 |
President Barack Obama gestures while speaking at an event with American
health care workers fighting the Ebola virus,
Wednesday, Oct. 29, 2014,
in the East Room of the White House in Washington. (AP Photo/Evan
Vucci) |
October 30, 2014 - THE EBOLA OUTBREAK - Pushing to confront
Ebola at its West African source, President Barack Obama said Wednesday
the United States was not immune to the disease but cautioned against
discouraging American health care workers with restrictive measures that
confine them upon their return from the afflicted region. "We can't
hermetically seal ourselves off," he declared.
Obama
said doctors and nurses from the United States who have volunteered to
fight Ebola in West Africa are American heroes who must be treated with
dignity and respect.
His remarks came amid
debate between the federal government and several states over how
returning health care workers should be monitored. The White House has
pushed back against overly restrictive measures, including proposals for
travel bans or isolation measures adopted by some states.
"Yes,
we are likely to see a possible case elsewhere outside of these
countries, and that's true whether or not we adopt a travel ban, whether
or not you adopt a quarantine," Obama said from the White House,
surrounded by health care workers who have volunteered or will volunteer
to serve in Liberia, Sierra Leone or Guinea, where the disease has
killed nearly 5,000.
"We have to keep in mind
that if we're discouraging our health care workers, who are prepared to
make these sacrifices, from traveling to these places in need, then
we're not doing our job in terms of looking after our own public health
and safety," he added.
Obama did not mention
any specific case, but a nurse who treated Ebola patients in West Africa
and has shown no signs of the disease was isolated in a hospital tent
in New Jersey and now is abiding by a voluntary quarantine in her home
state of Maine. The nurse, Kaci Hickox, said Wednesday that she planned
to defy those guidelines if the state's policy didn't change by
Thursday.
The White House has argued that
stricter measures adopted by states such as New Jersey and New York
could hurt efforts to recruit doctors and nurses to volunteer their
services in West Africa. The federal government's guidance says only
health care workers who have been exposed to Ebola directly, such as
through a needle pin prick or by not having adequate protection, should
face isolation.
Still, the Pentagon announced
guidelines Wednesday that said U.S. troops returning from Ebola response
missions in West Africa will be kept in supervised isolation for 21
days. Obama has said the military's situation is different from that of
civilians, in part because troops are not in West Africa by choice.
White
House spokesman Josh Earnest rejected suggestions that the policies
employed by the Pentagon and states that are stricter than guidelines
from the Centers for Disease Control and Prevention conveys a mixed
message to the American public.
"The fact of
the matter is, those differences in application of the policy have not
interfered with the ability of the federal government to coordinate with
them as these policies are implemented," he said.
The
president was introduced by Dr. Kent Brantly, who was infected with
Ebola while working in Liberia and was successfully treated in the
United States.
Ahead of his appearance, Obama
met in the secure Situation Room with his public health and national
security team on the government's Ebola response.
Obama's
Ebola response coordinator, Ron Klain, was planning his first visit to
the CDC in Atlanta on Thursday. The White House said Klain would meet
with Director Dr. Tom Frieden and other senior CDC officials. -
AP.
Americans may still see some Ebola cases, Obama says
President
Barack Obama
said on Wednesday that Americans may continue to see individual cases
of Ebola in the United States until the outbreak in West Africa is
contained.
Obama said it was essential the United States and other countries work to stop the Ebola outbreak at its source in Africa.
Until
the outbreak is stopped, he said, "we may still continue to see
individual cases in America in the weeks and months ahead."
"We can't hermetically seal ourselves off," he said at the White House.
He said the U.S. healthcare system is proving to be well capable of handling those Americans who have contracted Ebola. -
Reuters.
If Ebola batters US, we are not ready, as small clusters of cases could overwhelm system
 |
FILE-
In this Oct. 24, 2014, file photo, members of the Department of
Defense's Ebola Military Medical Support Team dress with protective gear
during training
at San Antonio Military Medical Center in San Antonio.
Even small clusters of Ebola cases could overwhelm parts of US medical
care system, according to an
Associated Press review of readiness at
hospitals and other components of the emergency medical network. (AP
Photo/Eric Gay, File) |
The
U.S. health care apparatus is so unprepared and short on resources to
deal with the deadly Ebola virus that even small clusters of cases could
overwhelm parts of the system, according to an Associated Press review
of readiness at hospitals and other components of the emergency medical
network.
