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Ebola outbreak: call to send in military to West Africa to help curb epidemic

Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

That is the problem. There are not enough military, health care workers, logistical support, etc. Thousands upon thousands are needed. This is not possible. We need to be realistic and we need to go to plan B.

The only way to stop this ebola epidemic is to encourage the voluntary cooperation of the populace. Most people can not go without an income - so pay them to stay home for 21 days. Deliver nourishment.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

I hope I'm wrong, but I don't think this is stoppable.

What I see is a perfect storm brewing with lack of education, burial practices, superstitions, poverty, hiding the ill patients to prevent the stigma of the disease, lying about contact with ill people, running away from contact tracers, lack of sanitation/hygiene and extreme distrust of everyone, from burial teams to foreigners, government and medical personnel all playing a role.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Another major issue is the potential for co-epidemics (malaria, cholera, even YF) where there will be 0% capacity to respond.

As Sharon mentions above, this will require thousands and thousands of staff, where only hundreds exist. One of the MSF ETUs was using 8k Euros of PPE a day?! And the teams at Emory produced 40 bags of waste a day for 2 patients?
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

What we need to worry about most is large numbers of people fleeing across 'borders' through jungle or similar to adjacent countries, where they perceive it is disease free. This may have started already. And they will take ebola with them.

Sharon - I dont disagree with you, but the logistics involved to support what you are suggesting would be equally massive. You could not do this country wide. Only county by county.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Only for the countries where ebola is out of control - Liberia to start:

There would be some essential personnel who are not quarantined as long as they have not had contact with any ebola cases. These people, who are still in the majority, would be enough to provide the logistical support for food and water delivery.

The only matter is the amount of cash needed. It would have to be enough to compensate for loss of wages for the household. It would need to be a generous amount by Liberian standards so people have incentive to comply.

Also, essential would be home entertainment services. The internet and television must be up and fully functional. For those persons without those services, another group of essential personnel could deliver donated books, games, and other types of entertainment.

And, of course, the elderly and young children would need special considerations.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Only for the countries where ebola is out of control - Liberia to start:

Also, essential would be home entertainment services. The internet and television must be up and fully functional. For those persons without those services, another group of essential personnel could deliver donated books, games, and other types of entertainment.

I think that you are overestimating the availability of such services based on this info:

In mid-2011, Liberia has possibly the lowest rate of access to public electricity in the world. While the average rate of access to electricity in Sub-Saharan
Africa is 28.5 percent, and in neighboring Sierra Leone and C?te d?Ivoire 6 percent and 43.7 percent, respectively, Liberia?s rate of access to publicly provided electricity is close to zero. An urban access rate can only be derived for Monrovia: of an estimated 210,619 households, 1,217 are supplied with public electricity (as of late 2010), corresponding to 0.58 percent of Monrovia?s population. With the exception of a very limited municipal mini-grid in Gbarnga, Bong County, no publicly supplied electricity service is available outside of Monrovia.
The root cause of this situation is Liberia?s civil war. In 2003, at the end of 14 years of warfare, Liberia?s power sector emerged seriously damaged. By 2005
what remained had been destroyed by looting. This included the complete destruction of the hydropower plant at Mt. Coffee and Liberia?s entire transmission and distribution network. Operations of the Liberia Electricity Corporation (LEC) ceased completely. As a result, Liberia faces the challenging task of fully reconstructing its power system.

In early 2010 the high costs of electricity and low
quality of energy services in general imposed a
significant barrier to Liberia?s long-term economic
development. Over 80 percent of Liberia?s household energy requirements are met using thermal energy for cooking, and both urban and rural households rely almost exclusively on charcoal and firewood.
For lighting, households expend a significant amount of their income on inferior sources such as candles, flashlights, small battery-operated LED lamps, and kerosene or oil lanterns. Production activities, notably agriculture, rely primarily on human power. Some households have small generators of 500
to 900 watts to serve larger processing loads such as rice mills.
While the electricity services available in Liberia are poor, the cost of these services is nevertheless high in comparison with other Sub-Saharan African countries.

In April 2010 the price of electricity from the grid was US $0.43 per kilowatt-hour (kWh), possibly the highest in Sub-Saharan Africa. People without access to public electricity pay even more: the use of dry-cell
batteries costs US $74.01/kWh, car batteries US $8.43/
kWh, candles US $8.27/kWh, generators US $3.96/kWh, and kerosene for lighting US $1.53/kWh.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Welcome Sollydog!

Thanks for the information. The lack of usable power grid further illustrates the public health challenges.

