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Old 09-19-2014, 08:33 AM   #51
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Sierra Leone capital at standstill as Ebola lockdown begins

Reuters
Published: 09.19.14, 15:18 / Israel News


FREETOWN - Sierra Leone began a three-day lockdown on Friday in an effort to halt the spread of the Ebola virus, as President Ernest Bai Koroma urged residents to comply with the emergency measures.

Streets in the normally bustling seaside capital Freetown were deserted, barring vehicles carrying police officers and health workers. Radio stations played Ebola awareness jingles on repeat and encouraged residents to stay indoors.

"Today, the life of everyone is at stake, but we will get over this difficulty if all do what we have been asked to do," Koroma said in a television address late on Thursday.
http://www.ynetnews.com/articles/0,7...572936,00.html
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Old 09-19-2014, 09:39 AM   #52
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I was up very late last night watching Scottish referendum returns. One of the Canadian networks I settled on chose the SL 'national shutdown' as one of the few other major stories being covered. The focus of the admittedly brief reports was the worry felt by Sierra Leonians about their ability to have enough food & other necessities at home to handle 3 days stuck there.

There were market scenes as people tries to stock up. Hundreds, thousands of people crowded in together in tight lines, pushing their way forward to the market stalls. Lots of brushing by each other, adults gently grabbing OTHER PEOPLES' kids to prevent them falling - parents are parents & it's something most of us would automatically do.

At the stalls, people crowded even closer. The focus wasn't Ebola but food. One itme might be touched by 10-20 people before being bought - who knows? The stall owners & workers - touching everybody's money. Those coins you just handed out in change - were they given you 4 minutes ago byt a customer just breaking with symptoms & putting it down to a long wait in line?

Long story short - the corwding involved in making sure people had enough items to handle three days at home may have served as a major amplication activity for the disease.

I've never been to Africa - my 'exposure' to living conditions there, day to day, is limited to articles, news videos, first person accounts from folks I know who have visited. From these sources, I understand many homes are considerably different from ours. They may not be fully enclosed, comprising of a roof & perhaps 3 walls. If they are closed in, (roof & 4 walls); those tend to be smaller. It's expensive relative to everyday expenses to obtain material needed for walls.

Must living is done outside. Homes serve as family storage areas for cooking implements, clothing, tools & any obtanium they have. Cooking is done outdoors. Some may sleep indoors, others outside depending on the weather. In bad weather, they may all crowd indoors to grab some sleep. In that heat & humidity, I think I'd choose to do my cooking, laundry, socializing, etc. outside as much as possible. If people are forced to stay IN their homes, the crowding for many will be unbearable. Not to mention, not healthy.

As it stands now, one person in a family who contracts Ebola may sicken the immediate caregivers & a few others in the family. Force them all into crowded quarters & you're giving the virus a free pass to nail everybody. Other illnesses need to be considered. Your old auntie who normally has a decent sleeping pallet because her pain from... pick a condition... requires a bit of room to move around suddenly doesn't have that space - more suffering. Got a kid with non-Ebola diarrhea? Have fun if you're all jammed in together.

And this isn't a priority issue compared to Ebola but psychiatric & social issues within a family are going to be magnified if people can't get away from each other. People are people - addicitons, family violence, psychiatric ills exist everywhere.

Then, as MSF so rightly warns about - what on earth do they do with people they identify as suspect/probable Ebola cases? IDEALLY, those go to care centers - the few around are beyond full. Even if they existed, the rest of the family/household now has to be isolated until they either break with symptoms or eventually are deemed clear. It's going to have to be done at home., So... if the SL government prepared to bring in food, water, other basic necessities in order to ensure these people stay at home & SAFELY? I don't think so.

There may be military, police & other security forces in the streets trying to enforce this mandatory 3 day quarantine but they can't be everywhere. I can see a situation where a young man sneaks out to go to his friend's place for an hour or two, to visit. Maybe he's about to break with Ebola & doesn't know it - now we have too households where the virus is concentrated.