Experts broadly agree that a
widespread outbreak across the country is extremely unlikely, but they
also concur that it is impossible to predict with certainty, since
previous Ebola epidemics have been confined to remote areas of Africa.
And Ebola is not the only possible danger that causes concern; experts
say other deadly infectious diseases - ranging from airborne viruses
such as SARS, to an unforeseen new strain of the flu, to more exotic
plagues like Lassa fever - could crash the health care system.
To
assess America's ability to deal with a major outbreak, the AP examined
multiple indicators of readiness: training, manpower, funding,
emergency room shortcomings, supplies, infection control and protection
for health care workers. AP reporters also interviewed dozens of top
experts in those fields.
The results were
worrisome. Supplies, training and funds are all limited. And there are
concerns about whether health care workers would refuse to treat Ebola
victims.
Following the death of a patient with
Ebola in a Texas hospital and the subsequent infection of two of his
nurses, medical officials and politicians are scurrying to fix
preparedness shortcomings. But remedies cannot be implemented overnight.
And fixes will be very expensive.
Dr. Jeffrey
S. Duchin, chairman of the Public Health Committee of the Infectious
Diseases Society of America and a professor of medicine at the
University of Washington, said it will take time to ramp up readiness,
including ordering the right protective equipment and training workers
to use it. "Not every facility is going to be able to obtain the same
level of readiness," he said.
AP reporters
frequently heard assessments that generally, the smaller the facility,
the less prepared, less funded, less staffed and less trained it is to
fight Ebola and other deadly infectious diseases.
"The
place I worry is: Are most small hospitals adequately prepared?" said
Dr. Ashish Jha, a Harvard University specialist in health care quality
and safety. "It clearly depends on the hospital."
He
said better staff training is the most important element of preparation
for any U.S. Ebola outbreak. He believes a small group of personnel at
each hospital needs to know the best procedures, because sick people are
likely to appear first at medium-size or small medical centers, which
are much more common than big ones.
Jha pointed to stepped-up training in recent weeks but wondered, "Will it be enough? We'll find out."
A
high ranking official at the U.S. Department of Health and Human
Services said Wednesday that the government does not expect every
hospital in America to be able to treat an Ebola patient, but "every
hospital has to be able to recognize, isolate and use the highest level
of personal protective equipment until they can transfer that patient."
"The
moment anyone has an Ebola patient, (the U.S. Centers for Disease
Control and Prevention) will have a team on the ground within a matter
of hours to help that hospital," Dr. Nicole Lurie, the HHS assistant
secretary for preparedness and response, said Wednesday. She
acknowledged "some spot shortages of personal protective equipment" but
said many kinds "`are still pretty widely available" and that
manufacturers are ramping up production.
AN OVERTAXED EMERGENCY CARE SYSTEM
Without
any stress caused by Ebola cases, the emergency care system in the U.S.
is already overextended. In its 2014 national report card, the American
College of Emergency Physicians gives the country a D-plus grade in
emergency care, asserting the system is in "near-crisis," overwhelmed
even by the usual demands of care.
According to
data from the Centers for Medicare & Medicaid Services, patients
spend an average of 4 1/2 hours in emergency rooms of U.S. hospitals
before being admitted. The data also show that 2 percent of patients
leave before even being seen.
In a CDC study on
hospital preparedness for emergency response in 2008, the latest data
available, at least a third of hospitals had to divert ambulances
because their emergency rooms were at capacity.
Add
an influx of people with Ebola, along with those who fear they might
have the disease, and the most vulnerable segments of the health care
system could wobble.
"Even though there have
been only a couple cases, many health systems are already overwhelmed,"
said Dr. Kenrad Nelson, a professor at Johns Hopkins Bloomberg School of
Public Health and former president of the American Epidemiological
Society, referring to new federal procedures for screening, tracking and
treating the disease and people who are exposed. He added that if a
major flu outbreak also occurred, "it would be really tough."
"We're
really going to have to step up our game if we are going to deal with
hemorrhagic fevers in this country," said Lawrence Gostin, a global
health law expert and professor at Georgetown University.
How big of an outbreak would it take to overpower the U.S. health care system?
"It
would have to be only a mediocre outbreak," said Gostin. "The hospitals
will be flooded with the `worried-well.' People with influenza or other
infections that are not Ebola could jam up the public health system."
