As the number of victims who have succumb to the Ebola virus steadily rises and more people become infected all over the world, one thing becomes very clear: the Ebola epidemic is a global crisis and every nation is concerned
This year in March, the West-African state of Guinea, reported an Ebola outbreak which quickly spread to the bordering countries of Liberia and Sierra Leone as well as a little further away to Nigeria. On August 08, the World Health Organization (WHO) declared the epidemic a “public health emergency of international concern.” According to the WHO, about 5,300 people have been infected with the deadly virus so far, 2,600 of them have already died. The declaration of the WHO indicates that the Ebola epidemic is not only a national or African crisis, but that the global community as a whole is affected and actively called to assist in fighting the further spread of the virus.
The international dimension of the outbreak becomes clear, if we look closer at how the virus spreads: like other viruses, the Ebola virus can be transmitted through human-to-human transmission via direct contact of the blood, secretions, organs or other bodily fluids of infected people and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. Unlike the common cold, it cannot be transmitted via airborne droplets. However, in its early stages, Ebola symptoms resemble strongly those of the common cold: infected patients have a sudden high fever, head and muscle pain, sensations of weakness and a sore throat. Subsequently, diarrhea, vomiting and skin eruptions follow, also gastrointestinal bleedings can occur, since the blood plates are reduced, resulting in the bleeding to death of the patient. The death rate of infected patients is 50-80%, making it one of the most deadly viruses which exists. Patients remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to seven weeks after recovery from the illness. In case of the current outbreak, it has been stated that the large majority of infected patients received the virus from other people. Often burial ceremonies in which mourners had direct contact with the body of the deceased person played a role.
However, not only the population in the affected regions is threatened, more and more cases of infected medical personnel and health-care workers are reported. Transmission is possible when precautions and infection control are not strictly followed. This has been occurring more often: the health-care workers, locals and delegates of international humanitarian organizations such as the Red Cross and Médecins Sans Frontières (Doctors without Borders), often have to work twelve hours or more per day in close contact with patients now that the epidemic has reached a new peak.
Subsequently they have become less strict with hygienic precautions. It is also often reported, that many hospitals are not equipped with the necessary tools to treat patients with Ebola, such as protective suits, rubber gloves, and surgical masks. Another problem is also the information communication with locals: the majority of the population in the affected countries still does not know how the Ebola virus is transmitted, how they can protect themselves from receiving it and how they have to treat infected patients. This has resulted in very harsh measures in order to prevent further infections: Sierra Leone’s government administered a three-day curfew aimed at containing the Ebola outbreak. It has been declared a success by authorities that said more than a million households were surveyed and 130 new cases discovered.
At this point in the crisis, the international community has to step in and send money for medical equipment, medication and skilled health-care workers. The health-care workers should not only help to treat infected patients, but serve with their expertise to train local hospital personnel. They could function as multipliers to enlighten the general public and prevent new infections since trustful medical workers, who have knowledge of the local cultures and tribes, are also very important. The German military last week agreed to send soldiers and equipment to assist in battling the virus. In addition, the Bundestag (the German parliament) scheduled a debate to determine how much financial help will be issued for the affected areas. The US has also announced an expansion of its help for the regions with medical supplies and military resources. President Obama offered to help Liberia in the construction of as many as 17 Ebola treatment centers in the region, with about 1,700 treatment beds.
Some of the infected international health-care workers, European and US citizens, were flown out to their home countries for treatment. This increases the risk of the spread of the virus to countries outside of Africa, although it has been rated as unlikely. However, recent developments show that the outbreak is more severe than estimated in the beginning, making it the worst outbreak since the discovery of the virus in 1976. In an interview with German news magazine Der Spiegel, the discoverer of the virus, Belgian infection researcher Peter Piot, admits that he “had never thought it would become this bad.” He now also fears that the epidemic could spread to other continents, by painting a possible scenario: “Many Indians live and work in Africa and could introduce the virus to India, when they return or visit home.” A large event planned in India has already been rescheduled: The India Africa Forum Summit (IAFS) slated for December 2014 has been postponed to next year.
The human-to-human transmission makes it difficult to control the spread of the virus, although in theory it could be simple to contain it: infected patients have to be isolated and dead bodies have to be buried immediately, to prevent further physical contact with non-infected people. Nevertheless, due to its high safety and hygienic standards, Western countries are well-prepared for incoming infected citizens: passengers with symptoms are already carted off at airports and remain under quarantine. Preparation and safety precautions are key, because hygiene is the only effective weapon to battle Ebola since no specific medication to cure the virus nor a tested vaccine exists.
Treatment focuses on alleviating symptoms such as fever, vomiting and diarrhea – all of which can contribute to severe dehydration. Last week, the Japanese government announced that they are willing to provide a new anti-influenza drug, which has not yet been approved by the WHO, but showed effective when tested on animals. It could be a possible solution for the shortage of ZMapp, a US-produced experimental drug, which showed good results on some Ebola patients, but without guarantee. The Japanese drug could be delivered fast in great quantities and if necessary, it could also be produced quickly, the Japanese government has announced.
The Ebola crisis shows the interconnectedness of not only people on different continents, but also the global exchange of resources and knowledge, which are necessary to fight it. The 2014 International Forum of the last Council on Business & Society, which met to discuss the global dimension of health and healthcare in Japan in March, highlighted how necessary this type of exchange is and searched for solutions how business schools support the health care industry in the face of new challenges such as the global Ebola epidemic.
For more information from the last forum, take a look at the 2014 Forum White Paper.
By Laura Miller, University of Mannheim, Business School
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