Mid-course

February 25, 2015 - As of today, I’m at the halfway point of my work at the ETU (and 2/3 of the way through this whole posting, including training). The unit only has six patients tonight. Well, really, five – one is a baby who almost CERTAINLY has malaria (which we’re treating) and not Ebola, but whom we need a negative PCR on to be able to allow to go. He (and his mother, who has no symptoms at all) are holed up in a separate building in the “suspect” area which has not housed an Ebola case for at least 10 days, with instructions to basically stay away from everyone else! I’m very hopeful we can avoid giving them Ebola while we wait for the test – which we really, really hope will be back by tomorrow afternoon.

But, anyway – a low patient census, which allows us to do our work with a thoroughness which is very satisfying. Unfortunately, however, Sierra Leone as a whole has had between 12 and 16 new cases a day over the last 4 or 5 days. That’s higher than last week, when the average was closer to 10. And if you have deduced from the above that most of the new cases aren’t in our area, you are correct – a lot of them are near Freetown, in fact, always concerning since spread in a city is everyone’s nightmare. The higher number of cases per day may end up being a statistical blip, of course. And, even if it continues, it might represent hopeful as well as discouraging facts (i.e., it might be better case-finding by public-health teams, not a higher incidence). But you can’t really call it encouraging. Again, it brings you up against how hard actually ending the epidemic, for good, will probably be.

PS, March 1, 2015 - Here are links to a couple of articles discussing the difficulty of actually ending the epidemic here. Very, very interesting reading:

http://www.theguardian.com/world/2015/feb/27/ebola-sierra-leone-village-lockdown-31-new-cases

http://www.nytimes.com/2015/03/01/world/africa/nearly-beaten-in-sierra-leone-ebola-makes-a-comeback-by-sea.html?_r=0