WHO raises alarm over rapidly spreading Ebola outbreak in East and Central Africa

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[00:00:00]All right, now we get into that conversation on Ebola. Is there cause to panic? Well, the World Health Organization says it is spreading rapidly and that is the B I struggle with the the the name of of this particular strain, but the BVD uh virus is spreading rapidly in the DRC. We're joined in studio by Sam Taylor, director of communications as well as fundraising MSF Medicine San Frontier uh Doctors Without Borders in short MSF. Welcome to the studio. Good to have you here. We also have joining us virtually, Professor Omu Anzala and he is a professor of immunology and vyology.

[00:00:38]>> Let's begin with you Sam. Can you give us a status update on what the situation is in the DRC? Officially the confirmed cases are 82, seven confirmed deaths. Uh but the WHO says the figures could be much higher than that in the hundreds.

[00:00:52]Uh what is your team telling you? So the thing we need to know about DRC is the area where the outbreak is ongoing is an area where there's already 1 million people displaced from conflict. So um >> Eastern DRC >> Eastern DRC MSF and other humanitarian organizations and the WHO and local authorities are trying to respond in what's already a very complex area. Um what's going to be key is making sure that people are aware of what the symptoms are, being able to isolate people, identify them and give them the treatment that they need.

[00:01:21]>> Okay. Um so I'll come to now the professor of of viology. Um the initial s uh symptoms from what I've read uh professor Anzala include fever, uh muscle aches, um fatigue, tummy ache. I mean that's those sound like symptoms for many different conditions. Um so is what do you advise? you know, should screening be particularly uh stringent or stricter with people who've been to the DRC or Uganda as a professional?

[00:01:53]What would you advise?

[00:01:55]>> Yeah, thank you. Thank you for uh inviting me to this forum. Actually, that is actually the difficulty with a lot of viral fever. you know the presentation in terms of fever, vomiting, you know, diarrhea, headaches, all these are actually very common uh presentation for various viruses even some parasite. However, the critical aspect of it is that there are case definitions very clear need case definitions. Our health care professionals have actually been trained very very well to adhere you know to that and more so under situations like these where there's heightened surveillance you know such that any suspected fever and for us it is not just somebody who has come from DRC Congo or somebody has come from Uganda we have we are at a heightened position where we are looking at each fever very very critically ally each year very very critically so that we don't actually miss out uh any suspected Ebola case because there are two words here to remember one word first of all called bio bioisk and then within that word bioisk we have two word the biosafety and the biocurity so those are the critical things and biosafety really actually means that our healthcare providers are well trained to be able to notice this and take uh action immediately to protect themselves and protect the other uh the other patients who might be nearby if there is any suspected case and at the same time uh be able to collect enough sample for testing and as well as isolate these individuals for the duration that is needed.

[00:03:54]Okay. U speaking of bio safety, um the WHO has confirmed at least four health workers have died. So in my reading, uh this strain does not have a specific treatment or approved vaccine. What precautions are your team taking? Yeah, as you note, Olive, um Ebola is sometimes known as the disease of compassion because the people that catch it the most are those caring for the positive patients, the nurses and and family members. So what's absolutely key for MSF teams and and all medical actors is that we have the correct uh personal protective equipment, that we have Ebola treatment centers that are set up correctly, that we can, as the professor said, identify cases, isolate patients, and treat them for for infections or other illnesses that they might have alongside the Ebola virus. The the news on on this particular virus is that the mortality rates are significantly lower than other strains. But as you know, there is no vaccine currently. Um and there is no um there is no treatment currently. But early detection and you know having a a strong system that can make these decisions is is going to be absolutely key. But no reason for panic at all. Mhm. I I I read that uh in fact the WHO uh uh said this that a tent a hospital uh um in it which is the epicenter of of this um outbreak.

[00:05:19]A tent was torched um some medical equipment was torched. So there is also the concern from that there's stigma >> right the community is scared. Um does that not also pose a threat to your team? It's absolutely key that that communities are engaged in a meaningful way. That health actors like MSF help communities understand what Ebola is and and what it isn't. I've worked on on many Ebola outbreaks and and bringing the community and helping them understand what the symptoms are and what to do in the case of of symptoms being present is really important. The thing about Western DRC about Eastern DRC, Western DRC, sorry, is as I mentioned, it's an active conflict, sorry, Eastern is that it is an active conflict with with a million people displaced. So, um, it makes that even more challenging. It makes getting the community on board even more challenging.

