Sunday, August 24, 2014

Do Ebola quarantines make good neighbors?

    It's not even a mixed metaphor, but do quarantines, like fences, help or hurt? Diplomatic relationships between the nations of West Africa are being tested in the worst ebola epidemic ever, exceeding the previous largest outbreak in Uganda in 2000-2001 by almost 600% , as of Aug 22, with more than 2,615 human cases as reported by CDC, plagues the region. (Plague has become such a common colloquial verb that we forget the frightening origins of the term-- disease and epidemic.)
    The International Health Regulations (2005), implemented in 2007, have an objective to avoid hurting nations already under pressure from serious outbreaks of contagious diseases, in addition to protecting global health.  Avoiding travel restrictions and trade embargoes against countries reporting these outbreaks are part of the recommendations that are designed to keep the world from unnecessarily impoverishing and crippling the economies of countries particularly in need of response and recovery from a disease outbreak.
  Consistent with the International Health Regulations (2005) the World Health Organization has cautioned countries NOT to impose sweeping bans on travel and trade.  World Bank officials have already predicted a drop from 4.5 to 3.5 percent as the estimate for economic growth in Guinea this year.
  Quarantines, called "unified sectors", established in these countries are considered to be largely ineffective due to their vast size and the inability to control what goes on inside these areas.  Further, food and water are not going into these areas and supplies will soon run out.  There is no law enforcement and there is little to no medical care inside these areas.  The people in this unified area of Liberia are shown in a stand-off with police trying to enforce the quarantine in this photo from The New York Times, Aug. 21, 2014.  WHO recommendations are not being followed, but the Liberian President expressed her reasons why when she said that she took these extreme measures because no one listening to the public health instructions and advice. 
   When it comes to local politics, the Presidents of these nations will have to act in accordance with the fears and pressures of their constituents to keep order, and that may be in contradistinction to any advice they receive from the global community.  That is the reality.  In the end, quarantines may make better neighbors than showing no control efforts at all.


   
   Here is a map produced by CDC, Aug 14, showing the closed borders of West Africa and the intensity of the number of human cases.


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