Massive Aid Needed for Ebola Outbreak as Outlook Worsens

CHART: Ebola Confirmed Cases & Deaths
Data as of Sept. 20, 2014

Massive amounts of supplies and additional health workers are still needed in Liberia, Sierra Leone and Guinea to help control the Ebola outbreak there that may grow to more than 1 million infections under one worst-case scenario, according to aid agencies.

Curbing the virus will require 1,000 more international medical personnel as well as 20,000 local residents who know the area well and can work as doctors, nurses, communication specialists, burial teams, contact tracers and trainers, said Dan Epstein, a spokesman for the World Health Organization.

While the U.S. has committed 3,000 troops to the region, that may not be enough help. “There are people who haven’t been trained; there are other people available who haven’t been deployed yet or who have been working on something else,” he said in a telephone interview. “We need people from the public sector and private sector as well. We need lots of people.”

The call for more help arose as the U.S. Centers for Disease Control and Prevention estimated infections may reach 550,000 to 1.4 million in Liberia and Sierra Leone by Jan. 20 without additional intervention.

Despite the international response, the outbreak hasn’t slowed, according to aid group Samaritan’s Purse, and is rapidly eclipsing the U.S. military’s plan to build more treatment centers as thousands of people are infected.

Treated at Home

“People will be in their homes and they will be treated in the homes,” Ken Isaacs, vice president of programs and government relations for Boone, North Carolina-based Samaritan’s Purse, said in an interview with Bloomberg Television. “They will have to be. There will really not be a choice,”

Doctors Without Borders, an aid agency, has said it has been forced to turn away sick people because there isn’t enough room at clinics, and the WHO has said there are still more patients than spaces at the treatment centers. Even with the additional international aid, “the truth is that nothing has put a dent in the growth of the disease,” Isaacs said.

Another aid group, Direct Relief, said donations have dropped off even as the need has accelerated. The group is struggling to provide elbow-length gloves, aprons, coveralls, disinfectant and IV fluids, Tony Morain, a spokesman for the group, said in an e-mail. “We do not currently have the financial resources to purchase these items.”

Supply Jet

The Santa Barbara, California-based aid organization sent a jet on Sept. 20 with 100 tons of equipment to West Africa. The gloves, gowns and masks they sent are enough to supply 280 health workers for a year based on the current utilization rates. If the outbreak grows significantly, the supplies will be used up sooner, Morain said.

The CDC’s estimate released yesterday is a range based on how well cases have been reported and identified, the agency said. It also assumes a failure of public health efforts and a lack of additional resources to control the outbreak, aspects governments and international aid agencies are working to improve.

“If conditions continue without scale-up of interventions, cases will continue to double approximately every 20 days, and the number of cases in West Africa will rapidly reach extraordinary levels,” CDC researchers wrote.

There are 4.3 million people in Liberia and 6.1 million people in Sierra Leone. The model doesn’t include Guinea, because the number of cases there has fluctuated too much to make modeling valid, the CDC said.

Death Toll

Since the start of the outbreak, the virus has infected 5,864 people, killing 2,811, according to a Sept. 22 WHO report. It has spread through five West African nations, accelerating in cities, including Monrovia, the capital of Liberia.

The outbreak’s concentration in cities and slums is complicating the response, as it is easier to transmit the virus in close quarters.

This outbreak is “very different because it’s urban,” WHO’s Epstein said. “In the Democratic Republic of the Congo and Uganda and Sudan and other places where there have been previous Ebola outbreaks, since 1976, almost all of them were in isolated rural areas.”

Relief agencies and governments last week renewed efforts to hasten aid, including a $1 billion commitment from the U.S. and the creation of a United Nations special emergency mission.

While experimental vaccines and drugs are being explored, they “are unlikely to be available in the quantities needed to make a substantial difference in control effort for many months,” WHO researchers said.

There is no cure for Ebola, which is spread by contact with the blood and bodily fluids of those infected. The disease normally is treated by keeping patients hydrated, replacing lost blood and using antibiotics to fight infections. The hope is that a patient’s immune system will fight off the aggressive attack of the virus.

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