A Possible Light At the End of the Tunnel.

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   Some preliminary signs of possible break in the Ebola outbreak.  However these could be deceptive...  John L.
 http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-wellAFRICA
In Liberia, a Good or Very Bad Sign: Empty
Hospital Beds
By SHERI FINK OCT. 28, 2014
SUAKOKO, Liberia — For days this month, the ambulances from this
Ebola treatment unit went out in search of patients, only to return with
just one or two suspected cases. And many times, those people ended up
testing negative for the disease.
“Where are the patients?” an aid worker wondered aloud as colleagues
puzzled over the empty beds at the International Medical Corps treatment
unit here in Bong County, Liberia, which opened in mid-September.
Around the country, treatment centers, laboratory workers who test for
Ebola, and international and national health officials trying to track the
epidemic have noticed an unexpected pattern: There are far fewer people
being treated for Ebola than anticipated.
As of Sunday, fewer than half of the 649 treatment beds across the
country were occupied, a surprising change in a nation where patients had
long been turned away from Ebola units for lack of space.
Now, new admissions to treatment centers are dropping or flatlining,
the number of samples being submitted to Ebola laboratories has fallen
significantly, and the percentage of people testing positive for the disease
has dropped as well.
“The numbers are decreasing, but we don’t know why,” said Malin
Lager, a spokeswoman at a Doctors Without Borders treatment center just
outside Monrovia, the capital. Its vast campus of white tents, which has a10/29/2014 In Liberia, a Good or VeryBad Sign: EmptyHospital Beds - NYTimes.com
http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&modul… 2/6
capacity for 253 patients, had only 90 on Sunday.
“It’s too early to celebrate,” Ms. Lager said.
Liberia has long been a focal point of the Ebola epidemic, the nation
with the most cases and deaths from the disease, prompting a global call
to action. Hundreds of new beds have been added in recent weeks, but
now many are going unfilled even before any of the 18 treatment centers
being built by the American military have opened, leaving many officials
here confounded.
Some are debating whether the World Health Organization’s dire
warnings about the epidemic — that there could be as many as 10,000 new
cases each week in West Africa by December, about 10 times the rate it
recently reported — might be grossly inflated.
“The projections were based on nothing happening” to curb the
outbreak, said the United States ambassador to Liberia, Deborah R.
Malac, during a visit to the International Medical Corps treatment center
this month. “More things are happening every day.”
For now, most officials are continuing to plan for the worst so as not
to interfere with the mounting international response, which is seen as
critical to preventing a resurgence. Even a single unsafe burial, in which
mourners touch a highly infectious corpse, can result in dozens of new
cases.
The empty beds in Liberia come in the context of an intense public
health campaign to educate the nation about the dangers of the disease
and ways of combating it — from posters and billboards to messages
broadcast when residents make phone calls.
“Lonestar Cell cares about your health. Ebola is real,” one company’s
recording says.
Some consider the latest developments an indication that the efforts
to combat the virus, including the opening of new treatment units, are
beginning to succeed.
“We can see it subsiding bit by bit,” the Rev. Omalley M. Segbee told
his congregation at Sunday services at Grace Baptist Church in the town of10/29/2014 In Liberia, a Good or VeryBad Sign: EmptyHospital Beds - NYTimes.com
http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&modul… 3/6
Gbarnga. “This means you are on our side, oh Lord.”
But because Liberians celebrated early once before — believing the
virus had been eradicated in the spring, only to see it rage back with
greater force in the summer — there is a near universal hesitance to call
the outbreak under control. Liberia’s neighbors, Sierra Leone and Guinea,
have been experiencing a troubling surge of cases in recent weeks.
There is also the likelihood that many people dying of Ebola in Liberia
are hidden from the authorities, as has been true throughout the epidemic.
Many parts of the country are not well monitored, many contacts of
Ebola patients are not traced, and officials have long acknowledged that
the statistics on the numbers of Ebola cases across West Africa are rough
estimates, at best.
Treatment beds and laboratories in Liberia are also concentrated in
the capital. Large swaths of the country are hours away from these centers
on bad roads, in areas that lack cellphone services, which is why the new
treatment centers being built far from other Ebola facilities are considered
so important.
Many of the monitoring experts, too, are based in the capital. Months
into the crisis, officials still remind themselves of the need to get out into
the wider country to test their assumptions about the epidemic. But even
in the capital, many Ebola patients are suspected to have died at home,
leaving big gaps in data on the scope of the disease.
