TIME ebola

What It’s Like To Fight Ebola When the World Stops Listening

My first deployment into the Ebola outbreak was in September, when I was sent to Liberia. After three months there I was eventually stationed in Guinea, another Ebola-affected region where I am currently serving as an emergency response coordinator.

Over the last year, the Ebola outbreak has infected more than 27,500 people in Liberia, Guinea and Sierra Leone and killed more than 11,200 of those people. It’s still ongoing. When I first joined the response, the situation was very serious. Cases were increasing exponentially, and Médecins Sans Frontières/Doctors Without Borders (MSF) was putting out calls for help and for more actors to get involved. The calls were largely ignored and unfulfilled until later.

Today in Guinea there are many people and organizations involved, but there is virtually no external interest. Despite the fact that we are still seeing cases of Ebola every week—something that would have been considered a disaster just two years ago—the outbreak has stopped dominating the public conversation and news cycle.

Have we noticed the world has stopped paying attention? Yes, we have. Are we surprised by it? No, we’re not. It’s the news cycle, and we know that. Many of my colleagues have a healthy dose of cynicism that goes along with idealism. We wouldn’t pursue this job if we didn’t, because you don’t last long if you let yourself be disappointed. People lose interest. It happened with Haiti, it happened with Nepal, it happens every single time. In some ways, it reinforces our conviction that this is the right place for us to be.

We still have about twelve to eighteen cases of Ebola per week in Guinea, and a third of the cases we saw last week were not on a contact list—meaning they were surprises. When there are unexpected cases, it’s dreadful from a public health point of view. The current situation is better than it has been, but it’s not as good as it should be. In an absolutely perfect and best-case scenario, we could see an end for Ebola in Guinea by October. But that’s an optimistic estimate.

We are aware everyone is tired. The national authorities are tired— they have been working on this non-stop and they just want the outbreak to end. The people of Guinea are tired of the uncertainty and fear. This is an observant Muslim country, and people are very affected by the fact that they can’t go on pilgrimage to Mecca until the epidemic is over. The public is tired of hearing about Ebola. MSF has been working on this for more than a year. We are tired.

But the outbreak is not over yet. And while the lack of attention is normal, it’s not very helpful. The problems that contributed to the scale of this outbreak still exist in many places. People need to realize that the World Health Organization (WHO) is only as good as its member states. If people want to help, they should insist that their country respects its commitments to donations and spending. They should realize that these problems do not exist in isolation and that to some extent they affect everybody.

We understand that people cannot believe that the Ebola outbreak is not over. Neither can we. But we can’t stop paying attention.

Anna Halford is the Ebola Emergency Coordinator in Guinea for Médecins Sans Frontières/Doctors Without Borders (MSF).

TIME ebola

Ebola Cases Resurface in Liberia After 2 Months of Being Ebola-Free

Liberia Ebola West Africa
Abbas Dulleh—AP Health workers wash their hands after taking a blood specimen from a child to test for the Ebola virus in an area where a 17-year old boy died from the virus on the outskirts of Monrovia, Liberia, on June 30, 2015.

A teenage boy died from the virus and may have infected others

Liberia has reported its second case of Ebola on Tuesday after nearly two months of being Ebola-free.

Liberia had been declared officially Ebola-free on May 9 after it had gone 42 days with no new cases.

On Sunday, the body of a teenage boy was discovered in a rural area outside of the capital Monrovia and was confirmed to have the virus, Reuters reports. The news was not made public until Tuesday. People who came into contact with the boy have been isolated, and at least one of those patients has tested positive.

Though Liberia was declared free from Ebola infections in May, the outbreak has continued in Guinea and Sierra Leone, which share borders. “There is no known source of infection and there’s no information about him traveling to Guinea or [Sierra Leone],” a spokesperson for the ministry of health told Science.

So far, Ebola has infected 27,400 people in all three countries, killing over 11,200.

TIME ebola

A Rapid Ebola Test Can Diagnose the Disease In Just Minutes

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The new test is faster and as effective as the current standard practice, one study finds

A new Ebola diagnostic test that can identify in minutes whether a person has Ebola has proven to be faster and just as sensitive as diagnostics performed in a lab, according to new data published in the journal The Lancet.

