By Liz Widas, JD, EMT, and DAP Volunteer
When the United States announced military operations to control the explosive growth of Ebola cases in Liberia, few questioned whether this response would be adequate to the urgent demands of the situation. The World Health Organization reported Saturday that there have been 10,141 cases of Ebola in this current outbreak, 4,665 of the cases in Liberia, with 2,705 dead and up to 30 new cases per day in some areas of that country, and the infection rate is not dropping.
Is the United States military’s plan for Liberia capable of dealing with a health disaster of this magnitude? And why should Americans care?
A study published October 24, 2014 in The Lancet Infectious Diseases medical journal finds that the U.S. military response to the Ebola epidemic in Liberia, dubbed “Operation United Assistance”, which will cost some $750 million, send 3,000 U.S. military personnel to the West African nation, and provide up to 1700 beds for patients, is grossly inadequate to bring the epidemic under control in that nation. The study focuses on Montserrado, the county in Liberia in which the capital, Monrovia, is located, and where the disease is prevalent. Without expanded efforts, the scientists predict 90,122 deaths there by Dec 15, 2014.
The study’s authors, a team of scientists at Yale University, stated, “Perhaps most alarming is that, although we might still be within the midst of what will ultimately be viewed as the early phase of the current EVD [Ebola Virus Disease] outbreak, the window of opportunity for aversion of calamitous repercussions from an initially delayed and insufficient response is diminishing rapidly. Our predictions suggest that current commitments are grossly inadequate to provide beds for all infected individuals, even only considering near-term growth of the epidemic in Montserrado. “
The authors interpret their findings as follows: “The number of beds at EVD treatment centres needed to effectively control EVD in Montserrado substantially exceeds the 1700 pledged by the USA to west Africa… Our findings highlight the rapidly closing window of opportunity for controlling the outbreak and averting a catastrophic toll of EVD cases and deaths.”
The Lancet study uses a mathematical model to predict that under a best-case scenario of 4800 Ebola beds present in Montserrado, if such intervention had begun on October 15 there would be a total of 27,378 EVD cases and 18,606 deaths compared with 112,960 cases and 66,820 deaths with a best-case intervention start date of November 15, 2014. According to the World Health Organization, by late September there were 360 Ebola beds available in Monrovia.
In The White House Fact Sheet: The U.S. Government’s Response to Ebola at Home and Abroad distributed on October 22, 2014, the U.S. reports plans to deploy 3,200 troops with over 600 currently in the region, the construction of a hospital for infected health care workers, and the construction of up to 17,100-bed Ebola Treatment Units [ETUs] in Liberia.
Work on the hospital and three ETUs has begun, though in an October 16, 2014 article in the Wall Street Journal Major General Darryl Williams, head of U.S. Army Africa, said that the hospital won’t admit patients until early November, and the Fact Sheet predicts that three ETUs, with a total of 300 beds, will be completed “in November.”
The commander of U.S. forces in Africa, General David Rodriguez, stated in an October 7, 2014 news conference, “The real critical thing to this, based on USAID and the CDC is to get about 70 percent of the personnel that are infected into a treatment facility. And then at that point, they believe the curve will start going down.” Based on the figures provided by The Lancet authors, by November 15 there could be 112,960 EVD cases in Montserrado, 70% of which is approximately 79,000 people needing treatment.
Other nations, including Great Britain, France, Germany, and Cuba, are sending troops, supplies, and medical personnel to the region. On October 18, the aid charity Oxfam called for troops to be sent to West Africa, following the similar September request by Doctors Without Borders.
The U.S. military effort is by far the largest among those nations who have committed their militaries, but not as large as the U.S. response to the 2004 Indonesian tsunami disaster. According to the Department of Defense publication “2005 Year in Review,” following the late 2004 Indonesian tsunami, “Within days, more than 15,000 U.S. military members were in Southeast Asia assisting relief and recovery efforts under Operation Unified Assistance, the name given the post-tsunami relief efforts focused on Indonesia, Sri Lanka and Thailand.”
In non-military U.S. aid efforts, USAID, with the financial support of billionaire Paul Allen, will provide 400,000 home care kits to Liberia so families can care safely for infected relatives. Such kits may cut in half the transmission rate of the disease, in the estimation of The Lancet study. According to UNICEF, as of September 25, 2014, 9,000 such kits had arrived in Monrovia.
So ask yourself: with 2,705 people dead in Liberia as of today, and with The Lancet study calling the U.S. military response wholly inadequate to avert 90,000 probable deaths by December 15 in only one county in Liberia, are you satisfied that our country is doing enough to stop this epidemic from ravaging West Africa?
As we are well aware, Ebola is only a plane flight away from our airports and cities. There can be no doubt that stopping this disease in Africa is our own best defense here at home. We have seen the United States military performing magnificently when called upon to perform miracles in disaster zones; they just need to be asked to do this most important mission.