Anna Halford, a field coordinator for Doctors Without Borders, said
the charity had a broad network of community members who promoted
Ebola awareness in and around the capital.
“Not a single one of the supervisors believes there is a significant drop
in cases,” she said.
Families may keep sick relatives at home for many reasons, including
rumors of mistreatment inside Ebola units and fears of quarantine and
stigma, Ms. Halford said. Beyond that, “It is a disease that comes in waves
because of the variability of the incubation period and because of the
mobility of people.”10/29/2014 In Liberia, a Good or VeryBad Sign: EmptyHospital Beds - NYTimes.com
http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&modul… 4/6
And then there are the known hot spots, where the virus continues to
spread through families.
Last weekend, eight people from one community were admitted to the
International Medical Corps treatment center. In another cluster, the
mother and sister of a woman who died on her way here later became
patients; the mother died last week.
In the capital, teams in protective gear are supposed to pick up the
dead and ensure they are cremated. But some families continue to conduct
private burials, distrustful of the government’s handling of bodies.
Matthew Siakor said he wore two pairs of gloves and a raincoat when
he helped bury his mother, whose body had been spirited out of Monrovia
by his younger brother. He said the choice to do so came after another
family member died.
“After they took the body away and they did the testing, there were no
results back to the family whether the body that was carried was an Ebola
body,” he said, adding that he and his brother were voluntarily
quarantining themselves now. “It is difficult for people to lose their loved
ones, and they take them away and they can’t get the body.”
Community resistance to public outreach efforts also persists in some
pockets.
“People ran away,” the Rev. G. Victor Padmore, a member of an Ebola
task force here, reported after visiting a community where there had been
a case. Days later, in another district, he visited a family that had recently
lost a 3-year-old child.
“They don’t want to accept the child died of Ebola,” he said. “I made
them understand.”
Some rural health workers say the outreach efforts have made
residents more willing to report cases and seek treatment.
“It’s not as it was in August or September,” said Kollie Singbeh, an
Ebola case investigator for Margibi County.
But Elvis Ogweno, a Kenyan nurse who heads the International
Medical Corps ambulance team, said that several Ebola-affected10/29/2014 In Liberia, a Good or VeryBad Sign: EmptyHospital Beds - NYTimes.com
http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&modul… 5/6
communities he had visited still reacted with fear.
“They just took off to the forest,” he said. “You keep on shouting, ‘Is
someone there? Is someone there?’ ”
He sometimes drives five hours to reach communities, returning again
and again until the resistance dissipates, often once someone is very ill.
“After three days you go back and the patient is critical,” he said. “Now
they want to come immediately.”
He warned the doctors here not to trust the perceived drop in cases. “I
told them Ebola, from my five to six weeks of experience here, you find for
three days there are no patients, and then it erupts again.”
In part, that is because of the difficulty some of the sick have in
finding help. “Some patients say, ‘Since two days ago I’ve been looking for
assistance,’ ” he said.
Last week, to better understand whether gaps in detecting and tracing
cases might explain why treatment numbers are low, the W.H.O. sent
experts to the country’s far-flung districts.
Employees of the United States’ Centers for Disease Control and
Prevention also went out into communities to try to get a better
understanding of the situation. Their conclusions are expected in the
coming days.
As Dr. Samson Arzoaquoi, who heads the Ebola task force in Bong
County, bumped along a dirt road over the weekend, he said the area had
been quieter.
“This time is not yet a time for us to rejoice,” he warned a crowd
gathered to begin an Ebola outreach program. “If we begin to laugh and
celebrate, what will happen? We will go right back where we are coming
from.”

