Posts
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Try Ebola Contact Tracing in a Slum; Sledgehammer Approach on Quarantines, Bad; and the Clucking Cull
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EBOLA
Contact Tracing in a Slum
Contract tracing may be key to halting the spread of Ebola in Liberia, but it is a near-impossible task in a place like New Kru Town, a Liberian slum with open sewers and where requests for ambulances are routinely ignored for days.
Told from the eyes of contact tracer Bobby Pomney, we see how challenging his task is in a place where multiple families are accustomed to sharing everything from toilets, to meals, to beds. “I know this is my job … But I don’t think it works here,” Pomney said. As he works to save two girls whose mother recently died from Ebola, he realizes they have nowhere to sleep—except with their grandmother, who also has Ebola.
The Quote: “In the United States, many contact tracers have advanced degrees in public health. In Liberia, they are former students or shopkeepers or security guards. Until June, Pomney sold stationery,” writes Kevin Sieff.
** Washington Post (http://jhsph.us3.list-
Sledgehammer Approach, Bad
“The governors' action is like driving a carpet tack with a sledgehammer: it gets the job done but overall is more destructive than beneficial.”
In a New England Journal of Medicine smackdown of governors guided by un-science, NEJM editor-in-chief Jeffrey M. Drazen and colleagues pen an elegant argument against quarantine of all health workers returning from fighting Ebola.
To many, it seems reasonable not to take any chances and quarantine them all. This editorial—a masterpiece of cogent rhetoric—lays out all the reasons why exceeding CDC guidelines “is not scientifically based, is unfair and unwise, and will impede essential efforts to stop these awful outbreaks of Ebola disease at their source, which is the only satisfactory goal.”
The Argument:
1. An asymptomatic health care worker is not contagious.
2. The only way to stop epidemics like this is at the source.
3. Making it harder for volunteers to return only hurts us.
** NEJM (http://jhsph.us3.list-manage.
Related: Medical Journal To Governors: You're Wrong About Ebola Quarantine—** NPR Goats and Soda Blog (http://jhsph.us3.list-manage.
CDC Protocols, Tweaked
With some states mandating quarantines for health workers returning to the US from West Africa, the CDC revised its quarantine recommendations.
Emphasizing that Ebola is only transmissible through direct contact with an infected person's bodily fluids, the CDC guidelines do not advocate a mandatory 21-day quarantine as some states have. Instead, they emphasize individual assessment and close monitoring, and detail several categories of risk among travelers and health care workers.
"High risk" individuals, including those who have cared for an Ebola patient, were accidentally poked by a needle or lacked protective gear, should self-isolate themselves at home and avoid mass transportation or large gatherings. They will also undergo more direct monitoring, including a medical worker observing them taking their temperatures.
The Quote: "At CDC, we base our decisions on science and experience," said CDC chief Tom Frieden.
** NPR (http://jhsph.us3.list-manage.
Under-Funded
Of the estimated $260 million the WHO needs to tackle Ebola, the org has only received $69 million so far, says spokesperson Tarik Jasarevic, who calls for focused attention on affected West African countries rather than the U.S.
** Robert Wood Johnson Foundation, New Public Health Blog (http://jhsph.us3.list-
Related: Nurse placed in 'inappropriate' Ebola quarantine released from hospital – ** The Guardian (http://jhsph.us3.list-manage.
Related: A History Of Quarantine, From The Black Death To Typhoid Mary – ** NPR (http://jhsph.us3.list-manage.
Editorial Note: Please excuse our typo yesterday; the "related" story from ** The Guardian (http://jhsph.us3.list-
should have read "Ebola cases hit 10,000 mark" not 1,000. Subliminal wishful thinking, perhaps.
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