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  • Ebola in the DRC: expert sets out critical lessons learnt in Liberia

    https://theconversation.com/ebola-in...20in%20Liberia

    First, health care workers are being infected. In our experience in Liberia, and in most outbreaks, infected health care workers can be super spreaders. They can infect the people they treat or those taking care of the sick.

    Second, there are now cases (live and dead) reported in communities that were not on the contact list. This is a list of people that may have come into contact with an infected person. If there are people that are infected who weren’t on the list, it means that proper tracking isn’t happening. It also implies that people don’t trust, or are afraid, of the ebola response and are turning to home treatments, including traditional remedies or prayers. These could expose a larger population to infection.

    To contain an ebola outbreak, it’s crucial that 100% of the contact list is documented and tracked. If this is broken, then a spread should be expected.

    Why has the country been unable to contain the spread this time round?

    The failure to control this outbreak is due to a variety of factors.

    Because of the civil war and with huge numbers of people living in abject poverty – as was the case in Liberia – there is widespread distrust in the government and its institutions. This means it will be hard for people to trust the Ebola response team.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

    Comment


    • Why Ebola is proving hard to beat in the DRC

      https://theconversation.com/why-ebol...in%20the%20DRC
      Jo Bowyer
      Chartered Physiotherapist Registered Osteopath.
      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

      Comment


      • Protecting those on the frontline from Ebola

        https://www.sciencedaily.com/release...0202171849.htm

        Ebola virus is very easily contracted from body fluids -- a mere ten viral particles will do it -- and people who get it have up to a 78 percent chance of dying. Health care workers are among the most vulnerable.
        This training package aims to reduce the number of critical errors and risky actions committed when treating an Ebola patient. Critical errors put an individual at risk of infection or contaminate the clean zone. Risky actions increase the chance of committing a critical error.
        These scenarios included cleaning up spills, putting on a biosuit correctly and properly responding to a needle stick. Practicing all of these scenarios helps to reduce the risk of infection of the health care workers treating the Ebola patient.
        Biosuits were not available when I was working in barrier and reverse barrier nursing situations in the 1970s and '80s. I had several needle sticks due to overworked phlebotomists failing to wait until I had finished before starting their work, and I was advised to wait and see if I developed symptoms! This would not happen in today's NHS and hepatitis now has several subcategories.
        Jo Bowyer
        Chartered Physiotherapist Registered Osteopath.
        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

        Comment


        • Congo’s Ebola outbreak is a testing ground for new treatments

          https://www.sciencenews.org/article/...-newsletter-v2

          The antibody treatments “basically jump-start the immune system to have an immediate presence of antibodies directed against the virus,” Davey says. One, called mAb114, was cloned from a sample taken from an Ebola survivor 11 years after the person’s infection in 1995. This treatment targets a protein on the surface of the Ebola virus and somehow hampers the virus’ entry into cells. All macaques given a lethal dose of Ebola and treated with mAb114 survived even when the drug was administered five days after infection, researchers reported in Science in 2016.
          I had hoped from the start of this thread that I would eventually post something hopeful! Of course, once this is under control, another deadly disease will emerge. Survivors of once deadly disease are sometimes left with NMSK sequelae, which require decades of management by Rheumatology teams.
          Jo Bowyer
          Chartered Physiotherapist Registered Osteopath.
          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

          Comment


          • The DRC’s Ebola outbreak has all the makings of a humanitarian crisis

            https://theconversation.com/the-drcs...arian%20crisis

            A major obstacle has been community resistance for health interventions and mistrust of the health care workforce. It’s crucial that measures are introduced to enhance community engagement and participation in the public health activities related to the outbreak. In its latest external situation report, the WHO says that some painstaking strides are being made in winning communities’ confidence.

            Secondly, it’s important to manage the growing risk of fatigue among health care workers, public health professionals and other stakeholders as the outbreak continues to evolve with no end in sight. These workers are being pushed to the edge, working long hours, days, weeks, and months under very trying circumstances.

            Reactive and vigorous responses are required until the outbreak is declared over: taking care of the health care and public health workforce is critical. This is easier said than done and in addition, the safety and security of the outbreak workforce has been an issue in past months. Given the complex political situation of the region, an end to the violence may not be expected.

            The WHO reports that steps have been taken to improve the safety and security situation for health care workers. More guards have been deployed at treatment centres and the accommodation used by health care workers.
            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • WHO asks panel to weigh whether Ebola outbreak is global emergency

              https://www.statnews.com/2019/04/10/...931f-151138121

              To date the outbreak has not spread to other countries, which is thought to be one of the reasons a PHEIC has not been declared.

              But it is occurring in what is effectively a conflict zone, a reality that time and again has impeded the response team’s ability to bring transmission to a halt. As of Tuesday there have been 1,186 cases and 751 deaths; an online dashboard detailing the response’s activities shows 18 new cases today.

              Every time there has been a surge in violence there has been a corresponding sharp rise in cases. But whereas the violence was directed at Congolese soldiers or the United Nations peacekeeping operation in the outbreak area last fall, increasingly the attacks have been directed at the Ebola outbreak response itself.

              In late February, Ebola treatment centers at Katwa and Butembo were firebombed by armed assailants, putting both out of commission for a time. Doctors Without Borders, which had been operating those treatment centers, withdrew its staff, saying it could not ensure their safety. Both centers have since reopened and are being operated by the DRC ministry of health and the WHO.

              Since those attacks, case numbers have soared, and an outbreak that looked in February like it was coming under control now looks far from it.

