Public health officials in Sierra Leone are admitting that the Ebola epidemic in that country is spreading faster than they are able to respond to it:
FREETOWN, Sierra Leone — Acknowledging a major “defeat” in the fight against Ebola, international health officials battling the epidemic in Sierra Leone approved plans on Friday to help families tend to patients at home, recognizing that they are overwhelmed and have little chance of getting enough treatment beds in place quickly to meet the surging need.
The decision signifies a significant shift in the struggle against the rampaging disease. Officials said they would begin distributing painkillers, rehydrating solution and gloves to hundreds of Ebola-afflicted households in Sierra Leone, contending that the aid arriving here was not fast or extensive enough to keep up with an outbreak that doubles in size every month or so.
“It’s basically admitting defeat,” said Dr. Peter H. Kilmarx, the leader of the federal Centers for Disease Control and Prevention’s team in Sierra Leone, adding that it was “now national policy that we should take care of these people at home.”
“For the clinicians it’s admitting failure, but we are responding to the need,” Dr. Kilmarx said. “There are hundreds of people with Ebola that we are not able to bring into a facility.”
The effort to prop up a family’s attempts to care for ailing relatives at home does not mean that officials have abandoned plans to increase the number of beds in hospitals and clinics. But before the beds can be added and doctors can be trained, experts warn, the epidemic will continue to grow.
C.D.C. officials acknowledged that the risks of dying from the disease and passing it to loved ones at home were serious under the new policy — “You push some Tylenol to them, and back away,” Dr. Kilmarx said, describing its obvious limits.
But many patients with Ebola are already dying slowly at home, untreated and with no place to go. There are 304 beds for Ebola patients in Sierra Leone now, but 1,148 are needed, the World Health Organization reported this week. So officials here said there was little choice but to try the new approach as well.
“For the first time, the nation is accepting the possibility of home care, out of necessity,” said Jonathan Mermin, another C.D.C. official and physician here. “It is a policy out of necessity.”
The danger in resorting to home care, of course, is that it makes the probability that the disease will spread far more likely. People caring for loved ones at home are not going to be taking the same precautions as medical personnel, obviously, and they are far more likely to engage in the kind of direct contact with an infected person that allows the disease to spread. In a nation that has no other options, though, it’s hard to see what else can be done.
