The Road to Zero: CDC’s Response to the West African Ebola Epidemic, 2014–2015

December 22, 2019

Terrifying. Life-changing. Rapid. Unprecedented. It is impossible
to pick one word to adequately describe
the Ebola epidemic. From its origins in
Guinea early in the year, the Ebola virus caught the
world off guard, moving swiftly to neighboring Liberia and
Sierra Leone, claiming thousands of lives and requiring a
massive global response to help bring it under control. When we activated the
EOC on July 9th of 2014, it was a horrific situation. We knew that it was going to
get much much worse faster than we could respond. And whatever we did, whatever
we threw at the epidemic, we couldn’t turn it around. Early on we tried to, you know,
stick to the core principles of what we knew…that
it was contact tracing, it was case identification,
it was educating people about disease and
educating contacts to come to health care settings
for diagnosis or treatment should
they become ill. We are following the
ambulance you see ahead so that after these two cases are picked up we can do some
contact tracing. Cases in West Africa
escalated quickly and Americans faced
the harsh reality that infectious diseases
are just a plane ride away. Today, we are providing
the information that an individual traveling
from Liberia has been diagnosed with Ebola in the United States. I remember looking at the
results and thinking this is, you know, a very historical
moment, the first imported case of Ebola in the United States. In the fall of 2014, CDC set
key programs into action. Airport officials began
screening passengers from Ebola-affected countries, and those travelers were
monitored for 21 days. Experts worked around the
clock to help hospitals prepare to treat Ebola patients. We have 5,000 hospitals
in the United States, and so they’re not all going to have the exact same
personal protective equipment. So, in the past, CDC would
allow for some flexibility with regards to changes
in local protocols. What we learned with
Ebola is that we needed to be much more specific. I knew that making this
training really good could be an opportunity for us to regain
some of the confidence that I feel like we had lost when those nurses
got sick in Dallas. I could palpably feel the
tension in the room begin to go away as I went
through this talk and as we did this
demonstration. CDC sent their Ebola lab
experts to Sierra Leone to help rapidly detect cases;
this also lowered the chance of an infected patient showing
up in the United States. I think lab testing is critical
in any outbreak response. It’s very important to
get the positive patients into a treatment center, but
it’s also just as important to get the negative
patients out. A major challenge was
getting the cooperation from the West African community. People were afraid of
Ebola and skeptical of the foreigners
who had come to help. We needed to understand what
was driving the behaviors contributing to the outbreak, and then craft the right
communication messages to change those behaviors,
and then deliver ’em in a way that people could understand. As we moved into 2015,
there were signs of hope. When you can actually see
contacts being followed and patients being
discharged as survivors from Ebola treatment units
because they are coming in for early care, those
are the things that you see that can actually
give you some hope. Ebola has been a devastating
experience for many of us to see, to see death so up close
and personal, to see deaths that we couldn’t prevent. We’ve made great progress but
we can’t let down our guard. There will continue to be
cases and clusters of Ebola but an epidemic of
the kind we’ve had for the past year never
has to happen again. Over. It is a word
we can’t use… yet. The Ebola epidemic
highlights the need for strong public health
systems before outbreaks happen. CDC is establishing offices
in Liberia, Sierra Leone, and Guinea to help them
prevent future cases of Ebola and prepare for the
next health crisis.

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