One
federal study on emergency room visits indicated that at least 4
percent of visits involved patients with fever - a common symptom of
Ebola. Combining fevers with stomach pain, headaches and coughs, about a
fifth of emergency visits involve symptoms often seen in Ebola
patients.
A doctor who had recently treated
Ebola patients in West Africa came into Bellevue Hospital in New York
City last week with a fever and gastrointestinal symptoms. In announcing
the man had been placed in isolation, officials pointed out how his
symptoms also could be consistent with salmonella, malaria or the
stomach flu.
Last Thursday, the doctor tested positive for Ebola.
UNEVEN LEVEL OF PREPAREDNESS
National
surveys have repeatedly found that while most health care providers are
willing to care for people with dangerous diseases like Ebola, they
generally feel unprepared to do so.
This
summer, health care research group Black Book Rankings sought opinions
from hospital administrators, doctors and nurses at all U.S. hospitals
and health care facilities about infection control, emergency planning
and disaster readiness regarding Ebola. Nearly 1,000 personnel at 389
facilities, including 282 hospitals, participated.
Personnel
at almost all hospitals in the Black Book survey said their facilities
were not capable of quarantining large numbers of people possibly
exposed to Ebola.
Nearly three-quarters of
emergency doctors and four in five infection specialists at large
hospitals felt their facilities were not adequately prepared to deal
with Ebola patients.
Hospital administrators
and medical staff had widely divergent perspectives on their facilities'
ability to treat the disease. Among medical staff at big hospitals,
nearly all who participated in the survey believed their hospitals were
not adequately staffed and trained for Ebola patients. About two in
three of administrative and financial staff shared that worry.
Among
emergency nurses, nearly all worried about the impact of emergency
department crowding on the ability to deal with Ebola patients; just
more than half of administrative and financial managers felt that way.
Other
striking results: Personnel at only 1 percent of surveyed acute care
hospitals said they can handle more than 10 Ebola patients at once. That
was true at just about one-quarter of academic medical centers.
A
demonstrated weakness of U.S. hospitals in controlling other
hospital-acquired infections also suggests a soft spot in Ebola
readiness. In 2011, the most recent year of data, about 75,000 hospital
patients with health care-associated infections died during their
hospitalizations, according to a national CDC survey published this
year. Such infections are considered to be a proxy to measure hospitals'
readiness to contain Ebola.
Added Douglas
Brown, managing partner at Black Book: "We got a lot of feedback that
community hospitals aren't the place for Ebola patients to come." -
AP.
Uproar over US troops' Ebola quarantine in Italy
 |
| U.S. troops at the Vicenza base. Photo: Edward Braly/HO US Army/AFP |
The
decision to put a dozen American soldiers returning from Liberia into
quarantine for Ebola at their base near Venice rather than in the United
States sparked controversy in Italy on Wednesday.
"They
shouldn't have been sent here, they should do their quarantine for Ebola
at home," said the president of the region's assembly, Luca
Zaia, insisting "it would have been more respectful" of the United
States to have "thought about the risks posed to local citizens".
The
Messaggero daily spoke of fears among the local population, with a
rise in the number of calls to the emergency services from worried
citizens.
Soldiers from the base being given a wide berth in nearby pubs.
Zaia,
a member of the anti-immigrant Northern League party, was not the only
one to object to the US decision to quarantine the soldiers in Italy.
"The
government must send all the US soldiers back to Washington,"
the anti-establishment Five Star party said, according to media reports.
Not
only was information about the current state of health of the
soldiers "limited to general reassurances from the American
authorities", but there were fears other soldiers on the base "may have
been in contact" with those returning from west Africa, they said.
The
San Bortolo hospital in Vicenza has prepared a special isolation
unit within its department for infectious diseases, with five beds ready
for eventual Ebola cases.
The commander of the US military
mission in Liberia, Major General Darryl Williams, began 21 days of
isolation at the base in Vicenza along with 11 other members of his
staff after returning from west Africa this week. None of them currently
shows Ebola symptoms.
Another 35 American soldiers are expected
to return from west Africa on Wednesday to the northern Italian base,
where they will be put in isolation as well.
West Africa is the
epicenter of the Ebola outbreak which has claimed the lives of nearly
5,000 people. The often deadly virus is spread only through direct
contact with the bodily fluids of an infected person showing
symptoms such as fever or vomiting. -
The Local.
