A week after strong criticism met the announcement of the US military that it plans to help Liberia fight the Ebola epidemic with a "deployable hospital" which has only 25 beds, tomorrow plans US President Barack Obama to unveil major new efforts to help the West African country besieged by illness.
(Update: The White House Tuesday morning issued a fact sheet outlining its planned response He will be coordinated by a US army general. stationed at a new command center in Monrovia with an estimated 3,000 soldiers. the Ministry of Defence has requested "reprogramming" $ 500 million for the effort.)
Obama will visit the US Centers for Disease Control and Prevention in Atlanta to discuss the response of the United States, at the same time, a US Senate hearing on Ebola will also take place with the testimony of key officials and Ebola survivor Ken Brantly .
Nicole Lurie, assistant secretary for preparedness and response at the US Department of Health and Human Services (HHS), spoke with science Insider Friday and said she expected there would be "a substantial increase" in aid of the US government. It wants to see particular attention to providing people infected with good care. "There is a very, very great variability in what is delivered in clinical care, "said Lurie, noting that Case fatality rates are substantially different in different places." We know that simple interventions can save as lives. "
Lurie points out that, in the absence of adequate basic care, it becomes exceedingly difficult to determine whether biomedical interventions actually work. zmapp , an experimental cocktail of Ebola antibody, was given seven people (two of whom died) and have received considerable attention in spite of a complete absence of clinical data that suggests the treatment helped. A familiar researcher with blood tests of two recipients of five zmapp survivors who spoke with Science Insider, but asked not to be identified, said the declines in Ebola virus levels mirrored what we saw in monkey experiments with the antibody cocktail. But without being able to compare the clinical care they received, leaving aside the fact that there was no untreated control group data has little meaning.
Michael Callahan, a clinician at Massachusetts General Boston Hospital who consults HHS about Ebola and responded to past epidemics, said that "many" people die of Ebola even if their natural immune responses are driving down viral levels. Callahan notes that they do not die of Ebolavirus itself, but succumb to what he calls "side events", such as low potassium levels, wasting vomiting and diarrhea and bacterial infections. And many clinics in West Africa lack the simple devices that exist and can safely monitor blood electrolytes, organ failure, and acid-base balances. "The point is very important for the current epidemic," said Callahan, who believes care will drive reported rates higher than 75% lethality "down in the lower range of 40%."
What Lurie says will be a "substantial surge" in the response of the US government will probably also include sending staff to train more people in how to care safe for patients Ebola. One idea under consideration is to teach people who survived an Ebola infection to assist in providing care because they will probably immune to a second infection. "It is a very important issue and something we have had many discussions about," said Lurie, who said she spoke with a Liberian public health officer who is establishing a register of survivors. "It is very difficult for them to return to their communities," says Lurie. "I am very intrigued by the idea of setting up a training program with people who are otherwise a difficult time." She notes that jobs are hard to find in Liberia, and it could give under-employed people additional skills.
In a widely discussed op-ed on New York Times ran September 11, epidemiologist Michael Osterholm University of Minnesota, Twin Cities, argued that on top of more support, the global response to the epidemic of Ebola much better coordination necessary. "Many countries have committed medical resources, but donations will not lead to an effective treatment system if no group is responsible for coordinating," Osterholm wrote, formerly a bioterrorism adviser at HHS.
Osterholm suggested in the op-ed that the United Nations coordinated response, but he said science Insider he was just floating an idea and hoped that the international community would find a leader who included not only medical, but the supply chain, and logistics and tactical movement. "I do not want the world's best treatment doctor to Ebola," says Osterholm. "You must have a responsible person who can take command decisions and be the spokesperson really tell what is necessary and not necessary."
Osterholm said that for now, the government of the United States and every other country well-to-d or nongovernmental organization to try to help battle operates without a master plan. " we do not need 50 sergeants in the room trying to run D-Day, "says Osterholm. "Right now, everything moves at the speed of water in a Minnesota winter. This is exactly what we can not do. We must be able to move quickly and together, we walk. This is a fast marathon. This was completely missing "
* Ebola files :. Given the current Ebola epidemic, unprecedented in terms of the number of people killed and the rapid geographic spread science and science Translational Medicine made a collection of research articles and news on the viral disease available for researchers and the general public.
* update, September 16th, 11:45 :. This article has been updated to provide a link to the information sheet of the white House
0 Komentar