Monday, 9 February 2015
Ebola control - a real public health success story that is not being told enough.
A great global public health success is being played out in West Africa. Perhaps overshadowed by the challenges associated with the treatment side of the equation in grappling with Ebola.
Treatment however does not reduce the number of new cases, it may reduce mortality, and there is some evidence that mortality rates are decreasing from an initial 50% and down to about 40%. Good news for all those involved in treatment.
But the real story lies in the prevention of cases. The past 6 weeks have seen what was an average of 600 to 700 cases per week, has dropped over 80% down to just over 100. (124 for the week leading up to February 4 WHO weekly surveillance data. The outbreak curve information embedded below.
That is an amazing story and a tribute to the public education, public guidelines, body disposal, infection control, contact tracing, isolation procedures that have been implemented in response to the outbreak.
Yes there have tragically been 834 health care workers who have developed Ebola. That however is only 4% of all the cases and the only group amenable to improved infection control in the treatment facilities. A mere fraction of the reduced incident cases.
Noone should understate the contribution of these health care heroes working on the front lines. However, where are the celebrations of those whose contribution is now saving hundreds of lives a week through reduced incidence. It is typical of public health professionals to undersell their success and not celebrate too early, but perhaps a nod in the right direction that acknowledges their efforts to date and some support for continuing efforts are warranted. In typical fashion, the vast vast majority of aid resources are directed to the treatment and management sites, not to the public health efforts.
Thanks to the WHO and all those who have been involved in planning and implementing the fundamental public health interventions that have reduced this epidemic to the point that full containment is well within reach.
Kudos to all public health professionals who have been involved.