A comprehensive strategy to fight the Ebola epidemic that includes early diagnosis, secure transportation and treatment at both central and temporary remote facilities could contain the disease within months, the authors of a new commentary in The Lancet contend.
The authors, Ranu S. Dhillon of the Earth Institute and Brigham and Women’s Hospital in Boston, Earth Institute Director Jeffrey Sachs, and Devabhaktuni Srikrishna of Patient Knowhow in San Mateo, Calif. propose a three-part strategy for combatting the disease, particularly in the hardest-hit countries of Liberia, Sierra Leone and Guinea:
Early testing of individuals of Ebola-like symptoms: They note that in the present epidemic, most of those contracting Ebola are still unknown. As a result, they argue, all individuals with related symptoms should be tested, and new testing sites should be established as quickly as possible in districts across the region. Local community health workers using smartphones to track cases should be trained and deployed to help identify possible cases, and call in trained personnel to conduct the blood test used to identify Ebola. They argue that anyone with Ebola-like symptoms should be isolated in their home using home protection kits to minimize the risk of further infections.
Secure transportation: Any patients confirmed to have Ebola should be transported securely by dedicated vehicles with the appropriate protective equipment. The authors call on local mining and agricultural companies to use their trucks and other vehicles, with appropriate safeguards, to supplement ambulances.
Expanded tent-based treatment facilities: The authors urge expansion of tent-based treatment facilities in the region – a tactic they note is often used by relief agencies and armies, but that has not been used so far in response to the epidemic in West Africa.
“Without the provision of effective treatment, Ebola patients will continue to remain hidden in their communities. … Communities need to believe that treatment is possible and that response efforts can tame this epidemic,” they write. The strategy also needs a unified central command in each national government to coordinate all of the agencies involved, the authors say.
They also call for an information system based on mobile phones equipped to help health workers report on Ebola cases and track contacts, that in turn connects to treatment centers and central health care agencies, to coordinate treatment and track the availability of key supplies. Such a system could be deployed “within a few weeks” and would help create “a map of the epidemic in real time.”
“We believe that with a dedicated effort that integrates early diagnosis, secure transport, and effective treatment, the Ebola epidemic could be contained within 6 months in Liberia and Sierra Leone, and in an even shorter time in Guinea,” the authors say.