11 People in Delaware Monitored for Ebola-like Symptoms
Delaware
Gov. Jack Markell, joined by the state's top health officials, along
with infectious disease and emergency response experts, announced
Wednesday that 11 people in the First State are currently being
monitored for Ebola-like symptoms. It was part of the ongoing statewide
efforts in response to the Ebola virus epidemic.
"We are facing
an unprecedented situation with the Ebola virus, making prevention and
preparation efforts vital," Markell said. "While the risk of
transmission in Delaware is low, the state has been preparing for the
potential of any Ebola cases for months to ensure we are in the best
possible position to keep the public safe."
While there are no
cases in Delaware and the risk of transmission is low, the Division of
Public Health, which is part of the Department of Health and Social
Services, said it is working to ensure the appropriate screening tools
and disease prevention strategies are used to further reduce any chance
of transmission. These tools and strategies are based on the best
currently available science, which tells us that Ebola virus is only
transmitted by infected patients who have symptoms. The risk of getting
the disease through normal, everyday contact is extremely low.
Authorities
said the DPH is in direct contact with these people to check their
health status and will remain so for a 21-day period following their
last potential exposure.
"We've got a lot of people from
different agencies working on it. Based on the available information, we
believe this is the appropriate approach," Markell said.
DPH
said it is working closely with hospitals, medical providers, EMS
companies, and many other partners to prepare, coordinate care, and
provide advice and guidance. Issues being addressed by this group
include how to screen for the disease, safe ambulance transportation of
potential Ebola patients, personal protective equipment guidance and
availability, hospital readiness, infectious disease monitoring, and
protocols for any doctor's office that might see a case.
"Delaware's
hospitals know that the best way to address Ebola is to prevent its
spread. The division's approach to doing that is sound, science-based,
and will help protect both Delawareans and the health care professionals
who care for them," said Wayne Smith, president and CEO of the Delaware
Healthcare Association.
In addition, the governor has directed
engagement from all cabinet-level agencies to ensure statewide efforts
are coordinated and comprehensive.
"If a case is confirmed in
Delaware, a Centers for Disease Control and Prevention rapid response
team would be on the ground to assist us," said Secretary Rita Landgraf.
"They would support the Division of Public Health to trace any
potential contacts who might need to be monitored, have activity
restrictions or, although unlikely, be quarantined. The CDC also would
work with the State and the hospitals to determine if the ill patient
should be moved out of state for treatment."
In coordination with
the Centers for Disease Control and Prevention, the DPH is receiving
notice of all travelers from the three West African countries, Sierra
Leone, Guinea, and Liberia.
DPH said that currently there are 11
individuals in Delaware who are considered low-risk who are being
monitored. Eight live in New Castle County and three live in Kent
County. "Low-risk" is defined as having no known direct contact with a
person infected with the Ebola virus.
DHSS urges people not to
make assumptions that someone might be infected based on their accent,
background or skin color, and it is important to remember how hard the
disease is to transmit.
If you wish to discuss a suspected case,
you may contact DPH 24/7 at 888-295-5156, including weekends and
holidays. If you have general questions, the CDC has a 24/7 line
available for information on the Ebola virus at 800-CDC-INFO
(800-232-4636). -
WBOC.
‘I will go to court to attain my freedom’ – Maine nurse rejects quarantine over Ebola
 |
| AFP Photo / Bryan Thomas |
The American nurse who is being quarantined against her will after
returning from a mission in West Africa says she may sue officials in
the state of Maine if they refuse to lift the restrictions they’ve
imposed.
Kaci Hickox, the nurse, told ABC’s “
Good Morning America” on Wednesday this week
that she will soon outright reject the state’s attempt to keep
her isolated, despite the requests from officials who fear that
allowing the woman out of a Fort Kent, ME residence could lead to
an Ebola outbreak.
“I will go to court to attain my freedom,” Hickox told
the television network Wednesday morning during an interview
conducted over Skype.
"I don't plan on sticking to the guidelines," Hickox
added that same morning during an interview with NBC’s “Today”
show.
''I remain appalled by these home quarantine policies
that have been forced upon me even though I am in perfectly good
health."
Maine Governor Seeks to Force Nurse to Observe Quarantine
In response, Maine Governor Paul LePage said Wednesday that state
health officials are seeking
“legal authority to enforce the
quarantine,” the
New York Times reported.
“We hoped that the health care worker would voluntarily
comply with these protocols, but this individual has stated
publicly she will not abide by the protocols,” LePage said
in a statement.
