he left. But he didn't question his plans, which already entailed secluding himself after his four-month stint.

"That would be the least of my worries," Wegoye said by phone this week from Monrovia, Liberia. "Because being in quarantine for 21 days is nothing compared to people dying here without supportive care to help them see another day."



This undated file photo provided by University of Texas at Arlington shows nurse Kaci Hickox. Hickox successfully challenged a three week quarantine placed her in October 2014, when she returned from helping Ebola patients in West Africa. Adding an additional three weeks of absence from their jobs is causing some health care professionals who normally wouldn't hesitate on going, think twice about volunteering in Africa to treat Ebloa patients. (AP Photo/University of Texas at Arlington, File)


Ebola can be transmitted by direct contact with patients' bodily fluids after symptoms start. The federal Centers for Disease Control and Prevention recommend anyone who's had such contact — say, from touching patients without protective gear — undergo monitoring and avoid crowds during the 21-day window for developing Ebola.

But several states have recently gone further, requiring or requesting three weeks of sequestration.

"We need to do this to protect the public health" in densely populated places, and medical volunteers should understand that, New Jersey Gov. Chris Christie said. Hoping to promote volunteering, New York state has agreed to reimburse health workers and their employers for any quarantine time.

Hickox and aid groups protested her confinement in New Jersey and subsequent efforts to quarantine her at her home in Maine, saying such policies treat humanitarians like criminals, stigmatize people who aren't sick and aren't grounded in science.

Now, some aid workers' families are discouraging them from returning to West Africa, sometimes because the relatives themselves are getting hassled by people afraid of Ebola, said Sophie Delaunay, the U.S. executive director of Doctors Without Borders, the group with which Hickox worked.



In this Nov. 13, 2013 photo provided by the International Medical Corps, Dr. Robert Fuller, right, chief of emergency medicine at the University of Connecticut Health Center, exits a helicopter with medical supplies in Hermani, Philippines. Fuller was a member of the team from the International Medical Corps that responded to the Philippines after the November 2013 typhoon. Faced with a possible three weeks of quarantine at the end of a six week commitment, Fuller will not likely be able to go to West Africa in 2014 to help with care for Ebola patients. (AP Photo/International Medical Corps, Margaret Aguirre)


International Medical Corps is weighing whether to send longer-term volunteers to other countries, instead of back home to the U.S., for R&R breaks, international recruiting director Brandon Berrett said.

And the Elizabeth R. Griffin Research Foundation's team in West Africa has been apprehensively watching quarantine policies — and the calendar.

"We're working day by day, at the moment, to ensure we can bring them back safely and get them home for Thanksgiving," said Dr. Gavin Macgregor-Skinner, a Penn State University public health professor who manages the charity's project training Ebola care workers.

Even as aid groups decry the mosaic of state quarantine policies as more political reaction than public health benefit, they're sensitive to fears of the disease.

Some organizations tell returning health professionals forgo patient care for three weeks. Samaritan's Purse even sends them to one of its three safe houses, where they can have visitors and venture outside but must avoid crowded places. Each gets a $1,000 bonus recognizing the hardship, president Franklin Graham said.

"Public perception is a real issue," he said. "We can't ignore it."


http://news.yahoo.com/ebola-volunteers-wrestle-quarantine-mandates-141627349.html