Health Care Workers "Fighting a Forest Fire with Spray Bottles" as Ebola Spreads Unabated

September 9, 2014
Davy James, Associate Editor

Ebola epidemic expected to surge, though relief workers are already overwhelmed by increasing patient volume.

The number of patients infected with the Ebola virus is expected to increase exponentially over the next month, further straining an already overwhelmed group of health care workers fighting to contain the disease.

The World Health Organization (WHO) said Monday that the current outbreak in West Africa is outstripping the capacity of medical workers to respond. In fact, the hardest-hit regions are expected to see a surge of thousands of new cases over the next 3 weeks through an intense transmission of the virus.

“Liberia, together with the other hard-hit countries, namely Guinea and Sierra Leone, is experiencing a phenomenon never before seen in any previous Ebola outbreak,” the WHO said in a statement. “As soon as a new Ebola treatment facility is opened, it immediately fills to overflowing with patients, pointing to a large but previously invisible caseload.”

The virus has already caused approximately 2000 fatalities with nearly 4000 confirmed and suspected cases in West Africa. Further exacerbating the epidemic has been the risk health care workers are facing in trying to treat wave after wave of infected patients.

In excess of 240 health care workers have contracted the disease in Guinea, Liberia, Nigeria, and Sierra Leone, with more than 120 fatalities, according to the WHO. In Liberia alone, an estimated 152 health care workers have been infected, with 79 fatalities.

In Liberia and Sierra Leone, there are 0.2 and 0.1 doctors per 10,000 people, respectively. At the outset of the epidemic, Liberia had only 1 doctor to treat nearly 100,000 people in a total population of 4.4 million, according to the WHO. Liberia’s case to fatality rate currently stands at 58%.

“Every infection or death of a doctor or nurse depletes response capacity significantly,” the WHO said.

Similarly challenged are health care workers in Sierra Leone, where personnel are working around the clock to the point of exhaustion, according to relief group Doctors Without Borders.

“We’re all sorry. We’re sorry that we don’t have a medicine proven safe and effective to kill the Ebola virus,” said Doctors Without Borders health promoter Ella Watson-Stryker in a statement on the group’s website. “We’re sorry that we don’t have a vaccine. We’re sorry that we’ve failed to stop the epidemic. We know we should be doing more, but we don’t have the resources, we don’t have the capacity, we don’t have the staff. Some days, it feels like it doesn’t matter how hard we work because there aren’t enough of us.”

US President Barack Obama said Sunday on NBC’s Meet the Press that the country will step up relief efforts for the region, including military equipment and support for international health care workers.

The intervention will be necessary given the WHO’s recent conclusions regarding the response to the epidemic in the regions facing the greatest risks.

While effective in areas of limited transmission, conventional Ebola control tactics are not having an adequate effect in Liberia, the WHO said. The organization is calling for greater community engagement, specifically in rural areas, where protective measures enacted by individual communities have slowed Ebola transmission considerably.

The WHO also concluded that key development partners need to scale up current efforts three- to four-fold in anticipation of the coming wave of new patients. Without those efforts, Doctors Without Borders noted, an already exhausted population of health care workers may no longer be able to effectively meet the demands of the growing epidemic.

“We’re fighting a forest fire with spray bottles,” said Watson-Stryker.