Author	Message Topic Search Topic Options Post Reply Create New Topic Printable Version Translate Topic
jdljr1 Members Profile Send Private Message Find Members Posts Add to Buddy List Admin Group Joined: June 05 2006 Location: United States Status: Offline Points: 1621	Post Options Post Reply Quote jdljr1 Report Post Thanks(0) Quote Reply Topic: A Possible Light At the End of the Tunnel. Posted: October 28 2014 at 10:58pm
	Some preliminary signs of possible break in the Ebola outbreak. However these could be deceptive... John L. http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-wellAFRICA In Liberia, a Good or Very Bad Sign: Empty Hospital Beds By SHERI FINK OCT. 28, 2014 SUAKOKO, Liberia — For days this month, the ambulances from this Ebola treatment unit went out in search of patients, only to return with just one or two suspected cases. And many times, those people ended up testing negative for the disease. “Where are the patients?” an aid worker wondered aloud as colleagues puzzled over the empty beds at the International Medical Corps treatment unit here in Bong County, Liberia, which opened in mid-September. Around the country, treatment centers, laboratory workers who test for Ebola, and international and national health officials trying to track the epidemic have noticed an unexpected pattern: There are far fewer people being treated for Ebola than anticipated. As of Sunday, fewer than half of the 649 treatment beds across the country were occupied, a surprising change in a nation where patients had long been turned away from Ebola units for lack of space. Now, new admissions to treatment centers are dropping or flatlining, the number of samples being submitted to Ebola laboratories has fallen significantly, and the percentage of people testing positive for the disease has dropped as well. “The numbers are decreasing, but we don’t know why,” said Malin Lager, a spokeswoman at a Doctors Without Borders treatment center just outside Monrovia, the capital. Its vast campus of white tents, which has a10/29/2014 In Liberia, a Good or VeryBad Sign: EmptyHospital Beds - NYTimes.com http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&modul… 2/6 capacity for 253 patients, had only 90 on Sunday. “It’s too early to celebrate,” Ms. Lager said. Liberia has long been a focal point of the Ebola epidemic, the nation with the most cases and deaths from the disease, prompting a global call to action. Hundreds of new beds have been added in recent weeks, but now many are going unfilled even before any of the 18 treatment centers being built by the American military have opened, leaving many officials here confounded. Some are debating whether the World Health Organization’s dire warnings about the epidemic — that there could be as many as 10,000 new cases each week in West Africa by December, about 10 times the rate it recently reported — might be grossly inflated. “The projections were based on nothing happening” to curb the outbreak, said the United States ambassador to Liberia, Deborah R. Malac, during a visit to the International Medical Corps treatment center this month. “More things are happening every day.” For now, most officials are continuing to plan for the worst so as not to interfere with the mounting international response, which is seen as critical to preventing a resurgence. Even a single unsafe burial, in which mourners touch a highly infectious corpse, can result in dozens of new cases. The empty beds in Liberia come in the context of an intense public health campaign to educate the nation about the dangers of the disease and ways of combating it — from posters and billboards to messages broadcast when residents make phone calls. “Lonestar Cell cares about your health. Ebola is real,” one company’s recording says. Some consider the latest developments an indication that the efforts to combat the virus, including the opening of new treatment units, are beginning to succeed. “We can see it subsiding bit by bit,” the Rev. Omalley M. Segbee told his congregation at Sunday services at Grace Baptist Church in the town of10/29/2014 In Liberia, a Good or VeryBad Sign: EmptyHospital Beds - NYTimes.com http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&modul… 3/6 Gbarnga. “This means you are on our side, oh Lord.” But because Liberians celebrated early once before — believing the virus had been eradicated in the spring, only to see it rage back with greater force in the summer — there is a near universal hesitance to call the outbreak under control. Liberia’s neighbors, Sierra Leone and Guinea, have been experiencing a troubling surge of cases in recent weeks. There is also the likelihood that many people dying of Ebola in Liberia are hidden from the authorities, as has been true throughout the epidemic. Many parts of the country are not well monitored, many contacts of Ebola patients are not traced, and officials have long acknowledged that the statistics on the numbers of Ebola cases across West Africa are rough estimates, at best. Treatment beds and laboratories in Liberia are also concentrated in the capital. Large swaths of the country are hours away from these centers on bad roads, in areas that lack cellphone services, which is why the new treatment centers being built far from other Ebola facilities are considered so important. Many of the monitoring experts, too, are based in the capital. Months into the crisis, officials still remind themselves of the need to get out into the wider country to test their assumptions about the epidemic. But even in the capital, many Ebola patients are suspected to have died at home, leaving big gaps in data on the scope of the disease. Anna Halford, a field coordinator for Doctors Without Borders, said the charity had a broad network of community members who promoted Ebola awareness in and around the capital. “Not a single one of the supervisors believes there is a significant drop in cases,” she said. Families may keep sick relatives at home for many