I am thinking out loud above. The message is that in addition to food and water, people need something to do in their domiciles for 3 weeks - whatever is appropriate for the local culture. There are many sub-cultures and this is why massive intervention by foreigners is doomed to fail. This situation must be managed and staffed by local/village/town people: 1) they know the customs, 2) they will be seen as more trustworthy then federal/regional/foreign workers.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

The problems with working in the area are legion. Literacy for S.L, G & L are 35, 40 & 60% respectively, water in West Point and similar areas is not safe and sold in plastic cans or bags. Fuel tankers crews do not want to dock in Monrovia which CDC are trying to resolve. We are coming into the dry season which will aid communications but it is also the Lassa fever season, endemic diseases for Liberia
Major infectious diseases: degree of risk: very high
food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever
vectorborne diseases: malaria, dengue fever, and yellow fever
water contact disease: schistosomiasis
aerosolized dust or soil contact disease: Lassa fever
animal contact disease: rabies
I used the bed calculation in my previous post as an easily graspable example of the logistics problems involved in applying an exponential deployment for an exponential disease outbreak with a head start.

A 'Plan B' is also needed and it is being put in place. The key to letting the bed type physical deployment catch the run away case numbers is cutting the transmission chains. This can not be done with beds and traditional contact tracing so is being shifted to cut the rate of infection where it is really occurring - to care givers at home. 100s of thousands of very basic PPE kits are being produced and deployed.

The plan should, IMHO, be to massively advertise the arrival of these making clear that they include fever and pain relief for the ill and gloves and disinfectant for the care giver and some food. Delivered door-to-door the provider should hand out a safety leaflet and make it clear 'here is a free kit I can also give you right now if you have someone who is sick' this is the carrot to overcome the tendency to hide cases. If they admit to having someone ill in the house then their status can be checked for Ebola and instructions for the kit's use given. If the kits are percieved to have genuine value others will come forward for their kit.
Combined contact tracing and reduced risk of transmission.
This is a short PBS news report from 2012 looking at the water supply situation in Liberia with emphasis on the capital and West Point.
 
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Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

"In response to questions, Kirby said there ?is no intention right now that [deployed troops] will interact with patients or be in areas where they would necessarily come into contact with patients.?

He added, ?They're not doctors. They're not nurses. They're not trained for that and not equipped for that. That's not part of the mission. They will be kept in locations where they can do their jobs without coming into contact with patients.?

The troops will be acting in support of health care workers who are the experts at treating patients, he explained."

http://www.flutrackers.com/forum/showthread.php?t=227908
---------------------------------------------------------------------------------------------------------------
"Despite very strict safety measures imposed by MSF in the workplace, risk zero does not exist. However, the biggest threat remains transmission within the community, not during working time. Since March 2014, 14 MSF staff members have become ill, among whom 8 have sadly passed away.

http://www.flutrackers.com/forum/showthread.php?t=228112
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

My concern for the well-being of the troops is not necessarily that they will contract Ebola, but that they will be become entangled in some type of completely unforeseen violent encounter with the population. We already know that HCW and body burial teams comprised of local people have been set upon on numerous occasions and several individuals killed. How will people react to a foreign army in their midst?

Compounding the danger, there are rumors that the US actually "invented" Ebola and released it in West Africa. I've seen twitter feed like this already, and apparently an entire front-page article to that effect was in Liberia's most popular paper. Things like this seem completely crazy to us, but in the middle of a horrible epidemic, when fear and rumors are rampant, we should not be surprised if our troops are seen as a threat & not as aid. They have not been sent into the middle of an epidemic before and I am fearful that in our rush to help others this simply has not been well-thought out.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Welcome to forum, Dani! :)

Compounding the danger, there are rumors that the US actually "invented" Ebola and released it in West Africa. I've seen twitter feed like this already, and apparently an entire front-page article to that effect was in Liberia's most popular paper.

That is true and that article is by far their most popular article. Here is another:

http://www.liberianobserver.com/news/%E2%80%98us-military-not-here-change-government%E2%80%99
?U.S. Military Not Here to Change Government?
Mon, 09/29/2014 - 23:41 admin
Ambassador Malac Clarifies
By: Joaquin Sendolo

After weeks of speculation about the presence of the 3000-strong United States military contingent deployed by President Barrack Obama in Liberia, Ambassador Deborah R. Malac has clarified that the troops are not here to interfere with the Liberian political system, but to help fight the Ebola epidemic.

Making the clarification at a press briefing Monday, September 29, at the U.S. Embassy, Ambassador Malac stated with emphasis that other than helping to fight Ebola in line with President Obama?s instruction, the U.S. troops and their Government have no clandestine motive for coming to Liberia.

The U.S. Ambassador said during the press briefing that she had over time heard from community dwellers that the 3,000 U.S troops coming to Liberia and other Ebola affected countries is not only meant to fight Ebola, but to change the Government of President Ellen Johnson Sirleaf...

That should put rumors of regime change to rest, but I wonder how long this mission is really going to last.

http://www.theleafchronicle.com/story/news/local/fort-campbell/2014/09/30/fort-campbell-troops-headed-liberia-fight-ebola/16498771/
Fort Campbell troops headed to Liberia to fight Ebola
Andrew Tilghman and Patricia Kime, The Army Times 9:35 p.m. CDT September 30, 2014

...

