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How Nigeria Stopped Ebola
HughPickens.com writes Pamela Engel writes that Americans need only look to Nigeria to calm their fears about an Ebola outbreak in the US. Nigeria is much closer to the West Africa outbreak than the US is, yet even after Ebola entered the country in the most terrifying way possible — via a visibly sick passenger on a commercial flight — officials successfully shut down the disease and prevented widespread transmission. If there are still no new cases on October 20, the World Health Organization will officially declare the country "Ebola-free." Here's how Nigeria did it.
The first person to bring Ebola to Nigeria was Patrick Sawyer, who left a hospital in Liberia against the wishes of the medical staff and flew to Nigeria. Once Sawyer arrived, it became obvious that he was ill when he passed out in the Lagos airport, and he was taken to a hospital in the densely packed city of 20 million. Once the country's first Ebola case was confirmed, Port Health Services in Nigeria started a process called contact tracing to limit the spread of the disease and created an emergency operations center to coordinate and oversee the national response. Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected. As soon as people developed symptoms suggestive of Ebola, they were isolated in Ebola treatment facilities. Without waiting to see whether a "suspected" case tested positive, Nigeria's contact tracing team tracked down everyone who had had contact with that patient since the onset of symptoms making a staggering 18,500 face-to-face visits.
The US has many of these same procedures in place for containing Ebola, making the risk of an outbreak here very low. Contact tracing is exactly what is happening in Dallas right now; if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested. "That experience shows us that even in the case in Nigeria, when we found out later in the timeline that this patient had Ebola, that Nigeria was able to identify contacts, institute strict infection control procedures and basically bring their outbreak to a close," says Dr. Tom Inglesby. "They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria I do believe we will stop it here."
The first person to bring Ebola to Nigeria was Patrick Sawyer, who left a hospital in Liberia against the wishes of the medical staff and flew to Nigeria. Once Sawyer arrived, it became obvious that he was ill when he passed out in the Lagos airport, and he was taken to a hospital in the densely packed city of 20 million. Once the country's first Ebola case was confirmed, Port Health Services in Nigeria started a process called contact tracing to limit the spread of the disease and created an emergency operations center to coordinate and oversee the national response. Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected. As soon as people developed symptoms suggestive of Ebola, they were isolated in Ebola treatment facilities. Without waiting to see whether a "suspected" case tested positive, Nigeria's contact tracing team tracked down everyone who had had contact with that patient since the onset of symptoms making a staggering 18,500 face-to-face visits.
The US has many of these same procedures in place for containing Ebola, making the risk of an outbreak here very low. Contact tracing is exactly what is happening in Dallas right now; if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested. "That experience shows us that even in the case in Nigeria, when we found out later in the timeline that this patient had Ebola, that Nigeria was able to identify contacts, institute strict infection control procedures and basically bring their outbreak to a close," says Dr. Tom Inglesby. "They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria I do believe we will stop it here."
Once you have a couple dozen actual cases on your hands, this method is quickly overwhelmed. All it takes is for a few infected people to slip through and infect several people before they can be found and isolated. Nigeria did the right thing and was lucky.
It only takes one stupid uncooperative idiot ( maybe from a certain news station) to spread the disease.
And I wouldn't compare USA (or for that matter EU ) citizens to Nigerian citizens, Nigeria is known for it scare tactics, I don't see our governments try the same tactics without getting trouble back.
Let alone that no lower class person will stay home from their job for 3 weeks without pay, they will lose their job and get evicted.
Or is the government finally going to pay for those kind of expenses?
So, USA is following safety standards equivalent to those in Nigeria?
American exceptionalism at its finest. We know everything, the rest of world doesn't know jack shit.
Keep having that attitude and Ebola from an insignificant problem in the US will become a great problem.
Yes, but Nigeria went "Isolate THEN test", the US is doing "Test (and by the time they test possible other people may be infected) then isolate" i.e. Nigeria took this seriously, the US isn't.
Nigeria does it better.
"If any question why we died, Tell them because our fathers lied."
No, the US is hoping that it will be able to handle the situation as well as Nigeria did.
So far it isn't.
Watch this Heartland Institute video
The difference is that you can live with an HIV infection nowadays provided you are treated early and continuously, whereas there is a 50-90% chance of dying from Ebola.
