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http://www.theguardian.com/global-d...rontline-hope-fading-sierra-leone-isaac-bayoh
Life on the Ebola frontline: 'Hope is fading, but we will keep on fighting'
Isaac Bayoh in Sierra Leone. 29 November 2014
Isaac Bayoh, 25, volunteers as an Ebola quarantine and awareness worker. He is part of a team that isolates the houses of those who have the disease, educates the family and neighbours, and monitors the progress of patients. Here, in his own words sent via WhatsApp, he shares his experiences about how people and communities are affected
18 November 2014
I wake up almost every morning feeling pains all over my body – the reason is I have to cover many areas by foot to reach as many people as I can. Our work is making a great difference in these communities.
I get tired, being hit by malaria again and again, and my ulcer is also not making things easier, but even when I am pushed down I get up determined to go forward, determined to see many are saved. And it’s because of that I have decided to cover other districts (Moyamba, Bo and Bonthe), so that even those in remote villages that only have one or two houses will get this help; will know that people are still thinking about them and that they are not alone in this fight.
22 November 2014
Every day in our life is like the last. We don’t know when we are going to get a call saying a friend, brother, sister, father, mother or neighbour that we have shared so many great memories with is positive, or has died. [We] don’t know when the fever, the headache will start. Our life is full with worries, the trust we used to have is fading out, because with Ebola you can’t trust anyone – not even your very self confidence.
We are more than a virus – we are survivors. We are ordinary people, living our ordinary lives. Our sustainability depends on the daily basics. Ebola is here, we can’t go out to find our daily bread. It’s not just Ebola that is killing, hunger is also killing.
The sound of the ambulances has deteriorated the health of so many people. A population of 5 to 6 million – how many of us will survive this virus? It’s hard at times. More than 1,000 people have died. A family friend of ours followed all the preventive measures; she was just an ordinary girl who had her plans for the future, she was so scared and afraid. But she became infected, and how she became infected remained a mystery till her death.
Hope is fading gradually, but we will keep on fighting. You will not know the pains and sorrows until a family or neighbour gets infected – someone you used to see every morning, afternoon, night, or used to hang out with – is there no more. It is hard to believe. What can we do now, what is going to happen next, when are we going to start living our normal lives? When can I see a friend and be happy to hug him or her? It only takes one person to get the virus in a family, but I say we’re not the virus – we are caught between the virus and starvation. We still need to survive, but how can we?
Infected cases are increasing every day, and for every infected person there are going to be five to 10 people who came in contact with the infected person. Why us? Why do we have to suffer like this? Don’t we deserve better lives? Better things? What more can we do?
We need food. We need help – people are starving. To those who help, we say thank you for your support, prayers and love.
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http://www.nydailynews.com/life-sty...-test-undergo-trials-guinea-article-1.2026784
New 15-minute Ebola test to undergo trials in Guinea
November 28, 2014
A new test designed to rapidly diagnose Ebola virus infection is to be tried out at a treatment center for the disease in Guinea, international health charity The Wellcome Trust said on Friday.
Researchers developing the 15-minute Ebola test say it is six times faster than similar ones currently in use and, if it proves successful, could help medical staff identify and isolate confirmed Ebola patients faster and start treating them sooner.
The trial, led by researchers at the Pasteur Institute in Dakar, Senegal, and funded by Wellcome and the UK government, will use a "mobile suitcase laboratory" — a portable lab the size of a laptop computer with a solar panel, a power pack and a results reader, which is designed for use in rural areas of poor countries where electricity is often in short supply.
The reagent substances used in the test, which detects the genetic material of the virus, are available as dried pellets that do not need cold storage.
"A reliable, 15-minute test that can confirm cases of Ebola would be a key tool for effective management of the Ebola outbreak," said Wellcome's Val Snewin. "It not only gives patients a better chance of survival, but it prevents transmission of the virus to other people."
Almost 16,000 people have been infected with Ebola in the current outbreak — centered in Guinea, Sierra Leone and Liberia — and 5,689 of them have died, according to latest data from the World Health Organization (WHO).