“We are very concerned about her safety and
health and that of the community. We are exploring all of our
options for protecting the health and well-being of the health
care worker, anyone who comes in contact with her.”
Hickox, 33, arrived in the United States last week after
volunteering in Sierra Leone with Doctors Without Borders, and
became the first person forced to adhere to new mandatory
quarantine rules put in place in New Jersey amidst the worst
Ebola outbreak in history when she landed at Newark Liberty
International Airport on Friday. Although Hickox has yet to
exhibit any symptoms of the oft deadly disease, officials in New
Jersey confined her to a tent when she arrived in the US in
accordance with mandatory quarantine guidelines announced the
same day she returned from West Africa. When she was finally
released on Tuesday this week and arrived in Maine, she was asked
to stay isolated as long as it’s possible for her to exhibit
symptoms — upwards of 21 days since her last contact with an
Ebola patient.
Currently, Hickox is confined to the off-campus home of her
boyfriend, a nursing student at the University of Maine at Fort
Kent, according to the
Associated Press.
"I have been completely asymptomatic since I’ve been here. I
feel absolutely great,” she said Wednesday.
Nevertheless, officials in Maine want the woman to stay isolated
for the full three weeks, which may prompt her to pursue legal
action.
"We do not want to have to legally enforce an in-home
quarantine. We are confident that the selfless health workers,
who were brave enough to care for Ebola patients in a foreign
country, will be willing to take reasonable steps to protect the
residents of their own country. However, we are willing to pursue
legal authority if necessary to ensure risk is minimized for
Mainers," Maine Department of Health and Human Services
Commissioner Mary Mayhew told ABC News on Tuesday.
“We acknowledge that this protocol may go slightly beyond the
federal guidelines," she said, but called it a
"common-sense approach."
“The standard is, does Kaci have an infectious disease or
agent? Is she harboring an infection?” Steven Hyman, an
attorney for the nurse, said during Wednesday morning’s
broadcast.
“The answer is no. Medically, there is no basis to
quarantine Kaci at this point in time.”
"Our position is very simple. There's no justification for
the state of Maine to quarantine her. She has no symptoms and
therefore she's not contagious. And she's not at a risk to the
public or the health and welfare of people in the state of
Maine," added Norman Siegel, who is also representing the
woman.
"I am not going to sit around and be bullied by politicians
and forced to stay in my home when I am not a risk to the
American public," Hilkox said this week. Additionally, she
says she’s concerned that enforcing such restrictions will hurt
the efforts of American health workers who may want to travel to
West Africa to aid Ebola patients as she had.
“I remain really concerned by these mandatory quarantine
policies for aid workers,” she said.
"I think we’re just
only adding to the stigmatization that, again, is not based on
science or evidence.”
Meanwhile, US Secretary of Defense Chuck Hagel said on Wednesday
that the American troops deployed to West Africa to assist with
combating Ebola will be subjected to a 21-day quarantine upon
returning home. -
RT.
Released Ebola Nurse Kaci Hickox Works For CDC… Her Lawyer Is A White House Visitor
Ebola
health care worker Kaci Hickox, who was released from quarantine with
the support of the White House, is a Centers For Disease Control and
Prevention employee, records reveal. The lawyer who helped earn her
release is a recent White House state dinner guest.
Hickox was
released from Ebola quarantine in Newark, N.J., Monday afternoon after
the White House pressured New Jersey Gov. Chris Christie to release the
nurse that was working in Sierra Leone with Doctors Without Borders.
Hickox’s case for release was also bolstered by New York civil rights
attorney Norman Siegel, who took on Hickox’s case.
“I feel like my
basic human rights have been violated,” Hickox said before she was
evaluated by CDC and transported back to her home in Maine.
Here’s
an overlooked factor that could have contributed to her White
House-backed release: Hickox is an official CDC Epidemic Intelligence
Service (EIS) officer who performed work for the CDC in recent months.
Hickox was a Class of 2012 member of CDC’s two-year EIS officer training program, according to
the official program
for CDC’s 2014 EIS Conference (p. 98), which was held from April 28 to
May 1, 2014.
Hickox was featured in a photograph in the program.
Hickox was listed as an “EIS officer” for the CDC
in program materials
for a CDC course she taught in July 2014. She was specifically listed
as an active “EIS officer” as recently as July 18, 2014, according to
CDC documents.
