The Worsening Ebola Crisis
Recent
days have brought two alarming developments in the struggle to contain
Ebola. The campaign against the epidemic in West Africa, the only sure
way to eliminate the risks of transmitting the virus to the United
States and other countries, fell even further behind. And the discovery
that a nurse treating an Ebola patient in Dallas had herself become infected despite wearing protective gear raised questions about the readiness of American hospitals to deal with Ebola patients.
Reassuring
statements by health officials that virtually any hospital with an
isolation unit could treat such patients now look rashly optimistic.
That
said, the risk that the Ebola virus might cause outbreaks in this
country remains small. By far the greater danger lies in the very real
possibility that the virus will continue to spiral out of control in
Guinea, Liberia and Sierra Leone and spread from there to other parts of
Africa or other continents, opening a wider range of pathways for
infected people to reach the United States.
Many
countries and international organizations, led by the United States,
have pledged money, equipment and manpower to fight the epidemic in West
Africa. But the aid has been slow to reach the front lines, leaving
health care workers with too few treatment beds to accommodate the sick.
In Sierra Leone, on Friday,
health officials — facing just such a shortage of beds — adopted a new
policy of having families treat patients in their homes by distributing
painkillers, rehydrating solutions and gloves to hundreds of
Ebola-afflicted households. But if a nurse in Dallas, clothed in
protective garments, could not escape infection, it is hard to believe
that less well-equipped households in Sierra Leone will be able to
escape contamination from an Ebola patient in their midst.
The
pace of international aid needs to be stepped up dramatically. This is
not a task that can be left to such nongovernmental organizations as
Doctors Without Borders, which has heroically provided much, if not
most, of the care in the stricken countries. The United States has taken
the lead in providing aid to Liberia, a country with long ties to the
United States.
The
Army has started deploying thousands of troops to the area to help
build new treatment centers, perform laboratory tests and train health
care workers in how to treat patients, but most of that help has yet to
arrive. It was thus disheartening to hear Maj. Gen. Darryl Williams, the
commander of the United States Army Africa, dismiss criticism that
American aid had been “too little, too late” with the excuse that the
Pentagon was simply filling a “small gap” left by other health
organizations.
The
United States’ obligation is greater than that; President Obama needs
personally to ramp up the urgency of the American response and the level
and speed of the resources provided.
Perhaps
the Dallas case will add urgency to those efforts to control the
epidemic abroad. The case is not cause for domestic panic, but it is
cause for greater vigilance among health care workers. Even without
knowing fully what happened with the nurse, the Centers for Disease
Control and Prevention is exploring ways to make it easier to don
protective gear, wear it while treating a patient and take it off
afterward without infecting oneself.
The
task of treating Ebola patients can clearly be carried out by
experienced personnel. Five Ebola patients were flown back to the United
States from West Africa and have been treated safely at specially
designated hospitals in Atlanta and Omaha.But the Dallas hospital made
mistakes in handling this case from the start, and the infected nurse
was reportedly a young graduate of a nursing program with little
experience in infectious diseases. It seems possible that additional
health care workers who cared for the patient will come down sick as
well.
The
C.D.C. is urging all hospitals, no matter how small, to take travel
histories to identify any patients who have been in West Africa within
the past 21 days, and immediately place those with Ebola-like symptoms
in isolation. The C.D.C. plans to increase its training efforts for
hospital personnel, a vital need given that a survey of nurses found a
vast majority had received no instructions from their hospitals on how
to deal with Ebola. Smaller hospitals will probably have to transfer any
Ebola patients to more specialized centers for treatment.
But
all of these efforts, however useful, pale against this country’s much
larger responsibility to help defeat the disease at its source. http://www.nytimes.com/2014/10/14/opinion/the-worsening-ebola-crisis.html?_r=0
