CDC Director on Ebola: 'The Window of Opportunity Really Is Closing'

Daliborlev (CC), FLickr

Daliborlev (CC), Flickr

I said last month that I was going to try to stay out of Ebola news because so much is being written about it elsewhere. Since then, the African outbreak — now really an epidemic, since it is in multiple countries —  has ballooned to 3,000 cases, and the World Health Organization has predicted it may take 6 months or more to bring it under control.

Something caught my attention today though that felt worth highlighting. Dr. Tom Frieden, director of the US Centers for Disease Control and Prevention, gave a lengthy press conference immediately after returning to the US from a visit to the Ebola zone. Frieden has shown in the past that he knows how to be outspoken in a very strategic way; yet even so, the urgency of his language, and his call for an immediate, comprehensive global response, was striking.

You can find the whole transcript on this page, but here are some highlights:

“Despite tremendous efforts from the U.S. Government, from CDC, from within countries, the number of cases continues to increase and is now increasing rapidly. I’m afraid over the next few weeks, those numbers are likely to increase further and significantly.  There is a window of opportunity to tamp this down, but that window is closing. 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.”

“The number of cases is increasing so quickly that for every day’s delay, it becomes that much harder to stop it. There are three key things that we need. The first is more resources.  This is going to take a lot to confront. The second are technical experts in health care and management to help in country. And the third is a global coordinated unified approach because this is not just a program for … West Africa, it’s not just a problem for Africa, it’s a problem for the world and the world needs to respond.”

“In some ways the most upsetting thing I saw is what I didn’t see.  I didn’t see enough beds for treatment.  So in one facility which had just opened with 35 beds, there were 63 patients, many of them lying on the ground.  I didn’t see data coming in from large parts of the country where Ebola might be spreading.  I didn’t see the kind of rapid response team that’s needed to stop a single cluster from becoming a large outbreak.  I didn’t see the kind of efficient management systems and support and transport and jeeps that are essential for a rapid and effective response.”

“Everything I’ve seen suggests over the next few weeks it’s likely to get worse.  We’re likely to see significant increases in cases.  Already we have widespread transmission in Liberia.  In Sierra Leone, we are seeing strong signs that that will happen in the near future.”

“There’s a real risk to the stability and security of societies as governments are increasingly challenged to not only control Ebola but provide basic health services, security services, and keep the government running, the stability of these countries, of their economies, of their neighbors and of others is increasingly at risk.”

“There is a theoretical risk that may be very low: we simply don’t know that Ebola could become easier to spread through genetic mutation.  That risk may be very low, but it’s probably not zero.  The longer it spreads, the higher the risk.”

“In theory it’s not hard to stop Ebola.  We know what to do.  Find patients quickly.  Isolate them effectively and promptly.  Treat them.  Make sure their contacts are traced and tracked for 21 days, if they develop fever, do the same thing and make sure they’re tested and treated.  Make sure health care is safe and that burial practices are safe.  The challenge is not those efforts, it’s doing them consistently at the scale that we need.”

“One of the most experienced Ebola experts in the world was there on one of my site visits, his comment to me summed up my visit.  What has worked to stop every Ebola outbreak until now will work here if we can get it to scale.”

“The window of opportunity really is closing. I could not possibly overstate the need for an urgent response.”

For more about the epidemic, the work facing the 70 CDC people sent to Africa so far, and glimpses of what it’s like to wear protective gear in an Ebola hospital and to meet some of the victims, check out the full transcript.

Maryn

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