In West Africa has any effort been made to train survivors of this disease to care for victims?
It would seem they could move around more freely and easily and possibly be a valuable tool in the fight against theis disease. I realize education is a major issue over here but many of the duties required could most likely be taught rather quickly and they could continue to train while they worked. It would be a good source of income for them and even the training might prove valuabeonce ebola is brought under control in the region.
The idea has definitely been considered. The issue right now is that the immediate needs are so overwhelming that nobody is really up for experimenting right now.
I had a feeling this would play in as it does in nearly every aspect of our lives. Really a pet peeve of mine when things are done rushed and hurriedly because of immediate need. If I see a trend that is mushrooming I would tend to think the most pressing immediate need would be to develop a method for training and maintaining an efficent combat force against this disease.
There’s an immediate need for people to do the basic work of caring for the victims, hands-on. If survivors are immune to further infection, they are a priceless resource to be used in providing both better care and freeing more skilled workers from cumbersome full-suit care duties.
There is always the risk that these people could carry contaminated material away from the facility, after all they may not be at risk and so may not take the proper precautions.
It would need one heck of a lot of education and training, all this suggestion means is that those staff could not get the disease, it does not mean they cannot pass it on, and that is by far the greatest danger
From what I understand with proper protocal upon leaving a site this should not be a big issue, especially if they combined proper protocal with a short quaranteen just allowing surface contaminations to die off.
Well, outbreaks are usually short enough that there are no further victims needing care, so survivor recovery time is not of any particular essence.
This time is… different. It may be well to look to fully recovered survivors as general workers - and they could be paid a substantial wage for the service, by West African standards. Or even by Euro/US standards.
What sort of education and training do you think might be required or sufficient? As I understand it, the educational situation in many (but certainly not all) areas of Africa is that finding someone who can read and write at a 5th grade level, do basic math (±*/), and is willing to consider the fact that maybe having sex with virgins doesn’t actually cure AIDS is pretty tough. Are Ebola Survivor Care Workers going to need university degrees? University degrees in Nursing, Public Health, or Pre-Med? Just high school graduation or an equivalency? Just pass tests in basic literacy (see spot run!), basic patient care (how to move a patient, how to make a bed, how to clean a patient, how to clean beds, tables, and chairs, etc.), and Ebola trivia (no, you can’t get Ebola over the Internet, but you can get it from a laptop that an Ebola patient barfed on five minutes ago)?
It’s a great idea actually, but like many of the other posters say, there are details that would need to be fleshed out somewhat for it to become a workable strategy.
True, I would expect that a really and truly-o immune person wouldn’t be very likely to become contagious again - they would pretty much just have to deal with the virus particles that they are exposed to. They wouldn’t multiply very well, if at all, inside the person. So maybe a few days of quarantine where the person has to take industrial-strength showers every three hours and once daily doses of ipecac and a laxative to expel any viruses that might have been swallowed.
I’ve seen this all over the place in non-health workplaces. People talk about wanting to improve procedures, increase training, formally document existing knowledge, identify skill gaps, and try to predict and mitigate future problems. What happens is that people seem to always be busy trying to handle Today’s Emergency ™ that the future plans never get done. Right now many of us want to improve training to reduce the number of IT support calls (sometimes people just need to learn how to reboot their own damn server), but IT is too busy to set up or deliver training because the support desk is ringing 24/7 with “urgent” problems that should have been fixed yesterday. Oh, and everything is “high priority”. If you tell someone that their request will be handled after higher priority cases have been dealt with, you’ll reap the whirlwind.
For now, they are being trained to work with people who were potentially exposed (mostly children), not people already suffering from the disease. But it’s a great first step.
This is where it gets problematic. These places just aren’t equipped to provide showers and medicine. Decontamination will be a huge challenge.
A potential issue I could see is mental health. Someone who has fought a vicious disease and probably seen their friends and family suffer and die may not be ready to go back on the trenches. Some will, of course, but one of the founding principles of humanitarian aid is “do no harm,” and programs will need to be designed to ensure the health workers are not being harmed.
Which can be done, of course, but not probably not quickly.
Or maybe one of the conditions is that they have to stay in quarantine for an extended period of time. But maybe the pay they get from serving is enough compensation to get them to be willing to stay in the quarantine zone for the next six months. Maybe through some free broadband wifi in there too.
Thats is an interesting thought. Some may see it as an opportunity to fight the disease back and somehow give the tragedy a meaniful purpose in their lives.
After the tsunami, and again in Haiti, such an enormous amount of money poured in in shuch a short time that people tried all kinds of experimental programs based on little more than hunches and good intentions. Unfortunately, a lot of those had massive, massive unintended consquences, and harmed the very people they were meant to help. So the humanitarian community has become a lot more likely to stick to the tried and true when they are in the heat of the moment, and save more experimental approaches for times when there is more control and better monitoring, such that the learning can contribute to the next disaster.
The mental health aspect is just one way I thought of that it could go wrong. There are other ways- perhaps the previously infected hanging around sick people could make them seem to be the cause of the illness, leading to violence. I’m not ready to think of every way that it could go wrong. But the principal of “do no harm” is very much in effect, and reputable humanitarian programs are going to tread very carefully when it comes to trying new things in the “holy shit everything is out of control” phase of the emergency.
They are usually left generally weak for several weeks to months afterwards. They probably could provide some care, but would need more rest and would need shorter work shifts than a fully healthy volunteer.
Some people have lasting severe effects, which may be permanent, from vision problems to overall joint and body pains. These folks are, again, capable of some tasks but are disabled compared to people who are suffering from post-Ebola effects.
The most interesting question is whether people from prior outbreaks retain their immunity. If so, those are the people to recruit, assuming they’ve made a full recovery and aren’t suffering disabling side effects. Such people have been the objects of prejudice and fear in the past and so try to conceal their status as Ebola survivors, but in this context they may get an opportunity to be seen as heroes. If people don’t get hysterical and start thinking they could be sources of infection.
Have the worker wear a face mask to avoid accidental ingestion. Have the strip and shower thoroughly at the end of the work day and don new clothes. That should be all that’s needed. No need for 8 showers a day and an internal purge.
There may be merit in keeping them inside a quarantine zone just to maintain a certain level of discipline, and avoid accidentally carrying anything outside.