[00:06:11]>> Uh, Professor Anzala, um, I read that there's a 30 to 50% chance um of of dying once you contract um this virus.

[00:06:21]Is that accurate?

[00:06:23]>> Yeah. you you know there are uh six uh strains or uh variants of uh of Ebola.

[00:06:34]Ebola, Ebola Sudan, uh, Bondier, Thai forest, all these are strains that are very very uh, critical in terms of understanding and really you know from a healthcare point of of view any mortality is not necessary. People should not be dying from any mortality. So for me even saying that uh mortality is low is actually not good enough. We should actually have measures in place you know to be able to detect and give these individuals very high qualified supportive care so that they manage to actually recover and go back to normal.

[00:07:19]The reason why there is a lot of fear is actually when we talk of the word outbreak, we mention the word Ebola and from history, Ebola has been associated with the death and mortality. But that should actually not be the be the case with a a very well-trained health care system. these individuals who are diagnosed positive can actually given all can actually have given all the supportive care to be able to survive and actually not die you know from Ebola. So for me whether it is 10% or 5% or low percent from a healthcare point of view uh you you know when you withdraw yourself and say 10% and 5%.

[00:08:06]But for those individuals whose relatives and their colleagues have passed away, the figures don't mean what they see is restructured and mortality.

[00:08:19]>> Okay. So, Dr. I mean, Professor Anzala talks about um supportive care but in a conflict zone. How how easily have you been able to get supplies in and force isolation uh contact tracing? I imagine it complicates things.

[00:08:38]>> No, definitely. But uh MSF has been present in that area for for many years already. Um we had 480 uh staff already in in the area. We're bringing in um 50 over the next day or two 50 international staff. We've already landed uh planes that is bring that are bringing supplies. So we're able to get the equipment and supplies in that we need at the moment. But um yes, it is a challenge and we do need support with that.

[00:09:02]>> Mhm. Um so the out of this 480 you're bringing in 50. Have you had any health care workers um infected?

[00:09:11]>> No, not at this stage. But obviously that's why I was saying what's what's absolutely key is for health workers to have the correct protective personal personal protective equipment which is what we're bringing in 10 about 60,000 sets um of PPE. And we have um significant experience as MSF of working in numerous Ebola outbreaks as does the government of DRC. This is the 17th outbreak of Ebola in DRC. So they're well able to to manage it, but it is complex given the context. The other thing that people often forget in these outbreaks and everybody focuses on the Ebola is we need to focus on the regular health care that needs to be offered, the malaria, the um sexual and reproductive health. this often gets neglected and this can be you know as deadly as as the Ebola. So we really need to support the health services that are already fragile in this in this area in the first place.

[00:09:59]>> Okay. Professor um Anzala.

[00:10:03]So we've seen countries such as Rwanda take measures such as saying um any foreigners who've been in the DRC in the last 30 days will not be allowed entry into the country. They they've also said that there will be be there will be mandatory quarantine uh for 30 days for either Rwanda nationals or permanent uh residents who return uh to the country.

[00:10:24]Uh should Kenya be considering such a move? Because just yesterday um we heard the ministry of health say they will not be imposing a quarantine on on truck drivers for instance. What's your advice?

[00:10:38]You know with with enough training with enough knowledge and uh having learned from us as K2 you know closing borders is actually not the way to >> really is not the way to go. just put the right uh measures in place, counter measures in place ensuring that uh very good history is taken in terms of the travelers coming in and then also we are we can track where they are going within the country and uh we have ability to quickly move them to isolation should there be need to move these individuals to isolation. But you see once you begin to close border closing borders that's now what creates panic and also closing borders could actually mean that you are not well prepared to take care of it. The reverse is that what happens should there be an outbreak in Kenya you should there be an outbreak in Kenya would you want the reverse to be to happen as well. So really the idea here is to put stringent counter measures across the countries on both sides and that's why uh the aspect of looking at in country but actually looking at the region and enhancing border surveillance traveling and what have you becomes very very critical. But the issue of closing borders and putting people in quarantine unnecessarily is actually not there. the knowledge is available, staffs are trained and as our colleague has said if enough equipment should actually come in in terms of testing and healthcare workers who actually encounter these individuals for first time should be trained very well to have all the protective care to be able to protect themselves. So for me, yeah, if I were in a position to make a division, that's what I would actually do and just have heightened curve, heightened heightened curve and have also isolation units ready where individuals can actually go for isolation should the need arise.

