The Ebola Epidemic Is About to Get Worse. Much Worse…As in: We need to order 500 million vaccines. Now.
By MICHAEL T. OSTERHOLM
Politico.com
September 30, 2014
Ebola is spreading faster than anyone would like to admit, and the current, slow international response to the deadly disease is morphing into a modern tragedy. On Tuesday, the Centers for Disease Control and Prevention (CDC) in Atlanta confirmed the first case in the United States, in Dallas. If Ebola has already arrived on these shores, imagine how quickly it could be spreading in Africa.
Ebola’s dispersion on the African continent must be stopped soon. But right now there exists no realistic scheme to do so: Plan A is failing, there is no real Plan B and the best chance for a magic bullet—Plan C—is at best many months away.
Plan A—smothering the virus where it is currently an epidemic—hinges on having a sufficient number of Ebola treatment-center beds in African countries and necessary health-care providers for every Ebola virus disease (EVD) patient. In this ideal setting, each EVD patient is isolated and is no longer in a position to transmit the virus to family members or others in the community. Once patients are identified, public health workers begin to track down their contacts to ensure that if contacts become sick with EVD-like symptoms they are quickly provided a treatment-center bed, where they, in turn, can be isolated and the process repeats itself. This strategy has worked in containing every previous Ebola outbreak.
But Plan A is clearly not good enough this time. The truth is that we are failing miserably at containing Ebola, despite daily pledges by governments and philanthropic organizations to provide more health-care workers and additional financial and logistical support. It’s also despite the heroic work of a limited number of national and international volunteer health-care workers and public health professionals who are risking their lives daily so that others may live and the epidemic can be stopped.
Plan B—stopping any further spread—doesn’t exist, either for quickly stopping the transmission of the virus within Liberia, Sierra Leone and Guinea or for squelching it if it leaps to the slums of other large urban areas across Africa. Nigeria and Senegal, together with the CDC, succeeded in halting the virus’ spread after single introductions of the disease. If an infected person reaches a crowded area where health-care services are limited, however, it could spread exponentially.
In the end, the only guaranteed solution to ending this Ebola crisis is to develop, manufacture and deliver an effective Ebola vaccine, potentially to most of the people in West Africa, and maybe even to most of the population of the African continent. This is Plan C, and it is still a long way off. While the U.S government has done more than other international players to support the possibility of developing an effective vaccine, current efforts still fall short of what is needed to implement an effective vaccination strategy.
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