And I'm not sure wbout this whole marking of houses deal. Maybe you can indicated how many people live there; how many are supposed to be inside when security forces do a random check. But you cannot possibly mark a house Ebola free - not with a mere 3 day quarantine period.

This has disaster written all over it & I'll be very curious to see how the actual plan works out over the next few days.
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Old 09-19-2014, 10:13 AM   #53
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So, CS, your implying that there are in fact amplification "periods". This is going to be fascinating (in a rather gruesome way). We have seen that within about 8 days (it might have been 10 - but the point was that it was predicted) of the West Point clinic episode we had a slew of infected people.

Now, I predict that 10-13 days from today, cases will truly explode. You created a huge number of amplification points (shops), and created a singular amplification "period" (last 72 hours) to bring people together within 24 inches and exchange fluids via proximity, common surfaces, goods, and money. Further, You are going to cramp these people up in tiny spaces where they are going to have sex (normally not a problem), share food, fight, and breath on each other.

The government is not solving the problem - it is creating millions of opportunities for transmission and expansion.
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Old 09-19-2014, 10:47 AM   #54
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I suppose 'amplification period' is as good a term as any, until someone comes up with a more elegant sounding one. I may not be too certain of the specvific term yet but I'd go with your definition, pretty much.

Any set of circumstances whereby you gather together infected people as you described can serve as the locus of a new series of infections.

Theoretically, let's go to the end of the last day you can buy vitally needed items for the 3 day quarantine period. All day, you've been getting to different markets looking for specific items. Maybe some can only be bought in one or two locations. Others - maybe the first few markets you visited were out... so you kept traipsing through town, market to market until you finmally find what you need. Perhaps you've been at this all day. Hell, you're 6 months pregnant & towards the end of the day, you're almost overcome by a wave of fatigue. And you feel hot & headachy. Bot, could I persdonally, rationalize that way easily! I've been on my feet all day, much of it in the hot sun. The baby won't stop kicking. When I get home, I still have to put together a meal for the 9 in the household - all elders, young children or my husband. Just thinking about it worsens my headache.

Maybe I am just tired. Maybe I'm breaking with early symptoms. Maybe I know. Maybe I've been trying to hide symptoms all day, desperately in the mindset of 'anything but Ebola'. Whatever my reasoning, it may be I inadvertantly infect 5 other people... 3 live in my general neighbourhood, 1 lives across town, (just happened to be in the area that day) & one hiked in from a nearby village to make purchases for a few households.

8-10 days from now, they break with symptoms. Imagine that multiplied who knows how many times? Quarantine is lifted this weekend; I'm sick & my household is on security force enforced lockdown but by next weekend, many other cases may be breaking all over SL & how the behoozles do you contact trace when so many were frantically trying to get supplies?

This outbreak has no doubt had many amplification points or events. Sick people going underground in fear or their families hiding them at the homes of healers who are still seeing patients. Official care centers without adequate PPE? Taxis? The list is potentially large.

I agree with your prediction. The illnesses will start sooner but it will take 2 or 3 weeks for those cases to be reflected in official data. I fear SL may have essentially created another Monrovia but throughout Sierra Leone.
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Old 09-19-2014, 10:50 AM   #55
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I'm curious about what the level of compliance will look like. Day 1 vs Day 3, urban vs rural, different cultural areas etc. I'm also curious about the reception of the "teams" going door to door. I hope they have read up on what happened in Guinea.

A dry run for bigger and better quarantine?
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Old 09-20-2014, 02:52 PM   #56
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Ebola outbreak: Burial team attacked in Sierra Leone amid 3-day lockdown

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Health workers in Sierra Leone have come under attack while trying to bury the bodies of five Ebola victims east of the capital, a police official said.

Sgt. Edward Momoh Brima Lahai said there was a confrontation Saturday between a group of youths and the burial team in the Waterloo district.