Hickox was a presenter at the CDC conference this spring, according to the program’s list of presenters (p. 103).
Hickox
taught an April 29 session called “Contact Investigation of Health Care
Personnel Exposed to Maternal and Neonatal Tuberculosis—Clark County,
Nevada, 2013″ at the conference (p. 3). -
Daily Caller.
Ebola doctor ‘lied’ about NYC travels
 |
New York City police officers enter the building where Dr. Craig Spencer
(inset with fiancée Morgan Dixon)
lives in New York on Oct. 24. Photo:
Reuters/Mike Segar |
The city’s
first Ebola patient
initially lied to authorities about his travels around the city
following his return from treating disease victims in Africa,
law-enforcement sources said.
Dr. Craig Spencer at first told officials that he isolated himself in his Harlem apartment — and didn’t admit he
rode the subways, dined out and went bowling until cops looked at his MetroCard the sources said.
“He
told the authorities that he self-quarantined. Detectives then reviewed
his credit-card statement and MetroCard and found that he went over
here, over there, up and down and all around,” a source said.
Spencer
finally ’fessed up when a cop “got on the phone and had to relay
questions to him through the Health Department,” a source said.
Officials
then retraced Spencer’s steps, which included dining at The Meatball
Shop in Greenwich Village and bowling at The Gutter in Brooklyn. -
NY Post.
California issues quarantine policy for Ebola exposure
Anyone
arriving in California from an Ebola-affected area and who has had
personal contact with a person infected with the deadly virus will be
quarantined for 21 days, according to an order issued Wednesday by the
state's public health director.
The order provides a
more nuanced set of guidelines to assess the risk associated with people
returning from regions afflicted by an Ebola outbreak -- currently
Sierra Leone, Liberia and Guinea -- than the controversial blanket
quarantines in New Jersey, New York and Maine.
In California,
county health officials will have the ability to screen passengers
arriving from Ebola-stricken regions in West Africa, or who have worked
with infected patients, to determine if they’re at risk for the disease
and if they should be quarantined for the virus' three-week incubation
period.
Failure to comply with a quarantine order could result in misdemeanor criminal charges.
“This
order will allow local health officers to determine, for those coming
into California, who is most at risk for developing this disease, and to
contain any potential spread of the disease by responding to those
risks appropriately,” department director Dr. Ron Chapman said in a
statement.
Anyone who arrives in California from regions where an
outbreak is active, but who has not come in contact with an Ebola
patient, won’t be quarantined under the guidelines, the California
Department of Public Health said in announcing the mandate. Health
workers will screen passengers on a case-by-case basis.
The
announcement comes after strict quarantine rules mandated by East Coast
governors for returning healthcare workers from West Africa are facing
heavy criticism. -
LA Times.
Insurance companies start writing ‘Ebola exclusions’ into policies
 |
| AFP Photo/Simon Maina |
As Ebola spreads further from its current epicenter in West Africa,
American and British insurance companies have started to adjust their
standard policies for hospitals and other vulnerable businesses to
exclude the virus.
According to insurance industry insiders, companies needing to
insure business travel to West Africa or to cover losses
following a quarantine may now deal with revamped policies that
will likely increase in price based on the latest
Ebola
outbreak, which has killed nearly 5,000 people in West
African countries like Liberia, Guinea, and Sierra Leone.
"What underwriters are doing at the moment is they're
generally providing quotes either excluding or including Ebola -
and it's much more expensive if Ebola is included," Gary
Flynn, an event cancellation broker at London’s Jardine Lloyd
Thompson Group Plc, told Reuters.
Ebola has had less impact on liability insurance. For instance,
in the US, policies that cover the likes of worker’s compensation
claims are regulated on the state level. Thus, Ebola exclusions
are not likely, according to Reuters.
Property and casualty insurers, though, have more at stake and
are taking into account the possibilities of heightened Ebola
infections.
ACE Ltd told Reuters that its global casualty unit, used for US
companies to insure employees who travel abroad, was excluding
Ebola on a
“case-by-case basis” while underwriting new
policies and renewals for some clients with operations in Africa,
since there is a
"potentially higher risk exposure.”
“Business interruption” may be getting the most
attention, according to Tony DeFelice, managing director of Aon
Risk Solutions' national casualty practice in the US. Such
interruptions include possible loss of employees to illness, or
quarantine of an airliner or cruise ship due to a case of
suspected Ebola or other sickness.
