Regardless of International Public Health Emergency Declaration Decision, U.S. Should Remain Vigilant in Preparing for Ebola

Bio Hazard Scientists

Bio Hazard Scientists

August 7th, 2014 by Trudy Henson

As the Ebola outbreak death toll rises to over 900 people, the World Health Organization (WHO) leaders are convening an emergency meeting to address what could become a much larger outbreak of the virus. In the U.S., the Centers for Disease Control and Prevention (CDC) has moved to a Level 1 activation, reserved for the most serious public health emergencies, indicating it believes the outbreak could be long and serious. Indeed, the outbreak that started in Guinea—and is confirmed in Nigeria, Liberia, and Sierra Leone—is one of the largest Ebola outbreaks on record. It’s receiving attention for other record-breaking reasons as well: earlier this week, two Americans in Liberia were diagnosed with Ebola, received an experimental serum, and were flown to the U.S. to receive treatment at an isolation unit in Atlanta, GA.  More recently, a Spanish priest with a confirmed case of Ebola has been flown back to Spain for treatment.

In many ways, African countries’ response to the Ebola outbreak is similar to what a U.S. response might look like: Wednesday, the Liberian President declared a nation-wide state of emergency and instituted quarantine checkpoints. West African leaders have closed schools, authorized house-to-house searches for infected citizens, and ordered quarantine for people diagnosed with Ebola, even posting guards outside homes to enforce that quarantine. Officials have used public health messaging via posters and loudspeaker announcements in crowded city centers, and set up makeshift hospitals to treat those that are sick.

Although leaders have called for extraordinary measures to fight the disease, the difficulty lies in carrying out those measures. With limited resources, it can be difficult to consistently respond to a virus whose containment requires attention to “the smallest of details,” from meticulously wearing protective gear to properly disposing of the deceased. Furthermore, successful response requires the education and cooperation of everyone involved. Poverty and “entrenched religious and cultural practices” can be difficult to overcome.  Despite the highly contagious state of the deceased, family members handle the bodies extensively.  Neighbors and family come and go in houses that are supposedly under quarantine or isolation, sometimes even as guards stationed there to prevent such entry watch. Additionally, the sick themselves are reluctant to seek treatment, exposing others to the virus.

With New York City reporting patients with Ebola-like symptoms (all negative), what can be done to prepare for Ebola? U.S. health officials caution against panic, and state that while taking precautions, the chances of an outbreak in the U.S. remain low. Furthermore, a number of protective measures, such as health surveillance technology, would likely help early detection and containment, and the U.S.’ developed public health infrastructure, from local health departments to the CDC, would aid in response. Hospitals, including those in Maryland, are already taking precautions and reminding staff to be alert. States’ all-hazards and pandemic preparedness efforts mean that responders are continually educated and drilled in hazmat and containment procedures. Earlier this week, the Governor of Maryland convened a cabinet-level exercise to test the state’s ability to respond to a medical emergency.

The WHO’s Emergency Committee, which convened yesterday, will determine whether the current outbreak constitutes a Public Health Emergency of International Concern, and make recommendations to the Director-General. A summary of the meeting will be available Friday, August 8th. Regardless of what the committee determines, the U.S. should remain prepared and alert to keep its citizens safe.

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