It's one thing to have the official protocols in place. However the biggest problem is with cultural attitudes. If you have a huge portion of the population who are highly superstitious, and suspicious of the government, scientists, and modern medicine, as well as a lack of basic social safety nets, then you have a recipe for disaster. So what may have worked well in Nigeria is not guaranteed to be so effective in USA.
The Texas Health Presbyterian Hospital seems to have been overwhelmed with one case. That one case did not "slip through". he was turned away and sent home. Training was non-existent, proper supplies were not available. It's a fiasco.
Nigeria was more than lucky; they were prepared. Texas Health Presbyterian was not.
Countries do some things well, and other things badly. Apparently Nigeria has done a good job at stopping Ebola. We should respect that, and learn lessons from them on how to stop it here in the US.
The US health care system is a for profit medical system. This has resulted in a darwinian devolution of health care. The hospitals that care too much about treating patients and not their bottom line go out of business and fold. This leaves those that balance on the brink of bankruptcy and those who make a profit at the expense of patients who are uninsured or otherwise cannot pay for their medical services. Some keep their hospitals running by over billing those who are insured and those who can afford to pay, others do it by cutting back on training and equipment that is rarely used, like training for an infectious disease like Ebola or buying the equipment needed to prevent their own workers from being infected. The CDC sends out their protocols to all the hospitals, they cannot force the hospitals to buy the equipment, and train their staffs. Once the hospitals acknowledge they have received the protocols, not that they have implemented them, it seems the CDC marks them as being prepared for Ebola. Thus stands the current US preparedness for Ebola, a hodge podge of hospitals totally prepared and some totally without a clue, with protocols sitting in some filing cabinet somewhere.
Obama's response to Ebola is driven by politics and media not science or health. Doing this here would of course be condemned as being racist, homophobic, Islamophobic, immigrantophobic, and anyway, we're way passed the point where it's even practical to conduct face to face visits. So much time has gone by that we're in the millions of visits needed. No I'm afraid the best approach is Obama's approach which is to do nothing and blame it on someone else until it burns itself out.
Oh, wait ...
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Hmm, interesting theory, that.
Both Nigeria and the USA began their ebola problems with one (1) Liberian man entering their country with ebola.
Nigeria ended up with ~20 ebola cases, of which 9 died.
So far, the USA has had ~3 cases, of which one has died.
Now, the USA isn't done yet. Probably. Maybe. We'll see.
But so far, our situation is essentially identical with Nigeria's, and our outcome is the same as or better than their outcome. Note the "so far" - it's important.
"I do not agree with what you say, but I will defend to the death your right to say it"
Yeah, good luck with that. The last thing I saw on TV was people from her plane made hops to at least four states.
The President should have just ordered people with passports and travel stamps from these countries to not be allowed to enter the US.
A travel ban would kill more people than Ebola ever would.
Due to western workers refusing to travel to certain countries in Africa because of Ebola, the Cocoa crop has already been threatened:
http://www.reuters.com/article...
There are also travel bans between those countries. Because of that, the migrant workers that harvest them will have no work for the year. No income. Many will starve to death. MORE than would have been killed by Ebola. As bad as dieing from Ebola is, Starvation is worse.
Panic will always kill more people than the disease. Think critically before you demand action. The cable news networks are reveling in the profit they are making off of your panic.
The basic problem with Ebola in the US is that everybody in the US who knows what to do about Ebola is over in Africa right now trying to stop it at the source. The folks still stateside are the B team.
Moderating "-1, Disagree" is simple censorship. Have the guts to post your opinion.
No, the US is hoping that it will be able to handle the situation as well as Nigeria did.
So far it isn't.
If we would only learn to allow the free market to decide.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
Exactly. Typical Obama nanny state government thinks it's their business to protect us from ebola.
The hospital also waited until they got a positive Ebola test result back before taking any safety precautions. Staff were exposed for something like two days and administration resisted isolating the patient. The sample was sent through the normal channels for testing which potentially contaminated their tube system. High-risk individuals who treated Duncan were not placed in quarantine and they allowed something like 70 different people to come into contact with him. Then there's the issue of them initially prescribing antibiotics for a viral infection.
Yes, you absolutely can get it that way.