Special policies are being introduced to adequately address
Ebola-era business interruption (BI) claims, as those are only
triggered with direct physical damage to property, according to
insurance broker Marsh.
"This means that without special provisions - for example,
manuscripted wording to broaden coverage - healthcare providers'
property insurance and BI policies would likely not be triggered
based solely on the presence of Ebola," Marsh said this
month.
Meanwhile, Miller Insurance Services LLP and William Gallagher
Associates have worked with Lloyd's of London underwriter Ark
Syndicate to launch the first product to insure Ebola-stricken
hospitals that may incur losses.
Another company, Aon PLC, has created an
“Ebola task
force” to monitor how the virus is or is not spreading in
order to help clients prepare for risks. -
RT.
Health officials: Ebola infections may be declining in Liberia
 |
Health workers unload the lifeless body of a man, as they carry him to a
grave site, after he is suspected of contracting
the Ebola virus on the
outskirts of Monrovia, Liberia. |
The
rate of new Ebola infections in Liberia appears to be declining and
could represent a real trend, the World Health Organization said
Wednesday, but the epidemic is far from over.
There are empty
beds in treatment centers and the number of burials in the country has
declined, Dr. Bruce Aylward, the assistant director-general for WHO,
told reporters. He said there may be as much as a 25 percent
week-on-week reduction in cases in Liberia. But experts are still trying
to ensure their data is reliable.
Throughout the Ebola outbreak,
WHO has warned that its data have been incomplete and the number of
cases are likely vastly underreported. That is still a concern, Aylward
said, but the trend nonetheless appears to be real.
So far, more than 13,600 people have been sickened in the outbreak, which has hit Liberia, Guinea and Sierra Leone hardest.
"The
epidemic (in Liberia) may be slowing down," he said. But he cautioned:
"A slight decline in cases in a few days versus getting this thing
closed out is a completely different ball game."
Liberia's Red
Cross said Tuesday that teams collected 117 bodies last week from the
county that includes Monrovia, down from the high of 315 in September.
Benoit
Carpentier, a spokesman for the International Federation of the Red
Cross, warned that it was too early to celebrate those numbers, saying
Ebola outbreaks come in waves. He noted that Red Cross figures show
deaths are still increasing outside Monrovia.
Several times
throughout this outbreak, including in Liberia, officials have thought
the disease's spread was slowing, only to surge again later. They have
often blamed those false lulls on cases being hidden because people were
too afraid to seek treatment, wanted to bury their relatives themselves
or simply weren't in contact with authorities.
Aylward said that this is not the time to let up: The response has to continue going full bore.
"I'm terrified the information will be misinterpreted," he said, and the international response will slow.
Aylward said the danger now "is that we will end up with an oscillating pattern where the disease moves up and down." -
KATU.
In Ebola Crisis, New Vaccine Candidates Show Uncertain Promise
In the race for an Ebola vaccine, the clear front-runner is the
virus, which is expected to spread to tens of thousands of people in the
coming weeks. But new competitors are now gearing up for human trials,
and eventually the tables could turn. In the long run a vaccine could
prove extremely important if, as some predict, the virus causing the current outbreak in West Africa will remain in circulation as a low-level “endemic” disease indefinitely.
The latest entry to the race comes from the Maryland-based Novavax. On Sunday, a representative from the company told participants at a major vaccine meeting in Philadelphia that they’d achieved immunity in mice using a vaccine based on a synthetic delivery system called a nanoparticle.
The big selling point the company emphasized is that the Novavax
product is the only one designed to target the exact strain of Ebola
that’s currently raging through West Africa. Experts disagree over
whether this fact will make a difference because the parts of the virus
that are relevant to vaccines are nearly identical across strains.
 |
Illustration showing the Ebola virus-encoded glycoprotein trimers (pink)
embedded in the host cell’s lipid bilayer (gray). Novavax Ebola virus
vaccine is
based on recombinant GP trimers separated from host cell
lipids and other contaminants forming multi-GP trimer protein
nanoparticles. |
On the other hand, scientists working on the Ebola problem
acknowledge they are in new territory and can’t be sure what will and
won’t work until human trials are carried out.
