What is the risk of Ebola in the UK?
According to professor David Heymann, chairman of Public Health England (PHE), the risk of Ebola to Britain remains low. “There is certainly not a crisis in the UK at this time. The UK is prepared, having prepared over many, many years to deal with events such as this,” he told BBC Radio 4’s Today programme. PHE says UK contingency plans for Ebola have always been based on the assumption that there is a low, but nevertheless real, risk of importing the occasional case of Ebola from west Africa. “However, it is important to remember that, even if a case is identified here, the UK has robust, well-developed and well-tested NHS systems for managing unusual infectious diseases,” it says.
What precautions are being taken in the UK?
Four major NHS hospitals are on standby to deal with a possible Ebola outbreak. The hospitals have infectious disease units and, according to the latest guidance from NHS England officials, they are prepared to provide “surge capacity” if the virus spreads to Britain. London’s Royal Free Hospital – where nurse William Pooley was successfully treated after contracting the virus in Sierra Leone – has the most sophisticated specialist high-level isolation unit in the UK, with two containment beds. Under NHS plans, further specialist equipment would be transferred from the Royal Free to units in Sheffield, Newcastle and Liverpool in the event of a larger outbreak. The NHS England operational update, issued in September, states: “A letter has now gone out to the chief executives of the Royal Liverpool and Broadgreen university hospital NHS foundation trust, Newcastle upon Tyne hospitals NHS foundation trust and Sheffield teaching hospitals NHS foundation trust as part of a contingency plan to support a national surge.”
Are these precautions adequate?
Professor Peter Piot, director of the London School of Hygiene and Tropical Medicine and part of the team that discovered Ebola, says rich countries such as Britain and the US – where a man is being treated for the virus after returning from Liberia – have robust infection-control measures and clinical practices to stop its spread. Health services, says Piot, are well equipped to isolate the patient, to trace everyone he or she has been in contact with, and to put those contacts under surveillance for signs of fever.
What happens with an Ebola patient?
Dr Brian McCloskey, director of global health at PHE, said: “If an Ebola case is repatriated to, or detected in, the UK they would receive appropriate treatment in an isolation unit, with all appropriate protocols promptly activated. Protective measures would be strictly maintained to minimise risk of transmission to healthcare workers treating the individual. It is important to remember that for Ebola to be transmitted from one person to another, contact with blood or other body fluids is needed. As such, if England was to see a case of Ebola this will not result in an outbreak here.”
What happened in Spain?
A Spanish nurse tested positive for Ebola on Monday, the first person known to have contracted the virus outside west Africa. She was part of a team that cared for two elderly Spanish missionaries who died after being evacuated to Madrid for treatment. Her case has been blamed on substandard gear and a failure to follow protocol. Staff at the hospital where she worked told El País newspaper that the protective suits they were given did not meet World Health Organisation (WHO) standards, which specify that suits must be impermeable and include breathing apparatus. For Piot, the case underlines how the smallest mistake can be fatal. “For example, a very dangerous moment is when you come out of the isolation unit you take off your protective gear, you are full of sweat and so on,” he told the BBC. Piot said he was not surprised by the case in Madrid and expected more incidents in Europe and the US, although he did not expect to see the illness spread as rapidly as it had in Africa.
Should arrivals be screened at British ports and airports?
The WHO recommends screening for people with unexplained illnesses leaving Ebola-affected countries, but entry screening is not recommended. It would have to involve screening every returning traveller, because people could travel through a third country. Dr Paul Cosford, director of health protection at PHE, said: “The risk of travellers and people working in affected countries contracting Ebola remains low, but PHE continues to keep border staff and medical practitioners informed, and request they remain vigilant for unexplained illness in those who have visited these areas in west Africa. As part of contingency preparations, PHE has provided primary care and hospital healthcare workers with the latest information about the outbreak and actions to take in the event of a possible case.” Advice has also been issued to UK immigration centres, universities and schools, and humanitarian workers travelling to affected countries, and the public.
Are there signs of disquiet in the UK?
Despite repeated reassurances from PHE, a school has cancelled the visit of a charity worker and her son because of parents’ fears that their children could be infected with Ebola. The nine-year-old from Sierra Leone was due to study at St Simon’s Catholic primary school in Hazel Grove, Stockport, this month on a placement while his mother was on fundraising duties for the EducAid charity, which runs a network of free schools for vulnerable youngsters in the west African country. But Elizabeth Inman, the headteacher, has written to parents to say that “with a very heavy heart” the school and its governors had taken “the pragmatic decision” to halt the visit, despite the mother and her son having been screened and given unrestricted movement in the UK. “It is with great sadness that we decided to cancel the visit. The misguided hysteria emerging is extremely disappointing, distracting us from our core purpose of educating your children. It is not an environment that I would wish a visitor to experience.”