              Community resistance to the control measures known to stop Ebola transmission remains high in Katwa and Butembo, hotspots that are fueling the outbreak at this point. Many infected people are refusing to go to treatment centers for care, choosing instead to stay at home. That accelerates spread of the disease because the people who care for these patients will almost inevitably become infected themselves in the process.

              There was hope that an experimental Ebola vaccine, made by Merck, would help to contain the outbreak. And WHO officials insist that but for the vaccine, this outbreak would be many times more severe than it already is. More than 97,000 doses of the vaccine have been administered so far in this outbreak.

              But failings of the response are undermining the vaccine’s effectiveness. The vaccine is being used in what is called a ring vaccination approach — it is being offered to people who are known contacts of cases and the contacts of the contacts, as well as health workers and other frontline workers. The idea is to prevent spread of the virus by protecting people who are in contact with cases.

              For that approach to work, the Ebola response needs to be able to identify as many contacts as possible. But in many cases they have been unable to do the contact tracing work needed to draw up detailed lists; cases have occurred in neighborhoods or villages where it is unsafe for them to work. As a result, many people who should have been vaccinated have not appeared on the vaccination list.
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • Jo Bowyer
                Jo Bowyer commented
                Editing a comment
                WHO stops short of declaring Ebola crisis a global health emergency

                https://www.statnews.com/2019/04/12/...bcf7-151138121

                "The case count in the 8-month-old Ebola outbreak, already the second largest on record, topped 1,200 on Thursday and has surged by double digits most days over the past two weeks — a far faster rate than earlier in the epidemic."

                The WHO, which along with DRC’s ministry of health is leading the outbreak response, has been under pressure for some time to declare a PHEIC, which is a tool of the International Health Regulations, a treaty to which WHO’s member states are party. Its first decision not to do so came in October.

                David Fidler, a professor of global health law at Indiana University’s Maurer School of Law, warned that such a declaration would not on its own change the trajectory of this outbreak.

                “It’s not a Harry Potter wand,” Fidler said. “We need to be honest here. The IHR were not designed to deal with this. WHO is not equipped to deal with this.”

                "Fidler was referring to the fact that the outbreak is occurring in what is effectively a war zone. Multiple armed factions have been fighting the Congolese army for years. A United Nations peacekeeping operation has been in the region for the past two decades."

            • ‘On a knife edge’: Ebola outbreak threatens to escalate as violence rises

              https://www.statnews.com/2019/05/07/...266e-151138121



              In January and February it appeared that control measures were beginning to have an impact. The number of new cases being diagnosed daily was starting to decline and it looked like the outbreak might be coming under control.

              But in late February, fire-bombings at the Ebola treatment centers at Katwa and Butembo marked a tipping point, with Ebola control operations and staff coming under regular attack ever since.

              Each violent event forces a temporary slowdown of control operations. Last Thursday teams vaccinated nearly 1,000 people in one day — a record. On Saturday, they weren’t able to vaccinate anyone in Butembo, because it was too unsafe for them to move about, Ryan said.
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • Health officials ramp up Ebola response after first cases reported in Uganda

                https://www.statnews.com/2019/06/12/...be49-151138121
                Jo Bowyer
                Chartered Physiotherapist Registered Osteopath.
                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                Comment


                • After Ebola spills into Uganda, WHO decides against emergency declaration

                  https://www.statnews.com/2019/06/14/...676c-151138121
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • What the Ebola emergency means, what it doesn’t mean, and what’s next

                    https://www.statnews.com/2019/07/19/...7e76-151138121
                    Jo Bowyer
                    Chartered Physiotherapist Registered Osteopath.
                    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                    Comment


                    • Ebola epidemic officially declared a global health emergency

                      https://theconversation.com/ebola-ep...th%20emergency

                      Given the complex security and political matters affecting the response in the DRC, this declaration may motivate countries to bring the matter to other international forums. While not a requirement for action in UN bodies, the declaration of a PHEIC would be a clear signal from the world’s global health body that immediate and significant support is needed.
                      Jo Bowyer
                      Chartered Physiotherapist Registered Osteopath.
                      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                      Comment


                      • Ebola veteran warns virus could become entrenched in DRC if outbreak response does not improve

                        https://www.statnews.com/2019/08/09/...0236-151138121
                        Jo Bowyer
                        Chartered Physiotherapist Registered Osteopath.
                        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                        Comment


                        • Two of four Ebola treatments prove highly effective in a clinical trial

                          The field experiment will now focus on only the top-performing therapies

                          https://www.sciencenews.org/article/...test_Headlines
                          Jo Bowyer
                          Chartered Physiotherapist Registered Osteopath.
                          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                          Comment


                          • Modern science has delivered the world powerful tools to defeat Ebola. It is not enough

                            https://www.statnews.com/2019/08/14/...e237-151138121
                            Jo Bowyer
                            Chartered Physiotherapist Registered Osteopath.
                            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                            Comment


                            • Ebola outbreak spreads to third province in eastern Congo

                              https://www.statnews.com/2019/08/16/...7e6f-151138121

                              The Ebola outbreak in eastern Congo has killed 1,808 people out of 2,765 confirmed cases, according to the new report. The current outbreak, which started on Aug. 1 last year, is the second largest in history.

                              The spread of confirmed cases to a third province shows that health workers have struggled to contain the outbreak, despite the use of a vaccine. Many people in eastern Congo do not trust doctors and other medics.
                              Jo Bowyer
                              Chartered Physiotherapist Registered Osteopath.
                              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                              Comment

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