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http://www.washingtonpost.com/natio...8aa2bc-71cc-11e4-893f-86bd390a3340_story.html
U.S. hospitals wary of caring for Ebola patients because of cost and stigma
Lena H. Sun and Brady Dennis November 28
U.S. officials trying to set up a network of hospitals in this country to care for Ebola patients are running into reluctance from facilities worried about steep costs, unwanted attention and the possibility of scaring away other patients.
“They’re saying, ‘Look, we might be willing to do this, but we don’t want to be called an Ebola hospital. We don’t want people to be cancelling appointments left and right,’ ” said Michael Bell, director of laboratory safety at the Centers for Disease Control and Prevention.
The reticence, although perhaps not surprising, complicates government efforts to ensure that the country can effectively treat people with Ebola and contain possible outbreaks. Just a few facilities in the United States have special biocontainment units, which are ideal for treating Ebola, and they can handle only two or three patients at a time. And the case of Thomas Eric Duncan, the Liberian man who was initially misdiagnosed at a Dallas hospital and died, shows how easily a community hospital can stumble.
Of the 5,000 hospitals in the United States, dozens have volunteered to treat Ebola patients. As of mid-November, CDC infection-control experts had visited 41 facilities in 12 states and the District of Columbia, according to agency Director Thomas Frieden.
But it is not clear how many medical centers will pass muster and whether the number will be enough for the administration to meet its goal of establishing an adequate network of Ebola-ready facilities. Bell said the government would initially like to have “a couple dozen” facilities in the network.
The Obama administration’s $6 billion emergency funding request for Ebola, which includes $154 million for hospital preparedness and support, envisions at least one designated facility in every state, and additional ones in New York City; Washington, D.C.; Chicago; Los Angeles; and Puerto Rico. The White House wants Congress to approve the request by Dec. 11, when current government funding runs out.
In trying to set up the network, federal officials, working with state health departments and local hospitals, are taking a three-step approach. The first priority is to find hospitals near five international airports — John F. Kennedy in New York; Newark Liberty; Washington Dulles; O’Hare in Chicago and Hartsfield-Jackson in Atlanta — that travelers from Guinea, Liberia, Sierra Leone and Mali are required to use when arriving in the United States.
Among the hospitals designated in that category are Johns Hopkins, Rush University Medical Center in Chicago and Bellevue in Manhattan.
The next priority would be to designate hospitals in communities that are home to large numbers of West African immigrants. The last group would be hospitals in states that do not have other Ebola-capable facilities.
Ten people have been treated for Ebola in the United States, and federal officials say the number of future cases is likely to be extremely small — in large part because airport screening and follow-up monitoring allows health authorities to spot possible cases and refer them to hospitals for treatment.
Hospital experts note that academic medical centers may be the best prepared to take on the task of caring for Ebola patients because they already treat the most complex cases. California, New York, Maryland, Virginia and Illinois are among the states that have designated regional trauma centers affiliated with medical schools to provide specialized Ebola care. New York has designated 10 hospitals. Health officials in the District and Georgia have identified hospitals but declined to name them.
The handful of U.S. hospitals that have treated Ebola patients have discovered that doing so can be costly, requiring around-the-clock care involving scores of nurses and other health workers. That would be a big challenge for many hospitals, where staffing is often stretched thin.
Adding to the burden is the widespread media attention that accompanies treating an Ebola patient and the potential loss of revenue if other patients steer clear of the facility. There is also the constant worry that a mistake could result in employees’ becoming infected.
“Right now, there honestly isn’t any incentive, and that’s part of the problem,” said Jeffrey Engel, executive director of the Atlanta-based Council of State and Territorial Epidemiologists. “Why would I get in line for that if I were a private-sector business?”
The need to shore up U.S. hospital preparedness became clear after Duncan’s illness was not correctly diagnosed when he first went to Texas Health Presbyterian Hospital Dallas. Duncan died Oct. 8, and two nurses who cared for him were infected but recovered.
