Why Sealing Off Ebola-Stricken Countries Is Not The Answer

Ebola is ravaging West Africa.

Close to 7,200 people in Liberia, Guinea, and Sierra Leone have been diagnosed with the virus; nearly 3,400 have already died. Another 4,000 West African children have been orphaned since the virus broke out in Dec. 2013. These shocking numbers, along with the recent news that the US diagnosed its first Ebola, have spurned the question: Why doesn’t the world simply seal the borders of the hardest-hit countries?

Put simply, preventing people from entering or leaving the three countries where Ebola is raging will do nothing to stop the virus from spreading. On the contrary, cordoning off Liberia, Guinea, and Sierra Leone would likely make the outbreak worse.

Aside from being “simple and wrong,” quick fixes like isolation will make it even harder to get help into the countries that need it, Centres for Disease Control and Prevention director Tom Frieden told reporters on Thursday. All isolation will do, said Frieden, is “enable the disease to spread more widely” in the most affected countries, which will in turn create “more potential for it to spread elsewhere and become more of a problem.”

The longer the outbreak goes on, the more opportunities there will be for the virus to jump from the region. The first priority should be to focus all resources on containing the outbreak, not sealing off the area that needs the most help.

Making A Bad Situation Worse

One of the biggest obstacles currently facing the three countries where Ebola is raging is a lack of people power.

This is the first time Ebola has broken out in West Africa, and most people there (many of whom lack access even to basic medical care) don’t know how to diagnose it or what to do when someone becomes ill.”The whole country has been hit by something for which it was not ready,” Dr. Amara Jambai, director of prevention and control at Sierra Leone’s health ministry, told the New York Times.

Making it even harder for potential sources of aid to reach the country certainly won’t help.

Affected countries need more health workers trained to organise efforts to locate, isolate, and treat all the infected patients. Then they need more people to investigate the network of people sick patients may have infected. Potential contacts must be monitored for 21 days, the total period of time someone can carry Ebola before showing symptoms.

PLOS CurrentsMobility patterns and connectivity in West Africa demonstrate why intra-regional spread is an ongoing risk.

Two Countries, Two Very Different Outcomes

In Sierra Leone, Ebola patients in many of the country’s cities linger in holding centres guarded by police, where barely-trained staff wearing little to no protective gear provide the best care they can. International aid to the area has been too little and too late.

In Nigeria, the opposite has happened: As of last week, Africa’s most populous country — and one of its major trade and transit centres — succeeded in containing the outbreak. With the help of support from the Bill and Melinda Gates Foundation, the CDC, the World Health Organisation, Unicef, Doctors Without Borders, and the International Committee for the Red Cross, the country’s top doctors executed a quick and concentrated effort to contain the virus. Nigeria is also wealthier than the three main countries affected by the virus, and unlike in those countries, its outbreak began with a single person who flew into the country in July.

The people of Sierra Leone, Guinea, and Liberia need more attention, not less. They need to make sure their economies, already hollowed out by the crisis, do not grind to a complete halt. They need more support, including trained health workers; supplies like gloves, masks, and disinfectants; and money for treatment facilities.

The only way to do that is with a concerted, international effort.

Managing Risk

PLOS CurrentsAir traffic connections from West African countries to the rest of the world.

The CDC advises Americans travelling to West African countries affected by Ebola to take several precautions to avoid infection, including avoiding contact with wild animals, staying out of hospitals where Ebola patients are being treated, and not touching the blood or body fluids of the infected, or the bodies of those who have died from Ebola.

West African airports, meanwhile, are routinely screening travellers, both by inquiring about their exposure to Ebola and checking for fever. The CDC is helping with those efforts. In the US, the CDC has reminded airlines that people can legally deny boarding to a passenger who is visibly ill. (Ebola patients are not contagious until they have symptoms.)

Officials have also asked workers in airports and on airlines to be on guard.

“We’ve provided guidance to pilots, flight attendants and others who are responsible for staffing our transportation infrastructure to ensure that if they notice individuals who are exhibiting symptoms… that the proper authorities are notified,” White House spokesman Josh Earnest told reporters on Wednesday.

The governments of Guinea, Liberia, and Sierra Leone have, of course, also taken whatever steps they can to reduce the virus’ spread, including limiting mass gatherings, instituting screenings at major points of travel, quarantining communities acutely affected by Ebola, and visiting homes to search for people who’ve been infected.

In this context, completely sealing the countries’ borders would be an ill-proportioned response to a manageable level of risk — and one that would very likely make the outbreak even worse.

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