The West Africans have been catching media Hell for months now. They are blamed for everything from living in filth to pursuing strange funeral practices. Too dumb to fight off the Ebola virus. It's a game of Blame The Victim, racist to the core and aimed to damn locals for the current Ebola outbreak.
In truth, billboards went up in Monrovia early in August explaining basic protection tactics. Flyers went out in several languages and the communities responded. And it does take a community response to beat Ebola because individuals and single families, by themselves, are pretty much helpless when they try to do quarantine.
Now, the Liberian Red Cross reports that body pick-up in Montserrado County has fallen from 315 in the week of September 15-21 down to 117 deaths last week.
This is the continuation of a pattern seen all through October. The Liberia National Red Cross Society's Secretary General, Ms. Fayiah Tamba, reports that their teams buried 187 bodies during the week of October 6-12 and 155 bodies from October 13-19. The week of October 20-26 continues this pattern with the lowest total in recent months.
For the numerically obsessed that's a 63% decline from maximum. You have to be impressed: these Africans as a community are pretty darn good at this stuff. (There's a normal load for Red Cross picking up bodies. The variable part of the current load is from Ebola. As a result, estimating the Ebola change at two-thirds is likely an underestimation for the change.)
Previously from April into September the Ebola outbreak had been doubling every two weeks in the slum areas. More like 25 to 30 days for rural areas. And now it looks like the billboard campaign and zillions of one-page flyers and treatment with a generic antiviral med have taken hold. From Front Page Africa:
"FOR THE SAKE of our future we hope the drop we are witnessing would mark the beginning of the end of Ebola, a disease no one expected and one no one ever wants to see in our midst again."
When the decline was first noted, World Health Organization's Bruce Aylward warned while the numbers suggest “getting an upper hand on the virus,... A slight decline in cases in a few days versus getting this thing closed out is a completely different ball game.
(Reporting a single-area decline to mortality) is like saying your pet tiger is under control.”
For details on community response, together with a brief survey for what the scientists are saying, roll on through le trump l'orange.
What we had seen in coverage out of Monrovia from April through mid-September was staggering. Ebola deaths started small. Then it went like wild fire. The nature of the deaths, themselves, frightened witnesses: "starts like flu, ends like rabies."
No one had seen Ebola reach an urban population center. There was nothing for prior experience, certainly nothing in the period covered by written records.
So what formed up was a biological race. On the one hand we have had humans applying very-low-tech quarantine efforts in five and then three African countries. On the other there's the Ebola virus with it's contagion and mutate-and-select properties. From April through the middle of September, the virus was winning.
Some 50 viral mutations have been identified in the RNA string. That is rapid mutation, but typical for cross-species jumper viruses. It's just luck for the humans that these mutations did not produce a significant up-tick to viral contagion.
In any case, case load for Ebola continued to double with periods ranging from two to four weeks, apparently driven by population density. Public Health organizations went months lacked resources to make much of a dent in countries where the epidemic had established itself. Ebola became endemic to humans, in no way depending on animal carriers to maintain itself.
Then the African response to the epidemic expanded with new uses of three classes of tools.
K.I.S.S.
The three main factors might surprise you:
1. Bug sprayers with kitchen bleach
2. Flyers
3. "Blocker" drugs
Yeah, the ordinary $15 bug sprayer that you'd pick up at Home Depot. Most folks here get one to battle ants and roaches. It has a hand pump to pressurize the reservoir; add water and a couple ounces of Malathion and you're in business.
In Africa you add bleach. Mix kitchen bleach at a 10% mix with water. A fine spray kills Ebola on contact. In Monrovia the health service started handing these out in July.
Then flyers came out with a description of the virus, how small it is, how it compares with human RNA, how to kill it, how to avoid it, how to clean up, how to contact health services, and the many dangers presented by Ebola corpses.
The flyers changed community attitudes toward the Ebola threat. Denial all but disappeared within days. And the flyers got handed around. Add on the availability of the little sprayers, people had what they needed to put up a decent fight.
As to "blockers" they already had a usable medicine available. Generic antivirals are not "Experimental Drugs" as described in corporate MSM here in the U.S. The only part of it that's experimental is taking a drug that works with hepatitis, flu, HIV and using it with Ebola.
The best known drug is Lamivudine (common commercial name, Epivir.) This was invented in 1988 at McGill University in Montreal. It has been used for severe viral infections ranging from Hepatitis-B to HIV. Those are DNA viruses but apparently the transcription mechanisms are close enough that Epivir works to cut RNA-based Ebola fatalities.
Dr. Gorbee Logan, the physician at Tubmanburg, Liberia, started this approach in August when he treated 15 Ebola patients with Lamivudine/Epivir. His early-phase patients survived. Tubmanburg is an hour's drive from Monrovia so news of this treatment got into play right off.
This regime for treatment expanded out from Tubmanburg. The one and only limit is availability of Lamivudine/Epivir in West Africa. AIDS clinics have it; others do not and that includes all of the small towns. You can think of Lamivudine/Epivir as a generic antiviral. It blocks specific viral-induced DNA replication, but also inhibits RNA replication in certain circumstances. A big Biden deal.
Thank God, for Dr. Logan.
O-Ring Problems and Ebola Response
Most of this audience are familiar with the "Challenger" Space Shuttle disaster. That happened back in 1986. A huge o-ring that joined the sections of a rocket failed and a crew of astronauts were killed during launch at Kennedy Space Center. The problem wasn't bad engineering; it was bad management.
And of course there was a cover-up. A nasty, bleeding mess of a cover-up. If you yearn to believe in hierarchy, in Authority then make it a point of religion to avoid the "Challenger" disaster.
All Problems Are 85% Management.
That's Deming's Law. It applies to everything from the Christian Creation to "Challenger" to Ebola response. There's also this mini-rule, a product of several long dog walks on the Bethesda-D.C. border area:
No QC, No Q.
No quality control, no quality.
Hell, folks, it took Dr. Logan out at his county seat clinic to do quality control on the whole of Big Pharma and the government labs by throwing a generic antiviral at human-resident killer-bug Ebola virons. Nobody else was going to do it. Not USAMRID. Nobody in any hierarchy was running any project like what he did. The simplest, most obvious step fighting a Mad Dog virus and it took Dr. Logan out in Tubmanburg to do Design Time quality control and make the right move.
Without Dr. Logan, before the advances to Monrovia's Q system we were seeing African demographic model runs that predicted full saturation for human exposure to the Ebola virus. In Africa that does not mean 100% infection, but still some 80,000,000 cases and 50,000,000 deaths.
It was these Africans who did the quality control. Design Time and Implementation Time quality control. They are the heroes.
Assuming that the Tubmanburg/Monrovia enhancements can be transferred across West Africa, it looks like this outbreak can be contained. Over the next two or three years it can be erased.
Assuming that mutation on the part of the virus does not overcome these new human defense measures, one should not be blamed overly for believing that human prayers are being answered.
If one's god is all the good of the universe, why not ???