From the CDC:
"blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
objects (like needles and syringes) that have been contaminated with the virus
infected animals
Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus"
The problem in Africa is any fold. People lying and saying the people their to help are causing it. People spreading rumors that the people their to help are harvesting organs, The tradition of kissing the dead, the habit of not going to the doctor. Africans being target by peddlers of SCAMSs(Supplement, Complementary, Alternative Medicines). All of that is possible with exceedingly high levels of illiteracy, and a high belief in woo.
The Kruger Dunning explains most post on
The performance so far does not inspire confidence. Mistake after mistake and being reactive instead of proactive.
So far neither the CDC (nor WHO) has explained exactly how more cases of Ebola in more locations leads to eventual control. Texas is an informative example of what to expect when Ebola shows up in a new location that has no experience with such an unusual and deadly disease.
[And the flu trolls have to stop. Flu is already endemic. Meanwhile Ebola must be prevented from becoming endemic. There is a very rational reason to be agitated by the apparent lack of competent response. Ebola has never before been contained after an outbreak this large. This outbreak is already twenty times larger than the largest successfully contained outbreak.]
That is if the nurse(s) knew anything about Liberia. My experience is that people of the United States do not know the difference between Liberia and Belgium.
That's silly. Liberia is where they get books, and Belgium is the place to go for waffles.
But seriously, even Fox news watchers seem to know it's in that country where "Those colored people live" and that it's Obama's fault.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
This is the strange thing. It isn't like no one knew of the ebola threat, unless you didn't watch television, listen to the news, or use the internet.
It isn't that strange. Because if you did listen to the news or watch television, then no, you didn't know about the 'threat', because what has been repeated time after time is 'there is no threat, relax, we can deal with this, we're prepared'. Nigeria probably had a quite different message running through both media and government knowing that they have one single chance to stop this and that's at the source. Screw up a single thing and the preview of what happens was available next door.
Some like to think our health care standards make a difference, that the West is more civilized and it can't happen here. But the thing is, after a few ICU places and a few quarantine beds, modern medicine is left with aspirin and electrolytes as far as 'treatment' goes which doesn't give us much edge on African medicine. This needs to be taken as seriously in the developed world as it does in Nigeria, and we need to get useful treatments available _now_.
To be fair, there is an incubation period of about a week (the time between infection and transmissibility). You can still have geometric progression and not really know it for a couple of months before it becomes a crisis.
That said, Ebola has been around for years in Africa, where people don't have some basic sanitary practices. Even with a long incubation period, we'd have already seen a global outbreak if this virus were really as bad as the fear-mongerers are making it out to be.
Keep in mind that there's a difference between an exposure from one viral particle (as you might get from being handed a beverage cup) and a mass of them (handling the bodily fluids of the exposed as a nurse would). With one particle, your immune system has time to detect and react. It is those exposed to the mass particulates who will likely die.
I'll do what I can to avoid being exposed. I'll wash my hands, cook my food, and stay away from obviously sick people. Since I'd have done that anyway, my life hasn't changed much...
The Texas case just exposes (again) the fallacy that the US has the best healthcare in the world.
This hospital made too many amateur mistakes to count:
- Sent the guy home with antibiotics when he presented with a fever after travel to Ebola infected area.
- Did not institute full isolation protocol until three days after he was admitted (thus exposing nurses and other patients to the disease).
- Did not follow CDC protocol even after confirmed Ebola.
I don't read your sig. Why are you reading mine?
Nigeria was more than lucky; they were prepared. Texas Health Presbyterian was not.
This is the strange thing. It isn't like no one knew of the ebola threat, unless you didn't watch television, listen to the news, or use the internet. In addition, terrorist issues include biological warfare, a situation where similar isolation and contamination issues exist. Why didn't a hospital in Dallas Texas have materials on hand to provide a proper response - if it didn't have them.
Materials and preparation cost money. Hospitals that don't have them make more money than hospitals that don't, unless they actually have an Ebola outbreak. Hospitals figure they never will, so they don't prepare.
That is what happens when you don't mandate preparation by regulation and audit compliance, and combine that with a competitive market-based healthcare system. Nobody has incentive to prepare for anything unlikely to occur. If anything does go wrong they just throw their hands in the air and say that nobody could have seen this coming and beg for help from the (CDC/Federal Reserve/FEMA/whatever).