Currently, to confirm someone has Ebola, a vial of blood must be sent to a specialized laboratory where it is tested. The new rapid diagnostic test (RDT), called Corgenix ReEBOV Antigen Rapid Test kit, can be done right at the bedside with just a drop of blood. A rapid test puts fewer people at risk of infection, significantly cuts down on waiting time and helps health care workers determine who has the disease so they can be quickly isolated.

In a study of 106 suspected Ebola patients in Sierra Leone, researchers tested the patients with both the new tool and the standard laboratory procedure. They found that both tests detected all of the confirmed cases of Ebola, and the RDT was faster.

“Although the RDT requires refrigeration, this is already available in many health centers in endemic areas, particularly those that store vaccines and other medical products,” said study co-author Dr. Jana Broadhurst from Partners In Health in a statement.

The current Ebola outbreak infected 27,443 people in Sierra Leone, Guinea and Liberia, killing 11,207. Though the outbreak appears to be waning, having a better diagnostic tool is still desirable—and having a tool at the ready, should another outbreak arise in the future, could be critical to quicker diagnosis.

TIME ebola

Ebola Returns to Sierra Leone Capital After Weeks of No New Cases

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Cases found in a densely populated slum

Two new cases of the deadly Ebola virus have been recorded in Sierra Leone’s capital city of Freetown, about three weeks after the most recent new cases were found, underscoring the difficulty of ridding the region of the disease.

“This is worrisome because we had already closed all Ebola quarantine structures in Freetown since we had gone for weeks without a case,” Sidi Yahya Tunis, a spokesman for the National Ebola Response Centre (NERC) told Reuters. The cases were found in a densely populated slum called Magazine.

Sierra Leone, one of the three West African nations hit hardest during the outbreak, has so far experienced more than 13,000 cases and more than 3,900 deaths. Guinea is still struggling to hit zero cases; Liberia, which at one point last year led all three in the highest number of cases, was declared Ebola-free in May.

Altogether, the three countries have reported more 27,350 cases and more than 11,170 deaths. Overall infections are on the decline, with fewer than 25 cases in Ebola treatment units last week.

[Reuters]

TIME ebola

There Are Now Fewer Than 25 Cases of Ebola

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Guinea and Sierra Leone have around 10 patients each

There are currently just 23 confirmed cases of Ebola in West Africa, according to the latest numbers on the outbreak.

The World Health Organization confirmed to TIME that there are 10 cases in treatment centers in Guinea as of June 18, and 13 confirmed cases in Sierra Leone as of June 17. Case numbers are low, but that doesn’t mean there weren’t be more cases if infections continue to spread.

The outbreak has so far infected 27,352 people and killed 11,178. The hardest hit countries were Guinea, Sierra Leone and Liberia. There is still currently no drug or vaccine for the fatal disease, though the infections have significantly declined.

Read next: TIME Person of the Year: Ebola Fighters

TIME ebola

Health Worker Tests Positive For Ebola in Italy

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The patient was a healthcare worker volunteering in Sierra Leone

A healthcare worker in Italy has been diagnosed with Ebola, the first time a person has received an Ebola diagnosis in the country. The patient is currently undergoing treatment for the disease.

The worker was volunteering in an Ebola treatment center in Sierra Leone, and on May 7, the volunteer flew from Freetown, Sierra Leone to Rome, stopping in Casablanca, Morocco. The patient had no symptoms at that time. It wasn’t until May 10, when the patient was already in Italy, that they began to experience symptoms of the virus. The World Health Organization (WHO) reports that the patient isolated themselves in their home before they were transported on the May 11 to the Hospital of Sassari, Sardinia. On May 12th, samples from the patient confirmed that they did indeed have Ebola.

The patient was then transferred from the Hospital of Sassari to he National Institute for Infectious Diseases (INMI) Lazzaro Spallanzani of Rome in a special aircraft.