[00:12:53]>> Okay. Um some you you indicated earlier that you've been involved in in other um outbreaks. Do you think there are lessons we can take this time round? I think similar to what the professor was just saying um we need contact tracing.

[00:13:07]We need communities to come forward when there are symptoms there. We need to be able to work with communities um closely. We need to not neglect existing medical issues and and that you know as the professor says there there are plenty of um histories of of how to manage this disease. Um, and it's it's bringing the community on board and and not creating panic and and being, you know, making sure that we're undertaking safe burial practices uh for those that do succumb to the disease. These are all things that we have lots of experience of and we'll we'll be replicating in DRC.

[00:13:39]>> Okay. Uh, Professor Anzala, how do we safeguard ourselves? Should we go back to the measures um we had in place when there was COVID? Should we now start wearing masks maybe when we're traveling? uh on public transport uh you know the personal what was it called personal face distance you know should we start maintaining that with other people should we stop shaking hands how do we protect ourselves >> okay okay you see uh interesting bit with Ebola is that we've not had yet any documented case of Ebola being spread uh through personalization or through maybe through high in infestation in the caves but in terms of human to human contactization has not actually been documented.

[00:14:31]However, having said that you know all bodily secretions for one somebody who is having high uh who is having Ebola all bodily secretions actually carry this virus.

[00:14:46]All right. So but the whole approach would be uh social distancing might not really be necessary at this point in time but what we need is very early warning sign to the community that if you have fever please move to the nearest health facility you know be checked out and let's get all these other things actually done. But on the issues of wearing a a mask, what I will say Olive is that SAS CO V2 has not gone away. Okay? It is still similar. So I will still advise individuals if you are in a public crowded place. My advice has always been a mask will do you well. But process CO2 that is in uh circulating. But the other point is hygiene.

[00:15:42]Constant washing of hand is actually critical for SAS V2 for Ebola as well because the surfaces where you know where there has been sweat secretions from individuals okay these places can actually be able to be transmitted. So hygiene cleanliness all these things actually become critical both in the community as well as in healthcare safety.

[00:16:09]>> Okay. Uh lastly for you um Prof. do we have the capacity to manage an outbreak should we find ourselves in such a position?

[00:16:18]>> I I I think yes from the experience that we were dead on in Tasco 2. There was a lot of training with healthare workers.

[00:16:28]Uh there was a you know a lot of capacity building at the borders and everywhere else in terms of border checks. And I know very well that in the last week or a week and a half uh the Kenya National Public Health Institute has already ramped up uh support in terms of uh training health care professionals again and ensuring that all the border points and other places where surveillance should be done are actually equipped. So what I can say now is that uh we should be able to take care of this but my advice going forward is that uh we should not always wait till we hear that there's an outbreak.

[00:17:09]We should always have a constant h approach where we do drills just in case you know way the way they do drills at the airport. We also need to constantly do drills and have teams, you know, that are ready, have teams that can actually be dispatched very very quickly should we hear that there's an unusual outbreak of a hemorrhagic problem elsewhere so that we don't always wait till there's a problem then we start training. But we have teams ready, teams trained that can actually be deployed very very quickly to this level as other things are actually are actually being done. That would actually be my push as we move forward because you can see there's a lot of the frequency is high. Not too long ago we had MBA at the border of Kenya and Ethiop in Ethiopia. There was Marbag in Tanzania. There was mak in in Rwanda very closely following each other. So having teams that are trained that can be dispatched doing drills on a regular basis is something that I should call for immediately.

[00:18:21]>> All right. Uh our take what's should be our takeaway as we conclude this conversation Sam? I think as the professor said rely on on you know reputable information sources be careful about um panicking because there's there's absolutely no need and um yeah if if uh Ebola does come then work with healthare workers and and report symptoms and uh it is a manageable disease with with the right support. All right, thank you very much Sam Taylor who is the director of communication and fundraising uh MSF which is medicine San Frontrontier doctors without borders.

[00:18:56]We've also been joined uh should I say virtually we didn't see him the the zoom connection was not quite stable but we did hear from him. Thank you so very much, Professor Omu Anzala, uh, professor of immunology and viology.

[00:19:08]We'll continue the conversation in the days to come. But as things stand, there has been no confirmed case in Kenya. Uh, seven tests were carried out. Three people uh who had traveled uh from the DRC getting into Kenya. So they were tested negative. Uh, four of their contacts were also tested negative. So that is the situation as it stands. But of course uh we are in a state of heightened surveillance and so are we.

[00:19:30]We take a break, but citizen weekend continues on the other side.