The Best Way to Fight Ebola Now
The question of how to fairly distribute scarce doses of experimental Ebola treatments is capturing the world's attention. Yet the fate of the epidemic doesn't rest on getting these expensive and unproven drugs to the afflicted African countries. What medical teams there need most are protective masks, goggles, gloves, gowns and boots.
This gear enables doctors and nurses to care for Ebola patients without risking their own lives by coming in contact with the virus in patients' vomit, blood and feces. The equipment is in such short supply in Guinea, Liberia and Sierra Leone that, for lack of it, medical workers have fallen ill. About 15 percent of Ebola deaths in Liberia are of doctors and nurses, and 10 percent of those in Sierra Leone are hospital workers.
This exacerbates the shortage of care providers to contain the outbreak, and deters additional helpers from joining the effort. Outside organizations, including Doctors Without Borders, the World Health Organization, the U.S. Centers for Disease Control and Prevention, and the U.S. Defense Department have sent reinforcements, but they, too, are overwhelmed.
With the epidemic still expanding, thousands more volunteers must be recruited -- ideally from countries in east and central Africa. Caregivers from these countries already have Ebola experience; they know how to identify and isolate the infected, trace their contacts and care for the sick. Such care can keep more than 40 percent of sufferers alive, which in turn encourages others with symptoms to go into isolation.
Yet few additional workers will join the fight without sufficient protective gear. To supply them, governmental aid agencies, such as the U.S. Agency for International Development and China's Department of Foreign Aid, as well as health-care philanthropies, should organize and fund deliveries of this equipment on an emergency basis.
It would help, too, if the protective suits that Ebola caregivers wear could be improved, and quickly. The ones in use now are so stifling, they can be worn for only about 30 minutes in the tropical heat. Sometimes workers remove the gear momentarily to cool off -- a potentially fatal mistake. A science-oriented foundation could establish a prize for the rapid development of a suit that would keep viruses out but let air in.
In the meantime, yes, it is valuable to consider how best to allocate experimental Ebola therapies. Health-care workers, essential to controlling the epidemic, should be among the first to receive the medicines. Priority should also go to patients whose progress after treatment can be followed, so that doctors can learn as much as possible about the drugs' side effects and efficacy. Patients' overall health and life expectancy should be considered as well. Young adults with otherwise uncompromised health are better candidates.
In setting these priorities, though, public health officials will have to keep in mind that even if, against the odds, the treatments work, they cannot be produced in quantity fast enough to significantly slow the epidemic. Yet Ebola can be defeated without them, given enough trained medical workers diligently tracking cases and caring for the ill -- medical workers who are equipped to do the job.
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