The number of Ebola cases in Sierra Leone could have been halved if treatment beds had been set up by the UK government and charities just one month earlier, a report claims.
The slow response of the World Health Organisation and others to the increasingly desperate pleas for help from people on the ground, especially Médecins sans Frontières, has attracted widespread criticism. Now researchers from the London School of Hygiene and Tropical Medicine have revealed how many could have been spared the disease if action had been taken sooner.
Between September 2014 and February 2015, Britain – which led the response in Sierra Leone – introduced more than 1,500 beds into Ebola holding centres and community centres and 1,200 beds into specialised treatment units, with the volunteer staff and equipment to run them.
Dr Adam Kucharski, lecturer in infectious disease epidemiology, and colleagues from the LSHTM said this massive intervention prevented 57,000 cases of Ebola, saving 40,000 lives. But if the help had arrived a month earlier, it would have halved the numbers who were infected. Taking only the officially reported cases, the WHO said 13,945 people were infected with the disease and became ill. The LSHTM team said that had the beds been available earlier, 7,500 of those would have been spared the disease.
“There has been much criticism of the international community’s slow response to the Ebola outbreak,” said study co-author Professor John Edmunds. “Our analysis suggests that putting treatment beds in place just one month earlier could have further reduced the size of the outbreak and potentially saved thousands of more lives. The way we prepare for, and respond to, future outbreaks of Ebola and other infectious diseases needs to be strengthened.”
The authors stressed that the UK action saved many lives and that the epidemic would have been much worse if treatment centres had not been built and staffed. “Our findings show the unprecedented local and international response led to a substantial decline in Ebola transmission,” said Kucharski. “Given the rapid growth of the outbreak in Sierra Leone, if those beds hadn’t been in place to isolate the ill and avert further infections, the epidemic could have been much worse.”
But Edmunds said it was essential that the public and governments understood that the earlier the response to a disease outbreak, the bigger the impact. “This is a lesson that is obvious from the mathematics, but not necessarily in real life,” he said. “One of the fundamental problems with this is that if you do respond early and well, then what happens afterwards is that people say all that money was spent and it was only a few hundred cases – what a waste of money. I think it’s quite a difficult message to get across.
“The UK government did respond well when the penny dropped. The response was as rapid as it could have been [once it began], and a lot of resources were put in, but it is getting that action to be much earlier in the first place [that is important].”
