Sierra Leone Admits ‘Defeat’ In Ebola Fight, Allows Home Care Of The Infected

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.

FILED UNDER: Africa, Health, , , ,
Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.

Comments

  1. 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.

    Well, there is actually one other option, albeit one that poses a rather nasty moral dilemma. If protecting the healthy population requires isolating the sick population, but you lack the ability to care for the sick while they’re in isolation, at what point do you have to start considering euthanasia?

  2. Mu says:

    I guess the only difference to the middle ages will be that the body cart is an old pickup instead of a donkey cart.

  3. Ron Beasley says:

    We have other things to worry about that get little if any coverage. Number 1 – Enterrovirus D68 has already killed 5 children and left some of those who survived paralyzed. Number 2 – this year’s influenza vaccine does not include a rather nasty strain that has appeared. Both of these will kill more people than Ebola.

  4. @Ron Beasley:

    Number 1 – Enterrovirus D68 has already killed 5 children and left some of those who survived paralyzed.

    I’m not sure if Enterrovirus D68 is actually a problem, or if it’s just this year’s “Summer of the Shark” story. It’s not immediately clear that the current number of infections or deaths is statistically out of the ordinary:

    Enterovirus Surveillance — United States, 1970–2005

  5. @Ron Beasley:

    Five children? The only confirmed death linked to Enterovirus D68 that I’ve heard of is the boy in New Jersey

  6. Mr. Prosser says:

    No one seems to want to mention the elephant in Sierra Leone’s living room. From the Dallas Morning News on 9 October: “Sierra Leone officials finally released a shipping container filled with medical gear and mattresses that had been held up at the port for more than a month.
    Ibrahim Bangura, an official who handles medical supplies, said the container’s contents were finally in his possession on Thursday. Bureaucracy and political infighting were blamed for delay in distributing the aid.”

  7. DrDaveT says:

    @Ron Beasley:

    Both of these will kill more people than Ebola.

    About 1500 people in the US died of influenza in 2011. Half of those were 70 years old or greater. Ebola has already killed more than that, and is still ramping up.

    Or did you mean “will kill more Americans than Ebola”? Probably true, but I think that’s the wrong metric.

  8. André Kenji says:

    Tropical diseases like malaria kill fair more Africans than Ebola. And most people that are worried about Ebola are not worried about Africans, they think that if Africans are simply kept away everything will be OK.

    F**** the Africans, we just don’t want them here.

    And unfortunately after they found a Guinean suspect of having the disease here in Brazil I can say that stupidity is not limited to the US.

  9. Teresa Rothaar says:

    That’s just sad. =(

  10. gVOR08 says:

    @Stormy Dragon: I would expect draconian quarantine, including family members, first.