Despite initial reports that the deployment would last six months, the release stated, "The duration of this deployment has not been determined."

"Operation United Assistance is our next Rendezvous with Destiny," said Volesky. "We will deploy from Fort Campbell ready to conduct this important mission for as long as required."...

The time frame is now open-ended.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Thank you for the welcome, Emily!

You seem to be on top of this issue. I don't know much about the geopolitics of the region, but I do know that there was a civil war which ended about ten years ago and that there is a real risk of Sirleaf's administration crumbling in the face of this lethal epidemic. While I don't think the troops were sent there to shore up her government, I wonder if the troops will inadvertently & suddenly become a peacekeeping force as there will be no other source of stability in the country. Do you think that is possible? Things can change very swiftly in such an unstable environment and it would be terrible for our troops to be caught up in it.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

I wonder if the troops will inadvertently & suddenly become a peacekeeping force as there will be no other source of stability in the country. Do you think that is possible? Things can change very swiftly in such an unstable environment and it would be terrible for our troops to be caught up in it.

Welcome Dani!

I think it is highly possible. In the best possible circumstances Liberia is unstable. This is an emerging disaster.

UN Security Council partial statement September 15, 2014:

"..Anything short of our full collective commitment could have grave and destabilizing public health, humanitarian, economic, and security consequences which could reach far beyond the borders of Liberia, Sierra Leone and Guinea...?

http://www.flutrackers.com/forum/showthread.php?p=546574
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

My knowledge of Liberian politics is limited to some recent research, but my impression is that the country is at least as polarized as the US politically. There are still Charles Taylor fans there, as incredible as that seems after reading through some of the trial transcripts.

http://www.ijmonitor.org/2009/07/taylor-alleges-us-govt-helped-him-escape-from-us-prison/

Whether his allegations are true and what the future holds is impossible for me to know.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Oh, boy.

With so much going on in some other parts of the world, I wonder just how well the US has been able to keep on top of the political situation in Liberia. The US has certainly misjudged the local response to our actions before, I hope this doesn't just turn into another case of that.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Barbara Starr ‏@barbarastarrcnn 26m 26 minutes ago
JUST IN: SecDef Hagel has now authorized up to 4,000 US troops to West Africa for #EbolaOutbreak @cnnbrk @NatSecCNN @CNNSitRoom
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

Army Colonel: ‘I Think There’s Some Apprehension’ Among Troops Preparing To Fight Ebola

October 10, 2014 7:18 AM
FORT HOOD, Texas (AP) — ...

About 500 soldiers were doing three days of infectious disease training inside a concrete-floored building on Texas’ sprawling Fort Hood — getting ready to join as many as 3,900 troops nationwide authorized to go to areas affected by the virus.
...
“We’re going to check each other,” McGuffin said. “If we have a tear in the suit, we’re going to first remain calm. We’re going to remove ourselves from a potentially infectious area, and then we’re going to hit everything with disinfectant.”

The soldiers learned they should step forward, not backward, when removing suits, and clean masks and rubber gloves with alcohol wipes. Duct tape, they were told, works well to seal sleeves to gloves.
...
“I think there’s some apprehension here, of course,” said Col. Heath Roscoe, commander of the 36th Engineer Brigade, one of three Liberia-bound units from Fort Hood.

To assuage fears, he held a meeting Monday with troops and their families where surgeons fielded questions not only about safety in Liberia but potential risks to relatives once their loved ones come home.

“We’ve seen some other folks, American doctors who got it, were flown back, and I’m pretty confident that our leaders will make sure that happens with our soldiers” if they are stricken with Ebola, Roscoe said.
...
Full text:
http://houston.cbslocal.com/2014/10...ension-among-troops-preparing-to-fight-ebola/
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

My thoughts and prayers will be with these troops. They are not volunteers and even though they will not be providing direct patient care, the risk of anyone of them contracting Ebola is not zero. That NBC cameraman was not involved in direct patient care either.
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

That NBC cameraman was not involved in direct patient care either.

The NBC cameraman, Ashoka Mukpo was an NBC cameraman for 2 days. Before that he'd been in Liberia for weeks as a freelance writer, blogging and tweeting about the epidemic and the response. (He'd been in Liberia years before with an NGO and returned to write about the outbreak) He visited ETU's, clinics and hospitals as a private citizen and tweeted about conditions in Liberia. He was exposed before he started working for NBC through his efforts to help Liberians
 
Re: Ebola outbreak: call to send in military to West Africa to help curb epidemic

The NBC cameraman, Ashoka Mukpo was an NBC cameraman for 2 days. Before that he'd been in Liberia for weeks as a freelance writer, blogging and tweeting about the epidemic and the response. (He'd been in Liberia years before with an NGO and returned to write about the outbreak) He visited ETU's, clinics and hospitals as a private citizen and tweeted about conditions in Liberia. He was exposed before he started working for NBC through his efforts to help Liberians

Thanks for the details but the fact remains that he was not involved in direct patient care.
 
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