The terminology describing strains and species of Ebola can cause
some confusion. There are five species – the current outbreak being
caused by a species known as Ebola Zaire. Within that species are
several different strains. Biologists have analyzed genetic material from the strains
and found that evolution has led to some variation. What that variation
means and how it will influence the course of the outbreak is not well
understood, partly because the process of biological evolution is
unpredictable.
Some scientists at the conference – the 8
th Vaccine and
ISV Congress – were skeptical because the Novavax results came from
mice. The company has begun trials in monkeys, however, which are
considered much more relevant to humans.
Currently, several groups have tested vaccines in monkeys and found promising results. GlaxoSmithKline has already started testing healthy human volunteers in Europe
and the U.S. with a vaccine called ChAd3, based on a cold virus that’s
been altered to produce Ebola proteins. The proteins are what should
trigger a protective immune response. The vaccine was developed by the
National Institute of Allergy and Infectious Diseases – a branch of NIH.
It worked in monkeys, but vaccine researchers readily admit that this
may not translate to humans. That uncertainty clouds all research in the
vaccine race.
Another vaccine candidate has been developed by Walter Reed Army
Institute of Research collaborating with government scientists in
Canada. Instead of a cold virus, it uses an altered cow virus called
vesicular stromatitis virus, or VSV. This vaccine, too, has proven
effective in monkeys.
Meanwhile, researchers at Thomas Jefferson University in Philadelphia
have been working for the last four years on a modified rabies vaccine
that in monkeys can protect against both diseases. Rabies kills more
than 20,000 people every year in Africa, said lead researchers Matthias
Schnell. He said they have proven their product works in monkeys and
could be ready to start human safety trials by January. He has plans to
partner with a major pharmaceutical company to scale up production of
the vaccine, but as of this week, those plans are still being worked
out.
Also in the race is Johnson & Johnson
. Last week the company announced the development of a two-step Ebola vaccine that had shown promise
in monkeys and would be ready for safety testing in human volunteers in
early 2015. The company is working together with Bavarian Nordic, based
in Denmark. -
Forbes.
World Bank pledges $100m to send health workers to Ebola-hit countries
The
World Bank is to invest $100m (£63m) in an attempt to increase the
number of foreign health workers heading for west Africa to care for
people with Ebola.
Treatment centres in the three countries at the
heart of the epidemic – Liberia, Sierra Leone and Guinea – are being
built but the biggest need is for doctors, nurses and other healthcare
workers to staff them. The United Nations says around 5,000
international personnel are needed, including up to 1,000 foreign health
workers.
In the UK, 900 people have volunteered to go to Africa,
none of whom have left yet, while the African Union has pledged 2,000
people. More numbers are needed and progress in getting volunteers to
affected areas has been slow.
“The world’s response to the Ebola
crisis has increased significantly in recent weeks, but we still have a
huge gap in getting enough trained health workers to the areas with the
highest infection rates,” said World Bank Group president, Jim Yong Kim.
“We
must urgently find ways to break any barriers to the deployment of more
health workers. It is our hope that this $100m can help be a catalyst
for a rapid surge of health workers to the communities in dire need.”
Pay
and benefits, recruitment and training have all been issues, says the
Bank. Potential volunteers are also worried about their safety – health
workers are at the highest risk of contracting the disease because of
their physical contact with sick patients. There have been major scares
in the United States and in Spain where health workers have been
infected even though they should have been well-equipped and trained in
the strict safety procedures.
Health workers from Europe and north
America also want to be sure they will be repatriated in the event of
becoming ill, believing their chances of survival to be greater at home,
where health systems are more sophisticated because they are better
funded. The UK is building a treatment centre specifically for health
workers who become infected in Sierra Leone, where standards are
intended to be as high as they would be in the NHS. Other concerns
include transportation and housing, says the Bank.
The new funds,
which take the World Bank’s total Ebola contribution so far to $500m,
will help set up a coordination hub with the three countries’
governments, the World Health Organiation, the UN’s main Ebola
coordination centre in Ghana and other agencies. The hub will actively
recruit, train and deploy qualified health workers.
“Health
workers take an oath to treat the sick – and so it’s no surprise to me
that many health workers want to go treat Ebola patients at the source
of this epidemic,” said Kim, an infectious disease doctor who spent
years treating patients in poor countries. “So we need to find all ways
possible to remove any obstacle that stops health workers from serving –
whether it is pay for workers in developing countries, or the promise
of evacuation services. Health workers who treat Ebola patients are
heroes, and we should treat them as such.” -
The Guardian.
