Letter to the Editor of The Financial TimesPosted on by
Reposted from Letter to the Editor of The Financial Times, October 3, 2014
Sir, The Ebola epidemic is a problem not just for west Africa, but for the world. The longer the epidemic continues, the greater its economic, political and social impact. As you say in your editorial “The Ebola disaster is yet to be truly confronted” (September 26), the epidemic threatens public welfare and social stability, and had already had an impact on travel and trade to affected countries; in some instances, borders have even been closed.
This week I announced the first Ebola case diagnosed in the US. I have been asked whether we should stop travel to Liberia. The answer is no: to keep Americans and people in non-affected countries safe, we must continue to work to support efforts to stop the spread of Ebola in Liberia, Guinea and Sierra Leone. One strategy that won’t stop this epidemic is isolating affected countries or sealing borders. When countries are isolated, it is harder to get medical supplies and personnel deployed to stop the spread of Ebola. And even when governments restrict travel and trade, people in affected countries still find a way to move and it is even harder to track them systematically.
Involuntary quarantine and isolation of communities and regions within countries will also backfire. Restricting travel or trade to and from a community makes it harder to control in the isolated area, eventually putting the rest of the country at even greater risk. Isolating communities also increases people’s distrust of government, making them less likely to co-operate to help stop the spread of Ebola.
There are productive ways governments can support isolation. This includes providing services that increase patients’ chance of survival and that reduce the risk that caregivers will get infected. This breaks the chain of transmission. In parts of Liberia and Sierra Leone today, there are not enough facilities to isolate and treat patients. Efforts are under way in these countries to increase treatment unit beds rapidly, but the outbreak has continued to outpace these effects. Many communities in the affected regions have taken the initiative to safely isolate patients at the local level. Partners need to build on these efforts to support patients and their families.
During the smallpox era, in parts of Africa neighbors provided a hut, food and provisions to smallpox patients. Patients could not leave the hut until their smallpox scabs fell off (indicating that they were no longer infectious). Only smallpox survivors were allowed to enter the hut. This is the type of community innovation that could help stop Ebola today.
At the United Nations last week, delegates wore buttons that said: Isolate patients, not countries. The only way to stop the epidemic is to isolate and care for patients, not to quarantine entire communities, areas, or countries. Patients, communities, and countries that are fighting Ebola need our support.
Tom Frieden, MD, Director, CDC
- Page last reviewed:October 6, 2014
- Page last updated:October 6, 2014
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