reasons, including rumors of mistreatment inside Ebola units and fears of quarantine and stigma, Ms. Halford said. Beyond that, “It is a disease that comes in waves because of the variability of the incubation period and because of the mobility of people.”10/29/2014 In Liberia, a Good or VeryBad Sign: EmptyHospital Beds - NYTimes.com http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&modul… 4/6 And then there are the known hot spots, where the virus continues to spread through families. Last weekend, eight people from one community were admitted to the International Medical Corps treatment center. In another cluster, the mother and sister of a woman who died on her way here later became patients; the mother died last week. In the capital, teams in protective gear are supposed to pick up the dead and ensure they are cremated. But some families continue to conduct private burials, distrustful of the government’s handling of bodies. Matthew Siakor said he wore two pairs of gloves and a raincoat when he helped bury his mother, whose body had been spirited out of Monrovia by his younger brother. He said the choice to do so came after another family member died. “After they took the body away and they did the testing, there were no results back to the family whether the body that was carried was an Ebola body,” he said, adding that he and his brother were voluntarily quarantining themselves now. “It is difficult for people to lose their loved ones, and they take them away and they can’t get the body.” Community resistance to public outreach efforts also persists in some pockets. “People ran away,” the Rev. G. Victor Padmore, a member of an Ebola task force here, reported after visiting a community where there had been a case. Days later, in another district, he visited a family that had recently lost a 3-year-old child. “They don’t want to accept the child died of Ebola,” he said. “I made them understand.” Some rural health workers say the outreach efforts have made residents more willing to report cases and seek treatment. “It’s not as it was in August or September,” said Kollie Singbeh, an Ebola case investigator for Margibi County. But Elvis Ogweno, a Kenyan nurse who heads the International Medical Corps ambulance team, said that several Ebola-affected10/29/2014 In Liberia, a Good or VeryBad Sign: EmptyHospital Beds - NYTimes.com http://www.nytimes.com/2014/10/29/world/africa/in-liberia-a-good-or-very-bad-sign-empty-beds-.html?hpw&rref=health&action=click&pgtype=Homepage&modul… 5/6 communities he had visited still reacted with fear. “They just took off to the forest,” he said. “You keep on shouting, ‘Is someone there? Is someone there?’ ” He sometimes drives five hours to reach communities, returning again and again until the resistance dissipates, often once someone is very ill. “After three days you go back and the patient is critical,” he said. “Now they want to come immediately.” He warned the doctors here not to trust the perceived drop in cases. “I told them Ebola, from my five to six weeks of experience here, you find for three days there are no patients, and then it erupts again.” In part, that is because of the difficulty some of the sick have in finding help. “Some patients say, ‘Since two days ago I’ve been looking for assistance,’ ” he said. Last week, to better understand whether gaps in detecting and tracing cases might explain why treatment numbers are low, the W.H.O. sent experts to the country’s far-flung districts. Employees of the United States’ Centers for Disease Control and Prevention also went out into communities to try to get a better understanding of the situation. Their conclusions are expected in the coming days. As Dr. Samson Arzoaquoi, who heads the Ebola task force in Bong County, bumped along a dirt road over the weekend, he said the area had been quieter. “This time is not yet a time for us to rejoice,” he warned a crowd gathered to begin an Ebola outreach program. “If we begin to laugh and celebrate, what will happen? We will go right back where we are coming from.”
	John L

Albert Members Profile Send Private Message Find Members Posts Add to Buddy List Admin Joined: April 24 2006 Status: Offline Points: 47746	Post Options Post Reply Quote Albert Report Post Thanks(0) Quote Reply Posted: October 29 2014 at 4:42am
	This is starting to get confusing. There are some reports coming out that it's decreasing, yet Liberia just had their largest weekly increase ever. Today I'm guessing media reports will validate this and that total cases are over 12,000 with Liberia having the largest increase to date. MSF is doing a fantastic job, but I still don't fully trust their numbers and reports. Unless the numbers are way off and we're seeing 5000 - 10,000 cases per week and it's in the process of burning/dying off. The population in Monrovia is 400,000. There could be a very large die-off with nobody really left. Perhaps they're either dead or have fled, would be the best bet. There is currently nearly 35,000 total "estimated" cases in W. Africa.
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Iowa102 Members Profile Send Private Message Find Members Posts Add to Buddy List Adviser Group Joined: May 08 2007 Location: United States Status: Offline Points: 227	Post Options Post Reply Quote Iowa102 Report Post Thanks(0) Quote Reply Posted: October 29 2014 at 12:31pm
	Did they even keep track of the patients that were turned away when the beds were full? You know, those patients who went home and told their family and friends that going to the hospital was a waist of time. And then they wonder why the numbers are dropping off. God, what a nightmare for those people in the countries that are infected. I fear that a similar situation will develop here in the USA where we put a "czar" in charge of a medical crisis that has no medical training. This is what it looks like to me but I'm just an old man with minimal first aid training.
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