Sierra Leone’s president declared a public health emergency due to the country’s struggle to control an ongoing Ebola outbreak. Latest figures show that 233 of the 729 deaths caused by the outbreak have occurred in the country. The country suffered a significant set-back this week when one of its leading doctors, Sheik Umar Khan, died from Ebola.
Measures enacted by President Ernest Bai Koroma will last for up to three months. They include the mobilization of security forces to help medical teams by sealing off towns and homes until it is determined they are Ebola-free. There will also be stricter searches at the countries points of entry, a measure that follows in the wake of a man with Ebola traveling by plane to Nigeria.
The outbreak that originated in Guinea in March has now spread to neighboring Liberia and Sierra Leone. Leaders from the countries, are meeting with fellow West African presidents and the Director-General of WHO to launch a joint $100 million response plan today. Its aim is to ramp up efforts to stop the transmission of Ebola in the three countries and prepare neighboring countries so they can protect their citizens against the spread of the virus.
“The scale of the Ebola outbreak, and the persistent threat it poses, requires WHO and Guinea, Liberia and Sierra Leone to take the response to a new level, and this will require increased resources, in-country medical expertise, regional preparedness and coordination,” said WHO Director-General Dr Margaret Chan, in a press release.
Information remains a challenge to the response. Smith College professor Kim Yi Dionne, a health researcher, has been tracking and researching the ongoing outbreak. She recently explained in a blog post why she thinks the fatality rate is being misreported. On the face of it, the 729 deaths for 1,323 cases indicates a fatality rate of 55%. That well below the 90% fatality rate that is cited by some. She says that there is truth in both numbers. As Brett Keller showed, the fatality rate rarely stays at 90%.
— Brett Keller (@brettkeller) July 28, 2014
The data suffers from problems, most notably false positive results and the people who have died that are not initially counted.
“I think it’s most likely that there will be an undercount of deaths and that the fatality rate will be an underreport,” writes Dionne. “Bialik is confident from his conversation with a WHO spokesperson that eventually people who died from Ebola without seeking treatment will be counted. I am not so confident.”
The challenges to getting accurate numbers are illustrative of the hamstrung response to the outbreak. The three countries, WHO and international actors on the ground, like Doctors Without Borders and Samaritan’s Purse, are struggling to keep up. The $100 million plan launched today hopes to backstop everyone responding and help them get the resources they need to keep up their work. The situation right now is extremely difficult for the people working in the countries.
“[T]he fact is that the local staff have had their lives turned upside down. For this entire district, everything is upside down,” writes Ane Bjøru Fjeldsæter, a Norwegian psychologist who has been working with Doctors Without Borders in Kailahun, Sierra Leone. “Here in Kailahun, the banks are shut, the schools have been closed for more than a month – the students are very upset about the fact that they are missing their exams.”
Stigma, mistrust in health officials and misinformation are all acting to make matters worse for the countries. Dealing with these problems will have to be a part of the top line issues of coordination and increasing healthcare capacity.
For more in-depth analysis, read this piece by Dionne for Al Jazeera on the outbreak and why the response has been so troubled.