Introduction
The confirmation of the first Ebola case on the U.S soil occurred against a backdrop of growing concern about the readiness of America’s Medical community for a disease to become an epidemic. According to Riddel, the slip or the stagnated characteristic of the US medical community can be attributed to the challenging economic times and a growing malaise since the threat of anthrax in 2001 (Riddel). America’s premier for fighting and containing disease, the Centers for Disease Control and Prevention (CDC), provided an air of hope and confidence by declaring that the first case of an Ebola patient diagnosed in a Dallas Hospital was contained and handled carefully (CDC). The discovery of a second case of Ebola among the Dallas hospital staff that provided medication to the patient, concerns from the public increased on the ability of the United States’ health care system to properly respond and handle an epidemic. However, the increased cases of Ebola patients, the ignorance by health centers to diagnose and handle Ebola cases, and the recent death of an Ebola patient sounds less optimistic regarding the US being ready for a disease to become an epidemic.
History and background of the epidemic
The recent outbreak of Ebola in West Africa has claimed the highest number of lives since the discovery of the Ebola virus. According to Koba, currently the epidemic disease has claimed the lives of more than 4900 people in West Africa alone (Koba). It has disrupted the economies and communities in nations such as Liberia, Sierra Leone, Guinea and some other reported cases in the mentioned neighboring countries. Authorities, and US in particular has been deeply concerned on the ability of West Africa to prevent the spread of the disease which is claiming more and more lives every day (The White House). Furthermore, the mechanisms to contain the disease from its root origin has been hindered by several factors such as poor health systems and infrastcture, cultural practices among the local people, and stretched resourced and health personnel that have impeded the measures to control the disease (Keating).
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"Is our nation (USA) ready for a disease to become an epidemic?".
The current outbreak’s first case was reported in Guinea, in December 2013. However, the case was not initially identified until March 2014. The virus spread to the neighboring country of Liberia because of delays to initiate control measures and the common crossing of the border by citizens from both countries (CDC).
Outbreak of the Epidemic in the US and emergency of criticism.
After several months of severe outbreak of the Ebola epidemic, which had already claimed several lives in West Africa the response from the US and the World Health Organization is under attack. The US diagnosed its first case of Ebola and used testing drugs and the patient recovered. 42 year old, Thomas Duncan Eric from Liberia became the first person to die of the Ebola in the US during the last week of the expectedly deadly disease. Riddel argues that, efforts to contain, prevent, and control the disease to become an epidemic has been inferior, by and large (Riddel).
After the death of Duncan in October 8, 2014, local medical authorities faced a lot criticism for not diagnosing the victim early. According to Austin, Duncan had reported that he was ill and he had travelled from Liberia four days earlier. However, medics in the Dallas Hospital gave Duncan antibiotics and sent him home. After three days, Duncan was rushed to Texas Health Presbyterian Hospital and after two days, in September 30, he was officially diagnosed of Ebola by the Centers for Disease Control and Prevention (Austin).
After the death of Duncan, Texas Governor and a former presidential hopeful during the 2012 presidential race, Rick Perry, quickly touted the ability of the of the Lone Star State to control a disease with a potential of becoming an epidemic. During a press conference, he stated that (Riddel);
“Few places in the world are better equipped to handle an epidemic”.
However, his arguments were counteracted by Dr. David Lakey, the Texas Department of State Health Services Commission who said that;
“The chances of the disease spreading are very, very, very small”.
However, the efforts to quarantine Duncan in the Dallas Hospital have been questioned. With the emergence of new information, authorities have been questioned about the preparedness to handle a potential epidemic (Austin).
US not fully ready for a disease to become an epidemic.
Duncan’s case is a presentation of a large picture that the US medical system is not full ready for a disease ready to become an epidemic. For instance, it is now clear that the Texas Health Presbyterian Hospital in Dallas was not ready to detect Ebola (Riddel). This is evident by the actions and the fact that they gave Duncan antibiotics and sent him home after he clearly indicated that he had abdominal pain, and fever. Furthermore, Duncan had provided information to the hospital authorities and acknowledged that he had recently travelled from Liberia where he interacted with dozens of Ebola people (Goodwin).