A witness told state television the burial team initially had to abandon the five bodies in the street and flee. Lahai said the burial was successfully completed after police reinforcements arrived...
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Old 09-20-2014, 03:13 PM   #57
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Futility reaches new heights.


Lockdown Begins in Sierra Leone to Battle Ebola
Quote:
The most ambitious and aggressive government campaign against the Ebola epidemic gripping parts of West Africa began on Friday when Sierra Leone ordered everyone in the country to remain indoors for three days, suspending commerce, emptying the streets and halting this beleaguered nation in its tracks in an attempt stop the disease from spreading.

Calling the struggle against Ebola a matter of life or death, the government mustered police officers, soldiers and nearly 30,000 volunteers to go house to house, hoping to educate the country about the dangers of Ebola and identify people who might pass the disease to those around them.

...From the start, the limits of the government campaign were evident. The warnings, mobilization and exhortations quickly clashed with the reality that cases here are surging and the infrastructure to deal with them hardly exists.

There is no large-scale treatment center for Ebola patients in the capital, Freetown, so many patients have to be placed in a holding center until they can be transported to a facility hours away — that is, if an ambulance can be found to pick them up and if those packed facilities have room.

...In the streets of the capital on Friday, one woman lay curled in a fetal position, eyes shut, precariously balanced on cardboard sheets next to an open gutter in front of locked storefronts. From a wary distance, the anti-Ebola volunteers said she had high fever. Hours of calls had produced no ambulance.

A small crowd, including the police, soldiers brandishing guns, presidential advisers and spectators taking cellphone pictures of the immobile woman, milled about. A medical worker said two more bodies in the vicinity needed attention. But still there was no ambulance.

“They are not responding; they say they have lots of cases now,” said a volunteer, Alhassan Kamara.

Finally, a rickety ambulance pulled up, more than five hours after the initial calls, the volunteers said. But the loosely outfitted attendants refused to pick up the sick woman: they had no chlorine spray and said it was not their job. A loud anti-Ebola jingle played on a car radio. It took a second ambulance, and the president of a moped club who quickly suited up in protective gear, to get the sick woman bundled off to uncertain care.


...Dr. Oliver Johnson, a British physician currently working at the hospital with King’s Health Partners, said Friday that the 18-bed unit had received 10 patients during the first day of the lockdown and now had four physicians. He said two other isolation units had opened in the Freetown area in the past several days. “We’re starting to see more beds, more supplies. More staff are coming to work,” he said.

Sierra Leonean health workers, who he said have worked bravely, are now being offered hazard pay. “Things are improving,” he said, but “the real question is whether we can get ahead of the curve. We’ve been seeing more new patients than we’ve been able to build new beds.”

...Whether Sierra Leone’s lockdown will constitute an effective response is open to question. Despite the mobilization, the volunteers hardly appeared to be thick on the ground. In some neighborhoods, residents said they were yet to see any of the green-vested young men and women who had volunteered.

In other neighborhoods, the volunteers — many of them students, all working for no pay — complained that there was no response to their knocks at most houses. If they arrived without supplies like soap or chlorine, residents were not interested in speaking with them, the volunteers said.

Where there was a response, it was often followed by cursory admonitions to residents to wash their hands, report on neighbors suspected of illness and wear long-sleeve shirts at the market.

At one house, several volunteers talked loudly at once about hand washing, leaving the residents visibly dazed. At another, they were amazed to discover residents who were supposed to be under quarantine because of their suspected exposure to Ebola, but were actually unguarded and free to roam about. At still another, one gave out questionable information about the Ebola virus — seeming to contradict some basic precautions.


Well into the morning, the house-to-house visits had yet to begin in Kroo Bay, a densely populated neighborhood of iron-roof shanties where roughly 14,000 people live, despite officials saying they would start at dawn. The police cruised into Kroo Bay on a pickup truck, yelling at residents to go indoors and warning of imprisonment. People simply stared at the officers and continued lingering as the police drove off.

