Returning from a recent trip to the Ebola-stricken region of West Africa, CDC Director Dr. Tom Frieden warned that the outbreak is “spiraling out of control.” Although there is still time to take action, “the window is closing,” he warned.
Days after returning from an Ebola-stricken region of Africa, Director of the Centers for Disease Control and Prevention Dr. Thomas Frieden, MD, MPH, delivered what may be the most sobering admonition yet about the effort to contain the outbreak to West Africa: “the window is closing.”
In an interview with CBS This Morning on Monday, Dr. Frieden said the Ebola outbreak is “spiraling out of control” and urgent action is needed to contain what he describes as “the world’s first Ebola epidemic.”
“It’s bad now, it’s going to get worse in the very near future,” he warned.
So far, the ongoing outbreak has sickened more than 3,000 and killed nearly 1,600, primarily in the West African countries of Liberia, Guinea, and Sierra Leone.
The World Health Organization (WHO) recently warned that official figures likely “vastly underestimate” the true scale of the outbreak, with scores of cases going undocumented and many deceased victims being buried before local health agencies can account for them. And last week, the WHO said that the number of Ebola cases could eventually exceed 20,000 — over six times as many as those currently known to doctors.
Even with a scaled-up international response, the outbreak still appears to be picking up steam: According to the WHO, more new cases were reported last week than during any other week since the outbreak began. And nearly 40 percent of the total number cases reported during the 7-month outbreak have occurred within the past three weeks alone.
In an impassioned call to action, Dr. Frieden urged American doctors, nurses, and health care professionals to join Africa in its fight. “This isn’t just the countries’ problem,” he said. “It’s a global problem.”
In vivid detail, Dr. Frieden painted a gruesome picture of overcrowded isolation centers in Liberia, Sierra Leone, and Guinea, where health care workers are struggling to keep up with “basic care.” He described deficiencies not only in the number of doctors, nurses, and health managers available, but the protective gear needed to keep them safe.
Dr. Frieden described the desperate situation in West Africa, where some Ebola clinics don’t even have beds for all of the patients. Above, patients wait outside for a room to open up at a local clinic.
Without an immediate change in the current landscape, he said, the worst is yet to come. “The level of outbreak is beyond anything we’ve seen—or even imagined,” Dr. Frieden said.
At one particular 35-bed facility, Frieden described the chilling sight of more than three-dozen Ebola patients without beds, left with no other place to fight their infections but the floor. The health care workers, too, face “distressing” conditions, Dr. Frieden said, describing the working conditions as “roasting hot.”
“Sweat pours down into your goggles, your eyes,” Dr. Frieden added. Heavy personal protective gear including robes, masks, boots, and goggles, make simply drawing an IV a near impossible task. “It is very difficult to move…[the health workers] see the enormous need but the great risk, too,” he said.
Dr. Frieden said he met with burial teams whose families and communities would not let them sleep in their own homes for fear of bringing the virus with them. He also called the shortage of food and supplies in the region “a big problem.”
Furthermore, Dr. Frieden added, there is ongoing, widespread transmission in Liberia and strong signs it will happen in Sierra Leone in the near future. Of particular concern is that the outbreak will spread further into the region’s densely populated cities.
“The number of cases continues to increase and is now increasing rapidly. I’m afraid that over the next few weeks those numbers are likely to increase further and significantly,” Dr. Frieden said, issuing a startling warning about the need to take immediate action:
We need action now to scale up the response. We know how to stop Ebola. The challenge is to scale it up to the massive levels needed to stop this outbreak.
There is still a window of opportunity to tamp it down, but that window is rapidly closing…
The outbreak appears to be picking up speed as it enters its eighth month, Dr. Frieden said. The window to act to contain the outbreak “is closing,” he warned.
Dr. Frieden said more resources (including personal protective equipment for health care workers), expertise, and a unified response are needed. He also stressed the dire need for basic humanitarian support to address shortages of food, clean water, and other essential resources.
Throughout his comments Dr. Frieden repeatedly emphasized the urgent nature of the crisis. “The number of cases is increasing so quickly that for every day’s delay it becomes that much harder to stop it,” he said.
In a speech to the United Nations on Tuesday, Dr. Joanne Liu, international president of Doctors Without Borders, denounced the lack of deployment of resources to address the outbreak, which the group says has overstretched ministries of health and private non-governmental organizations.
“Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it,” Liu said at a United Nations forum on the outbreak. “Ebola treatment centers are reduced to places where people go to die alone, where little more than palliative care is offered.”
In Monrovia, Liberia, Doctors Without Borders estimates 800 more beds are needed. One of its treatment centers now contains 160 beds.
In the short term, Doctors Without Borders called for:
- Field hospitals with isolation wards to be scaled up.
- Trained personnel dispatched.
- Mobile laboratories deployed to improve diagnostics.
- Air bridges established to move personnel and material to and within West Africa.
- Establishing a regional network of field hospitals to treat medical personnel with suspected or actual infections.
The leaders of several national and international health organizations have criticized the global response to West Africa’s Ebola outbreak, saying that the global community has failed to help affected nations deal with the unprecedented outbreak.
In a similar statement earlier this week, World Bank President Jim Yong Kim called the international response “disastrously inadequate” and said many people are dying who could otherwise be saved. If international organizations and wealthy nations mounted a coordinated response with West African nations and used the plans outlined by the WHO, the fatality rate could drop to below 20 percent – from 50 to 60 percent now, Dr. Kim wrote in an editorial for the Washington Post.
“We are at a dangerous moment,” Dr. Kim wrote. “Tens of thousands of lives, the future of the region and hard-won economic and health gains for millions hang in the balance.”
Also this week, the charity SIM USA announced Tuesday that one of its missionary doctors in Liberia has tested positive for the Ebola virus and immediately isolated himself.
“The American doctor was treating obstetrics patients at SIM’s ELWA hospital in Monrovia. He was not treating Ebola patients in ELWA’s Ebola isolation unit, a facility separate from the main hospital on the mission organization’s 136-acre campus. It is not yet known how the doctor contracted the virus specifically,” SIM USA said in a statement.
Last week, Senegal reported its first case of Ebola, making them the fifth country affected by the current outbreak. Meanwhile, officials in the Democratic Republic of the Congo confirmed that they are experiencing an entirely separate Ebola outbreak.
Despite the chilling report from his time in West Africa, Dr. Frieden “remains confident” the there’s still time to contain the epidemic. “I saw many signs of hope,” he said, praising health care workers working around the clock to contain the disease. “I held a 2-year-old kid who is a survivor. Her parents have died but she’s being raised by family…she’s a symbol of hope,” he said. “The survivors are living proof that you can beat this.”
Above, CDC Director Dr. Tom Frieden visits with a young Ebola survivor during a recent trip to the Ebola-stricken region of West Africa.
Frieden ended his talk with a final plea to the international community. “There is nothing mysterious about we need to do,” he said. “The only real question is if we’ll do it fast enough.”
If we don’t, there is no telling how far it will go. “For everyday that this continues to spread in West Africa, the likelihood of someone getting infected and transmitting it elsewhere increases,” he said. “As long as Ebola is spreading anywhere, all of us need to be concerned.”