Since the patient did not start experiencing symptoms until 72 hours after returning to Italy, WHO says it is not necessary to conduct contact tracing of individuals who were on the same plane. Ebola can only be transmitted via the bodily fluids of a symptomatic person.

More than 26,720 cases of Ebola have been reported in Sierra Leone, Liberia and Guinea since the start of the outbreak, and more than 11,000 people have died.

TIME ebola

WHO Has Acknowledged the Failings of Its Ebola Crisis Response

Health workers walk inside a new graveyard for Ebola victims, on the outskirts of Monrovia, Liberia on March 11, 2015.
Abbas Dulleh—AP Health workers walk inside a new graveyard for Ebola victims, on the outskirts of Monrovia, Liberia on March 11, 2015.

“Our current systems ... simply have not coped”

Top leaders at the World Health Organization (WHO) have admitted to being “ill prepared” to handle the Ebola outbreak and released a comprehensive list of agency failings as well as suggested reforms they and global policymakers must realize moving forward.

“We can mount a highly effective response to small and medium-sized outbreaks, but when faced with an emergency of this scale, our current systems — national and international — simply have not coped,” said WHO Director-General Margaret Chan, Deputy Director-General Anarfi Asamoa-Baah and the organization’s regional directors in a joint statement dated April 16.

The statement listed eight lessons WHO learned from the crisis, including “communicating more clearly what is needed.”

The statement also articulated nine remedies WHO must undergo to better handle large outbreaks in the future — such as intensifying “our advocacy with national authorities to keep outbreak prevention and management at the top of national and global agendas,” as well as establishing a “Global Health Emergency Workforce” and a contingency fund.

In a separate “situation report” dated April 15, WHO said there were 25,791 suspected Ebola cases in Guinea, Liberia and Sierra Leone with 10,689 deaths.

TIME ebola

Ebola Cases Top 25,000

The outbreak has infected 25,178 people and killed 10,445

More than 25,000 people have been infected with Ebola in Sierra Leone, Liberia and Guinea, according to a new report.

As of Tuesday, the outbreak, which has persisted for more than a year, has infected 25,178 people and killed 10,445, according to new numbers released by the World Health Organization (WHO).

Overall, the region has seen a drop in the number of confirmed cases and the number of patients filling Ebola treatment centers. However, medical groups have warned against complacency and Guinea has seen a recent uptick in infections. The country also just recently launched an Ebola vaccine trial.

MORE: 14 Emotional Dispatches From Key Ebola Fighters

 

TIME ebola

The Red Cross: ‘Ebola Started In Silence and Will End With Our Words’

Leaders of the Red Cross reflect on the year of Ebola

A year ago, the World Health Organization (WHO) confirmed the mysterious disease that had earlier swept through the tiny village of Meliandou, in Guinea’s southern forested region, had been identified as a “rapidly evolving outbreak” of Ebola, affecting several districts of the country and its capital, Conakry.

Suspected cases were also being investigated in border areas of neighboring Liberia and Sierra Leone.

Ebola had started to become an emergency.

Last month, our thoughts turned to another place in Guinea: the town of Forécariah at the other end of the country, in the west. Two Red Cross volunteers had been attacked there while attempting to provide “safe and dignified burials.”

Probably the single most-important factor in driving down cases over the past year has been a reduction in unsafe burial practices in which the still-contagious bodies of the deceased are handled by bereaved relatives. Unsafe practices still continue, however, in many places.

In Guinea, Red Cross personnel have faced an average of ten verbal or physical assaults a month; Liberia and Sierra Leone have also reported some form of “refusal to comply” with public-health measures.

Our words, our actions

In the Ebola hotspot of Kono, Sierra Leone, and according to local data, many communities still prefer traditional funerals to safer alternatives.

Most medical equipment we need to stop the outbreak is now in place, and yet new cases are still occurring, particularly in Guinea and Sierra Leone.

We need more than just medical hardware to get to zero cases. Now our words must pave the way to the last mile.

Words to break the stigma against healthcare workers and survivors, words to educate communities on prevention, words of solidarity from all over the world to say to affected people and communities: We won’t let you down, and together we can end Ebola.

