The Center for Disease Control and Prevention hopes to send experts to the Congo in the coming weeks to train international and local staff in the fight against the Ebola rage that killed about 600 people and is nothing but under control, the director of the CDC said on Thursday in an interview.
Due to the worsening security situation, CDC experts would not have relied on the epicenter of the epidemic in parts of the eastern Congo conflict. Armed attacks against Ebola treatment centers in the province of North Kivu have increased in recent weeks. An attack took place a few hours before CDC director Robert Redfield and the general director of the World Health Organization Tedros Adhanom Ghebreyesus arrived last week as part of a delegation from the WHO to assess the situation on the ground . Another attack occurred on Thursday when an Ebola clinic was burned by people who set fire to a local official's house, according to reports.
Three CDC staff members are on a temporary mission some 200 miles south of the epicenter, in the city of Goma, the capital of North Kivu, Redfield said. If US security personnel give their approval, "we hope to significantly increase that team to increase that training," Redfield said in an interview. Government sources said the CDC hopes to send up to 10 people for temporary training assignments.
"This is a complicated answer," Redfield said. The epidemic, which is entering its eighth month, "is not under control" and is likely to last this year and in 2020, he said. "This is late in the epidemic and half of the cases are dead," he said, an indicator that an unusually high number of infected people are not identified when they fall ill.
When sick people do not go to clinics and treatment centers for help, "this is a disastrous indicator for an Ebola response," Redfield said. "This tells you that the community is not helping us. We need the community to become a key component of Ebola's response to public health."
During his trip to the Congo, Redfield said, he and the other officials arrived in an Ebola clinic Saturday after he was attacked by people trying to extort money from the facility. "There were bullet holes in the windows," he said. The police officer guarding the front was killed. Two nurses were injured. "But it didn't stop these workers from wanting to do their job," he said. But all of them, he said, raised concerns that "they don't feel safe at work".
Redfield spoke with the Washington Post after he and other US officials testified before a Senate group about the current epidemic, which took at least 932 people and killed 587. It was his first testimony before in Congress since his appointment a year ago.
The US assessment was much more sober than that offered by the head of the WHO. Tedros told reporters Thursday in Geneva that the Ebola epidemic can be completed in six months. He referred to several locations in North Kivu where the virus transmission stopped and noted that the number of new cases was cut in half by January, with an average of 25 new cases reported every week now compared to 50 all 39; beginning of the year. But he acknowledged that violence, disorder and community resistance remain challenges.
The Ebola outbreak in the Congo is the most serious since an Ebola epidemic expansion devastated three countries in West Africa between 2014 and 2016, killing more than 11,000. Ebola spreads through contact with the body fluids of its victims and is fatal in at least 90% of cases.
Eastern Congo was the site of some of the world's largest violence in the last quarter of a century, making effort to contain this enormously complicated outbreak of Ebola. The latest armed attacks forced Doctors Without Borders, known by its French acronym MSF, to withdraw from operating two of its Ebola clinics.
But some experts say that the response to public health is not keeping up with the worsening of the crisis.
Experts agree that the only way to contain the epidemic is through rapid identification and isolation of all cases and monitoring of the people they have been in contact with to make sure they can be offered an experimental vaccine against Ebola. Although nearly 90,000 vaccinations have probably slowed transmission speed, vaccinations have not stopped.
"A critical threshold has been exceeded in recent weeks: deliberate targeted violence is now targeting healthcare professionals," said Steve Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies. Violence appears to be linked to many factors, including the last controversial presidential election, he said.
"There is no plan B," Morrison said. "There is no high level diplomatic activism and it is unlikely to be so until the epidemic spreads to the major external urban centers. There is a need for something much larger and stronger, in external security, in political strength and community engagement. "
Although the CDC has deployed over 100 staff in the Congolese capital and neighboring countries and at the headquarters of the WHO in Geneva, its highly qualified Ebola experts have he was not allowed to line up at the epicenter due to the security situation.
"Right now we need well-trained experts in the field who have a profound experience in responding to the ebola and community resistance that often occurs during such epidemics," said Jennifer Nuzzo, a scholar of high level with the Johns Hopkins Center for Health Security. "The US government, especially the CDC, has no equal in doing this experience. We must find a way to enable them to go to the field safely to participate meaningfully in the response."
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