Isolating an area affected by a highly infectious disease may make intuitive sense. But according to the senior U.N. officials who spoke at a press conference here in D.C. this morning, the decision by dozens of airlines to suspend flights to countries fighting the Ebola virus may actually be hindering the efforts to bring the disease under control.
“We understand that there are certain countries in Africa that have reduced the extent to which planes may fly through their airports to move on to the countries that are affected,” said David Nabarro, the senior U.N. coordinator for Ebola. “This has had operational implications for ourselves at the United Nations and also for our colleagues at Médecins Sans Frontières who have not been able to move their staff dependably between locations or to move equipment.” He praised the Ghanaian government’s recent decision to set up an air corridor into the affected countries through Accra.
The officials also argued that flights bans unfairly stigmatize people from the affected countries. It seems like it would be a tough sell to get airlines (which are worried about the health of their flight crews) or countries (which are worried about their own outbreaks) to lift restrictions. After all, travelers from the affected countries have already introduced the disease to Nigeria and Senegal. But Nabarro argued that “it is possible to reduce the risk [the risk of transmission] greatly through the imposition of proper public health measures.”
According to the WHO, there have been 3,052 confirmed or suspected cases of Ebola so far in this outbreak, with 1,526 deaths. So far, the outbreak has been primarily in Guinea, Liberia, and Sierra Leone.
Given the scale of the problem, it seems a bit strange that public health authorities are still relying on volunteers and commercial airlines to contain the disease rather than coordinated international military efforts involving U.N. peacekeepers or others. But Nabarro insisted that the Ebola response should remain under the coordination of the affected governments and that the current structures were up to the challenge.
“This is doable with the institutions and resources that we have but the scale-up that is needed to actually achieve it in the time that is available before it really does get out of control is on the order of three to four times what is currently in place,” he said.
When I asked for a rough dollar figure for the amount of additional international resources that might be needed, he estimated that “it’s going to be at least $600 million and maybe a lot more.”
Keiji Fukuda, the assistant director-general for health security at the World Health Organization, estimated that for every 80 patients, 200 to 250 personnel are needed to provide care.
This means that thousands more local health workers and hundreds more international volunteers will be needed. On top of that, more money will be required to provide the equipment necessary to prevent more infections of health workers—a third American doctor was infected this week—and provide the hazard pay necessary to induce doctors into the field.
The toll of Ebola goes beyond those who have the disease. Fears of Ebola may prevent normal health care from being delivered, meaning cases of, for instance, malaria may go untreated. And the economic impact of the business closures and jobs lost due to the disease has only begun to be calculated.
“This Ebola epidemic is the largest and most severe and most complex we’ve ever seen in the 40-year history of this disease,” Margaret Chan, director-general of the WHO, said at today’s press conference. “No one, not even outbreak responders with experience dating back to [the outbreaks of] 1976 and 1995, have ever seen anything like it.”