Problem

REUTERS                                                                                                                       Dec. 15, 2014

GENEVA –  The failure of Sierra Leone's strategy for fighting Ebola may be down to a missing ingredient: a big shock that could change people's behavior and finally prevent further infection.

Bruce Aylward, the head of Ebola response at the World Health Organization, said Sierra Leone was well placed to contain the disease -- its worst outbreak on record -- with infrastructure, organization and aid.

Health workers spray themselves with chlorine disinfectants after removing the body a woman who died of Ebola virus in the Aberdeen district of Freetown, Sierra Leone. (REUTERS/Josephus Olu-Mammah)

The problem is that its people have yet to be shocked out of behavior that is helping the disease to spread, still keeping infected loved ones close and touching the bodies of the dead.

"Every new place that gets infected goes through that same terrible learning curve where a lot of people have to die ... before those behaviors start to change," Aylward told Reuters.

ANNALS OF EMERGENCY MEDICINE                                                                               Dec. 11, 014
By Kristi Koenig, MD, Center for Disaster Medical Sciences, University of California at Irvine

Despite our global experience with emerging infectious diseases, politicians empowered with making health policy decisions and even some scientists have created confusion, fear, and stigmatization of health care workers by inconsistent use of quarantine....

Instead of trying to allay public fears by misapplication of quarantine, we should instead educate according to rigorous science and apply evidence-based policies and procedures. Modern technologies exist for robust public health monitoring that can replace an antiquated system of quarantine for exposed persons who have no potential to transmit disease before symptom onset. Health care workers who have cared for Ebola patients and are asymptomatic should not be restricted from work or other activities as long as they can be effectively monitored for symptoms and then isolated and tested if those develop. Politicians must heed their scientific advisors and not be swayed by misinformed public fear. In addition, we should seek out and apply these simple modern technologic solutions that maximize public health and safety.

Why has Liberia -- once the epicenter of the outbreak -- been able to stop a rampaging killer disease, while the country next door can't even count its dead?

foreignpolicy.com - by Laurie Garrett - December 10, 2014

FREETOWN, Sierra Leone — It was a terribly disturbing sight. At first glance, Connaught Hospital in central Freetown looked unremarkable; the Sierra Leone facility featured a walk-in and ambulance entrance that led to typical hospital hallways and a central patients’ garden. But the entry was flanked by tented structures — on the left, a table at which sat three men, sweating in full protection suits, goggles, gloves, and masks. On the right was what appeared to be a wood-fenced pen with a sun-shading tarp over it, suitable for livestock. Patients and visitors were required to approach the suited men on the left for triage: If they had a fever or nausea they were sent to the pen.

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More blows to Sierra Leone economy

BLOOMBERG by Thomas Biesheuvel and Makiko Kitamura                                                             Dec. 12, 2014

As Ebola rages in Sierra Leone, the outbreak has claimed almost 2,000 lives and contributed to the collapse of the iron ore industry. Now the virus is hitting the diamond mines.

At the latest hotspot, in the gem-rich Kono district along the Guinea border, two workers at Octea Ltd.’s Koidu mine, Sierra Leone’s largest, were infected last week and are being treated. The outbreak may mean that production at the mine will miss its annual target -- measured in carats -- by as much as 20 percent, Chief Executive Officer Brett Richards said.

“Everyone thought this was under control and we were seeing the top of the curve,” Richards said in a phone interview yesterday. “It completely went out of control a couple of weeks ago. We may be uncovering a bit of an iceberg here.”