More than 100 hospital health-care workers and other contacts were monitored for 21 days for possible exposure. In one case, the U.S. Coast Guard used a helicopter to deliver a blood test kit and protective gowns to a worker on a cruise ship so she could be tested.
The crisis affected the Dallas hospital’s bottom line. From Oct. 1 through Oct. 20, a period in which the emergency room was closed for nine days, emergency-room visits plunged and net revenue dropped, according to financial disclosure documents filed by the hospital’s parent company.
A spokeswoman for Texas Health Presbyterian said that patient volumes for most services have returned to average levels for this time of year but that emergency department volume remains below previous levels.
Most of the 10 Ebola cases in the United States were treated at three hospitals with biocontainment units — Nebraska Medical Center, Emory University Hospital and the clinical center at the National Institutes of Health in Maryland.
Those hospitals would be “overwhelmed by even a modest surge of 10 to 20 patients,” Bryce Gartland, vice president of operations for Emory University Hospital, said in a Nov. 7 letter to Congress in support of more federal funds.
Emory, which treated four patients, spent close to $1 million in direct costs to care for “a single high-intensity patient,” Gartland said. Nebraska Medical Center, which cared for three patients, said its direct costs from its first two patients surpassed $1 million. The “opportunity cost” of taking 10 beds out of service — part of infection control — was another $148,000, hospital officials have said.
Under the Obama administration’s budget request, there are no additional funds to reimburse the hospitals that have already treated Ebola patients. “I don’t know that every hospital out there would want to get into this business, to be honest with you,” Sen. Mike Johanns (R-Neb.) told Health and Human Services Secretary Sylvia Mathews Burwell during a congressional hearing.
So far, the costs have been handled by the hospitals and private insurers. “To date, it has not been an issue that has come to us,” Burwell said. “If this is something that [Congress] wants to discuss as part of this funding, we’re happy to entertain that.”
She added that the goal is for an Ebola patient to be within eight hours of treatment anywhere in the United States.
Last week, Sens. Edward J. Markey (D-Mass.) and Rob Portman (R-Ohio) introduced a bill that would use $125 million to fund regionally designated “Ebola treatment hubs” to care for patients and cover unpaid expenses.
Some of the biggest challenges for hospitals involve logistics. Where should patients be isolated to prevent infection? How should staffs be trained in wearing full-body protective gear? How should Ebola-related waste, which requires special disposal, be handled?
Beyond logistics, hospital executives are worried about the stigma of being known as Ebola treatment centers, said James Blumenstock, who oversees health security for the Association of State and Territorial Health Officials.
Hospitals and the public need to “get beyond that initial fear factor,” he said. “People should not be fearful that a good, strong medical center is willing to accept an Ebola patient as well as meet other community needs.”
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http://www.reuters.com/article/2014/11/28/us-health-ebola-cuba-idUSKCN0JC1T220141128
Cuban doctor with Ebola 'improving' in Geneva hospital
Nov 28, 2014
The Cuban doctor who contracted Ebola while treating patients in Sierra Leone is improving with each day and eating normally, though he is still weak, a Swiss hospital said on Friday.
Felix Baez, 43, arrived at University Hospitals of Geneva (HUG) a week ago for treatment of the disease that has killed more than 5,600 people since March, mostly in Sierra Leone, Liberia and Guinea.
Baez is one of 256 Cuban doctors and nurses sent to West Africa to treat patients, a commitment that has won wide international praise for the poor, Caribbean island. "Today, Dr. Felix Baez is still weak and is recovering gradually. He is eating normally and his general condition is improving every day. He is in daily contact with his family," the statement said.
On Tuesday, the hospital had reported a significant decrease in the amount of the virus in his blood. Cuban officials previously said his fever was reduced before traveling from Freetown to Geneva on Nov. 20 and that he had lost his appetite.
Baez has been treated in a special room in an isolated area of the hospital by a team of five specialists employing strict safety protocols. He is the first Cuban known to have contracted Ebola in this outbreak, the worst on record with about 16,000 cases reported.
Some 165 Cuban doctors and nurses have gone to Sierra Leone for six-month missions, with another 53 in Liberia and 38 in Guinea.