We are trying to change behaviors and practices, and learning along the way that the transmission of knowledge is not enough.

Let’s use the power of words to repair misconceptions, promote dialogue, heal, reconcile and engage to overcome resistance, facilitate behavioural change, and ultimately get us to zero new cases.

Let’s do it fast: the rainy season will soon be upon us, and some areas could become very difficult to access. There is still work to do, and time is of the essence.

Adapting our response

We will not just treat our way out of this disease.

In Liberia, most people – local data suggests as many as 70 percent – believe all that’s required to ward off Ebola is to refrain from eating bush meat, rather than avoiding contact with the bodily fluids of patients.

In one district surveyed by the Red Cross in Sierra Leone, 90 percent believed this, although nationwide there has been a significant increase in safe burials.

It’s easy to imagine how health-workers in full protective garb, looking like creatures from a nightmare, spraying homes with foul-smelling chlorine, might appear to isolated villagers.

There has also been miscommunication. The black body bags our volunteers and staff were using in some communities were rejected by bereaved people for whom tradition dictates that bodies should be wrapped in white, signifying respect – a vitally important word in the context of funeral rites.

We may not have listened quite as carefully to local people as we should have at the beginning. The black bags were replaced with white ones.

Walking the right path

On the Ebola response overall, the road is forking. Down one path – characterized by sustained international solidarity and yet further heroism by local volunteers and health workers – lie zero cases, stronger health systems, and eventual recovery from the wounds Ebola has inflicted on human societies.

But if complacency or fatigue marks the other path, we may find ourselves dealing with a silent disaster that will threaten the gains already made as well as recovery.

We in the Red Cross Red Crescent warn that complacency is the enemy; but we believe we are not helpless in the face of Ebola. Our words and our actions will make a difference. They will pave the last mile back to trust and resilience.

Elhadj As Sy is Secretary General of the International Federation of Red Cross and Red Crescent Societies, responding to Ebola in 16 African nations; Yves Daccord is General Director of the International Committee of the Red Cross, which has long been present in the region, particular Liberia and Guinea, due to past conflicts.

TIME ebola

Ebola Vaccine Trial Starts in Guinea

A health worker prepares a vaccination on March 10, 2015 at a health center in Conakry during the first clinical trials of the VSV-EBOV vaccine against the Ebola virus.
CELLOU BINANI Cellou Binani—AFP/Getty A health worker prepares a vaccination on March 10, 2015 at a health center in Conakry during the first clinical trials of the VSV-EBOV vaccine against the Ebola virus.

10,000 people will be vaccinated

An efficacy trial for an Ebola vaccine launched in Guinea on Wednesday.

The vaccine, VSV-EBOV, was developed by the Public Health Agency of Canada and has already shown positive results in smaller safety trials. NewLink Genetics and Merck are collaborating on the vaccine, and the Guinean government and World Health Organization (WHO) are leading the trial, which is taking place in Basse-Guinée, a community where many Ebola cases spread.

MORE: 14 Emotional Dispatches From Key Ebola Fighters

The trial is using what’s called a “ring vaccination” strategy, which means that when a person is infected with Ebola, a group, or ring, of their contacts will be vaccinated. Some of the contacts will be vaccinated immediately, and some will be vaccinated three weeks later. The format was chosen so that everyone could get the vaccine, instead of giving some people a placebo. The hope is that the people who are vaccinated will create a “ring of immunity” from the virus, which could prevent its spread. Similar strategies have been used for smallpox, according to the WHO.

The trial plans to vaccinate 10,000 people in 190 rings in the next six to eight weeks, and all of those vaccinated will be followed for three months. The trial is voluntary, and researchers estimate that results may be available in July.

“We are committed to ending this epidemic,” said Dr. Sakoba Keita, the national coordinator of the Ebola fight in Guinea, in a statement. “Combined with control measures that we are putting in place with our partners, a safe and effective vaccine will allow us to close this trying chapter and start rebuilding our country.”

A total of 3,429 people have been infected with Ebola in Guinea, and 2,263 have died. The country recently experienced an uptick in cases.

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