“The policeman is doing his thing, and I am doing my thing,” said Kerfala Koroma, 22, a building contractor. “We can’t even afford something to eat on a normal day. How can we get something now?"
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Old 09-20-2014, 04:06 PM   #58
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Old 09-20-2014, 05:00 PM   #59
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Well, we've all been saying that here for a week or more now, haven't we? That this would be a complete cluster...?

No way such a dysfunctional government was going to make sure all teams had the same message. I'm pretty sure when all is said & done, some neighbourhoods will have been visited 2-3 times, others none at all. Many will never have had soap & bleach to hand out or information leaflets.

What were they going to do with found suspected cases? There are no beds left at the few, quasi-functioning care centers. All they can realistically do is note the locations of them, count how many else are in the household, all stuffed in together... because by Money the 29th or so, a quantity of those close contacts will be sick as well.

At this point, Sierra Leone needs the same military committment as Liberia got from the US. This would be an excellent opportunity for the EU to match what the US is doing, or the Commonwealth. Hell, both groups should already be planning - one for SL, one for Guinea. Liase with the US as their recon findings come in - conditions will natually differ somewhat but there will be enough similarities for some planning purposes.
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Old 09-21-2014, 12:21 PM   #60
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Now the government can pat itself on the back for a job well done.


Ebola shutdown uncovers 70 dead


Quote:
Freetown - Sierra Leone wrapped up its 72-hour shutdown on Sunday, with authorities reporting that the action aimed at containing the Ebola epidemic had uncovered up to 70 dead bodies in and around the capital.

Most of the west African country's six million people were confined to their homes for a third straight day, with only essential workers such as health professionals and security forces exempt.

Almost 30 000 volunteers have been going door-to-door to educate locals and hand out soap, in an exercise that was expected to lead to scores more patients and bodies being discovered in homes.

Deputy Chief Medical Officer Sarian Kamara revealed that the authorities had received thousands of calls but only a handful of new patients in the Western Area covering Freetown and its surroundings.

“We were... able to confirm new cases which, had they not been discovered, would have greatly increased transmission,” she said.

“Up to this morning, we had 22 new cases. The response from the medical (teams) has improved and the burial teams were able to bury between 60 to 70 corpses over the past two days.”

Independent observers have voiced concerns over the quality of advice being given out, deeming the shutdown a “mixed success” and complaining about the poor training of the door-to-door education teams.

...Kamara said however that the shutdown was “on track” in its objective to get information to the entire population on how to prevent Ebola spreading.

“There has been a total compliance to the order for people to stay at home... which made it possible for campaign teams throughout the country to reach families in their own homes to sensitise them about Ebola,” she said...
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Old 09-21-2014, 12:41 PM   #61
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Correction:

More than 50 new Ebola cases in Sierra Leone lockdown



Quote:
At least 56 new cases and 92 bodies have been discovered in Sierra Leone's Ebola lock down.

There is a "very strong possibility" the national curfew will be extended beyond the scheduled finish later today, an emergency official has said...
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Old 09-21-2014, 07:12 PM   #62
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Tip of the iceberg.....
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Old 09-21-2014, 07:16 PM   #63
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This was a big mess - eating a late supper & handling cleanup, so y'all are spared my pontificating for a while.
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Old 09-21-2014, 10:52 PM   #64
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There have been a lot of problems with this quarantine. Many simply didn't have the food & basics needed to stay home 3 days - hard to do when your daily pay buys the daily food. The government was to hand out emergency food packs to the poorerst - didn't work out too well. As a result, no doubt some broke quarantine. In some cases, people refused the food, suspicious it was poisoned. Same with soap - many were convinced it was poisoned or contained Ebola & refused it. Other households tore the 'checked' stickers off their homes, hoping a second team would drop by so they could get another bar of soap. The ration was one bar per household - no matter how many people were in the home. Some of the teams had no soap to hand out.

