We can prevent the next epidemic - George Zaidan
Ebola is one of the deadliest
viruses we know of.
If left untreated, it kills
about half of those it infects.
It can spread through pretty much
every fluid your body makes,
including blood and sweat.
Even the dead can transmit the disease,
often doing so at their own funerals.
On December 26th, 2013, a two-year-old boy
in southern Guinea got sick.
Just two days later, he died.
It took local doctors working
with the international community
four months to discover
that Ebola was to blame,
largely because it had never before been
detected outside of Central Africa.
In those four months, Ebola gained
a head start that would prove devastating.
The outbreak lasted two years
and mushroomed into the largest
Ebola epidemic in recorded history.
More than 28,000 people contracted
the disease and over 11,000 died.
In 2013, Guinea had no formal
emergency response system,
few trained contact tracers,
and no rapid tests,
border screenings,
or licensed vaccine for Ebola.
After that epidemic, Guinea,
with the support of the US
and other international partners,
completely overhauled
their epidemic response system.
And in January 2021, that system
faced its first real test.
It started when a nurse in southern Guinea
developed a headache, vomiting, and fever.
A few days later, she died.
As dictated by traditional
burial practices,
her family prepared her body
for the funeral.
Within a week, the nurse’s husband
and other family members
started experiencing symptoms.
Health officials suspected Ebola much
quicker than in 2013 and ordered tests.
They came back positive,
and Guinea activated its epidemic
alert system the next day.
Then, lots of things
happened very quickly.
Guinea’s National Agency
for Health Security
activated 38 district-level
emergency operations centers,
as well as a national one.
Teams of epidemiologists and
contact tracers began the painstaking job
of figuring out exactly who was
exposed and when,
generating a list of 23 initial contacts
that quickly grew to over 1,100.
Advanced rapid testing capacity spun
up in the city where the outbreak started.
At Guinea’s borders
with Liberia and Cote d’Ivoire,
public health workers screened
more than 2 million travelers.
A large-scale vaccination
campaign was started.
And, finally, more than 900
community mobilizers
alerted people of the outbreak
and suggested alternative burial practices
that were acceptable to the community
and reduced the risk of spreading Ebola.
Thanks to all these measures,
the 2021 outbreak ended
just four months after it began.
Only 23 people contracted Ebola;
only 12 died.
That's less than 1% of the deaths
in the prior outbreak.
The 2021 outbreak cost
$100 million to control—
which sounds like a lot
but pales in comparison
to the global economic cost
of the previous outbreak:
$53 billion.
So should every country just copy
Guinea’s approach?
Not exactly.
It is always important to respond
to an outbreak quickly,
so an early warning system is essential.
But beyond that, a successful response
can look very different
for different diseases
in different countries.
For example, Brazil quenched
an outbreak of yellow fever,
which is spread by mosquitoes,
primarily by mounting a massive
vaccination campaign.
That strategy worked well for Brazil
because it’s one of the major global
producers of the yellow fever vaccine,
and its population was accustomed
to regular, routine vaccinations.
But for many diseases, you don't even
need a mass vaccination program.
In August of 2021, a truck driver tested
positive for cholera in Burkina Faso.
Health care workers alerted
the government that same day
and contact tracing began immediately.
Cholera is caused by a bacterium,
so Burkina Faso gave antibiotics to those
exposed or potentially exposed.
This extremely fast response
stopped the outbreak
just a few weeks after it started.
Cholera often rears its head
in West Africa—
in 2021, there were over 100,000 cases
and more than 3,700 deaths.
Because Burkina Faso was so well prepared,
they had zero deaths that year.
Zero.
In Chiang Mai, Thailand,
health officials piloted
a community-owned, community-driven
outbreak alert system
to monitor animal health—
that’s important because some
animal outbreaks have the potential
to spill over and become human outbreaks.
Villagers used an app to alert health
authorities about outbreaks in animals.
Over the course of 16 months,
36 animal outbreaks were identified.
For any outbreak response system
to be effective,
it needs to be trusted, valued,
and ultimately used by communities.
That means reaching people where they are,
in the language they speak,
and aware of the culture, beliefs,
and practices with which they live.
Perhaps most importantly, we can't
expect to do nothing for years
and then just swing into action
when an outbreak occurs.
One of the best ways to save lives is to
invest in lasting health infrastructure,
365 days a year, for everyone,
especially the most vulnerable among us.