Controlling the epidemic has faced several hurdles in the countries mostly affected by the epidemic, and the US in general. Recently, the World Health Organization has come under serious criticism regarding its response to the Ebola outbreak especially in West Africa. The U.N Agency has been criticized for its sluggish response to contain the spread of the viral epidemic (Keating). According to information provided by Mariano Lugli, the deputy director of Medecins Sans Frontieresto to Reuters, the World Health Organization has not been actively involved in coordinating the efforts to contain the spread of the virus in West Africa. Lugli noted that there were no any WHO representative in the meetings he attended regarding the epidemic (Reuters). WHO is entitled to coordinate the activities of containing the spread of the virus, but it is not doing as mandated (Copeland).
According to Keating (2014), several critics have been arguing that many stakeholders in handling the outbreak have failed. Some of the criticisms include, the failure and the slow response of the WHO experts in West Africa to send reports regarding the state of the epidemic to WHO headquarters in Geneva, the inability of medical doctors to gain access to the affected countries because of issues obtaining visas, and the bureaucratic obstacles preventing the response effort of $500000 getting to Guinea (Keating). During the rapid spread of Ebola in Guinea, Liberia, and Sierra Leone, the WHO disregarded the concerns and termed the outbreak as a relatively small epidemic despite the warning from MSF that the virus was beginning to get out of control. On the other hand, according to WHO officials, the body was overstretched by several health care issues in the West African region. The officials fault the poor health care systems infrastructure and the population in the poverty stricken West Africa region which is uncooperative. According Margaret Chan, WHO Director General, the role of the organization was to advise the affected countries on what to do but not run Ebola clinics. W.H.O has also been accused of being politicized. According to information from the insiders of the WHO, the organization is the most politicized U.N body. Governments are influencing its regional activities. For instance, its Brazzaville based, African bureau (AFRO) director is appointed by governments. He enjoys autonomy from Geneva since he has access to funds raised locally (Reuters).
In the US, the Center for Disease Control and Prevention had several major trend lines which included the congressional funding to enhance preparedness in public health emergency had reduced by $1 billion from its previous high. This happened shortly after the terrorist attack and anthrax attack in 2001 (Riddel). Furthermore, CDC pointed out that the health departments of the state and the local public which are mandated to be on the front line to respond to health emergencies have reduced 45700 jobs since the financial crisis in 2008 (Reuters). Furthermore, the concerns of unpreparedness are far much beyond the issue of financial resources. According to the report by the inspector general of the Department of Homeland Security regarding the issue of preparedness for an epidemic, he warned that the department was ill-prepared for an epidemic, with lack of resources and expired medicines to equip its top responders effectively in the field. According to CDC, the Department of Homeland Security does not have the capability to provide enough epidemic preparedness supplies to its personnel to continue operations in case of an epidemic. The inspector general of the department found out that the Homeland Security Department did not keep correct regarding the items purchased and received despite it being mandated with the task of ensuring the US is protected from dangerous threats (Riddel).
In addition of the to the preparedness concerns regarding the US health system, other concerns have been raised in other State agencies such as the capacity of overstrained Border Patrol agents to ensure immigrants are screened and the availability of sufficient tools to combat or detect a bioterrorist attack. For example, the sufficiency of the code named BioWatch, the premier bio-surveillance system for the federal government has been questioned by several government investigations (The White House).
In the wake of increased criticism regarding US’ response to the Ebola outbreak, the United States has deployed more than 130 civilian medical personnel, disaster response experts, and healthcare from various US government agencies and department to West Africa. The team is under the U.S Agency for international Development’s (USAID) Disaster Assistance Response Team (The White House). The team also comprises an estimated 350 U.S military personnel, making it the largest response team the U.S has ever deployed to tackle an international public health issue. The US had also provide several medical kits, and increased the number of testing labs in the region. In the near future, the US will scale up the presence of its military in West Africa to help in handling the issue by overseeing the development of various health centers and to train the local health care personnel on how to safely handle Ebola patients. Domestically, the US has beefed up its efforts to prevent the epidemic by enhancing its laboratory testing and surveillance capacity to detect cases. The government has also directed the diagnostic test drugs to be used in treating Ebola patients. The US has also increased efforts of screening passengers especially those coming from the West Africa region (The White House).
