Ebola Still Deserves Our Attention

By Shawn Kennedy, AJN editor-in-chief

Photographed by Centers for Disease Control and Prevention’s (CDC) team member, and EIS Officer, Dr. Heidi Soeters during Guinea’s 2014 Ebola outbreak, this image depicts what resembled a garden of red- and green-colored gloves propped up on sticks in order to dry after having been washed in a hyperchlorinated solution, thereby, killing any live Ebola viral particles. The pink-colored gloves were merely inside-out red gloves with their interiors exposed. The image was captured on the grounds of Donka Hospital, located in the country's capital city of Conakry/CDC

Taken by Dr. Heidi Soeters during Guinea’s 2014 Ebola outbreak, photo depicts red- and green-colored gloves propped on sticks to dry after being washed in a hyperchlorinated solution./CDC

It’s sad but not surprising that Ebola has all but disappeared from the headlines. After all, it’s not an imminent threat here anymore. There’s no more news hype—no “you heard it here first” messaging each day to grab headlines.

While the numbers of new cases and deaths appear to have abated in most affected countries, the World Health Organization (WHO) emergency committee on the 2014 Ebola outbreak recently cautioned that “the event continues to constitute a Public Health Emergency of International Concern” and concluded:

“the primary emphasis must continue to be on ‘getting to zero’ Ebola cases, by stopping the transmission of Ebola within the three most affected countries

[Sierra Leone, Guinea, and Liberia]. This action is the most important step for preventing international spread. Complacency is the biggest risk to not getting to zero cases.”

As of the latest figures (Jan 21), there have been a total of 21,724 documented cases and 8,641 deaths worldwide—almost a 40% mortality rate. Among health care workers, there were 828 cases and 499 reported deaths.

Yet as communities are struggling to get back to normal routines (Sierra Leone, one of the hardest hit countries, with over 10,300 cases and 3,100 deaths, announced it will reopen schools in March for the first time in eight months), the rest of the world seems to have moved on, comfortable that the global threat has been mitigated.

The response of many governments and private organizations that poured resources into the hard-hits areas was laudable, and we saw how knowledgeable health care workers with the right equipment quickly made a difference.

But now what? What of the conditions—lack of health infrastructure, inadequate equipment, too few health care workers educated about Ebola and community health practices—that allowed the Ebola infection to spread unchecked for so long? The first WHO report on the Ebola outbreak was on August 29, 2014, but at first, the rest of the world remained unperturbed, seemingly viewing Ebola as an a problem specific to Africa.

This changed drastically, for a while, in the US, but once the fear began to subside, the media stopped paying attention. Are we going to just move on now, take our resources and wait for another outbreak that threatens us?

As with the Haiti earthquake in 2010, the developed world responded to the disaster, but after the crisis passed, our attention waned. Five years later, Haiti is still struggling to rebuild and continues to deal with a cholera epidemic that may have been inadvertently introduced into the country by UN peacekeepers. According to a UN news report, it’s estimated that over 707,000 people have been stricken with cholera and over 8,600 have died. Yet funding for immunizations and a sanitary water and sewage system is insufficient—a UN source has been quoted as saying that, at the current level of funding, it could take up to 40 years to end the cholera epidemic. (Last week, a US judge dismissed Haiti’s lawsuit against the UN to recoup damages because of international treaties. The UN has not acknowledged responsibility for the outbreak.)

It’s hard not to see a familiar pattern repeating itself now in West Africa: we are responsive in a crisis but then absent for the longer-term sustainability work that will truly make a difference. Does an illness have to be brought to our doorstep before we consider it worth addressing? To those who say we can’t afford to fix the problems in West Africa and Haiti, I say we can’t afford not to. If we learned anything from the Ebola epidemic, it’s that we live in a very small world.

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Some of our earlier coverage of the Ebola outbreak:

Ebola Changes You: Reflections of a Nurse Upon Return from Liberia

Addressing Nurses’ Urgent Concerns About Ebola and Protective Equipment

Ebola: A Nurse Epidemiologist Puts the Outbreak in Perspective

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.

One Comment

  1. Susan McBride January 28, 2015 at 2:52 pm

    Very well stated, and let us all take note that we cannot get complacent about Ebola particularly with symptoms that might be indicative of Ebola and foreign travel from one of the three areas that are continuing to see wide spread transmission (Guinea, Liberia, and Sierra Leone). Equally as important are the other lessons learned from what we did experience in the US.
    – Nurses are key players in the workflow of detecting, isolating and protecting staff and the public from infectious disease threats.
    – Electronic Health Records (EHR) can help us with triggering the right decisions in handling potential threat of infectious disease if the EHR is setup correctly and addresses clinical workflow at the point of entry,…all points of entry not just the Emergency Department.
    – Finally, there are additional global threats we need to be aware of along with Ebola that call for all nurses being aware of global infectious disease. Middle East Respiratory Syndrome (MERS) is one of those additional threats. While not as significant a risk as Ebola it constitutes an additional threat well worth noting with a 30% mortality rate and two cases imported into the US from Saudi Arabia last Spring.
    We cannot forget about Ebola, and that nurses need to stay up-to- date and vigilantly aware of infectious disease worldwide.
    For more information on MERS: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6319a4.htm?s_cid=mm6319a4_w

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