Many teams were apparently giving out incorrect information, although I have no details as to what the errors might have been.

The guards manning the checkpoints, who were supposed to only let by those with the paperwork authorizing them to be on the streets - some were holding out for shakedown money. Wanna bet people without papers were able to bribe their way through as well?

For fear of being fingered as having Ebola or maybe having it, it's reported tens of thousands blew through the 'border' into Guinea - not a whole lot of border checkpoints in the jungles. No doubt, a few or more ARE incubating Ebola - let's hope they didn't become symptomatic in Guinea - that will flare up that slow burning fire again.

Three days of quaratnine resulted in 50+ cases identified - that we know of now. Within a few days, we'll probably get a more accurate tally. How many of those infected others, because they were all cooped up together?

Thankfully 70+ bodies were located & buried & hopefully wherever they were found was nuked with bleach.

Within a few days, we'll see a bump upwards in SL's official stats as the new finds are added to current counts. 2 weeks from now, I expect that will go up a good bit, both in SL & Guinea as a result of the quarantine.

Damned if you do, damned if you don't.
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Old 09-22-2014, 08:05 AM   #65
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Quote:
Thousands ‘evade’ Ebola lockdown in Sierra Leone

20/09 14:34 CET

Thousands of people have defied Sierra Leone’s three-day lockdown to combat the Ebola virus by crossing the border into Guinea without going through health controls.

Health officials in Guinea said people were coming “in waves” through the bush, fearing they would be taken away if they were found to have the disease.

Nearly 30,000 thousand health workers, teachers and volunteers are going house to house until Sunday to educate people about Ebola and isolate the sick.
http://www.euronews.com/2014/09/20/t...-sierra-leone/
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Old 09-22-2014, 08:12 AM   #66
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Quote:
Sierra Leone's Ebola Lockdown Likely to be Extended

Reuters | Updated: September 22, 2014 03:23 IST

FREETOWN, SIERRA LEONE: A three-day lockdown in Sierra Leone aimed at stemming the worst Ebola epidemic on record has identified dozens of new infections, but has not reached everyone in the country and is likely to be extended, a senior official said on Sunday.

In one of the most extreme strategies employed since the epidemic began, Sierra Leone ordered its 6 million residents to stay indoors as volunteers circulated to educate households as well as isolate the sick and remove the dead.

"There is a very strong possibility it will be extended," Stephen Gaojia, head of the Emergency Operations Centre that leads the national Ebola response, told Reuters after meeting with President Ernest Bai Koroma.

"Even though the exercise has been a huge success so far, it has not been concluded in some metropolitan cities like Freetown and Kenema."

Gaojia said 92 bodies had been recovered across the country by the end of Saturday, the second day of the lockdown.

Some 123 people had contacted authorities during the drive, believing they might be infected. Of these, 56 tested positive for Ebola, 31 tested negative and 36 were still awaiting their results, he said.
http://www.ndtv.com/article/world/si...url=1411340656

---------- Post added at 08:12 AM ---------- Previous post was at 08:11 AM ----------

Quote:
Ebola: 150 new cases found during Sierra Leone lockdown

By AFP11:15AM BST 22 Sep 2014

Sierra Leone's controversial Ebola lockdown has uncovered some 150 new cases of the deadly virus in addition to around 70 bodies previously unaccounted for, according to the authorities, who said they may repeat the campaign.

Most of the west African country's six million people were confined to their homes for 72 hours from Friday, as 30,000 volunteers went from door-to-door to educate residents on preventing the spread of the deadly epidemic.

"We have an overflow of bodies which we still need to bury but this has been an everyday occurrence since the Ebola outbreak... Now at least we have about 150 new cases," Steven Gaojia, head of the country's emergency operation centre, said late Sunday.

The country's chief medical officer earlier said up to 70 bodies had been uncovered, but these were in and around the capital, and results for the whole country are likely to push up the figures significantly.
http://www.telegraph.co.uk/news/worl...-lockdown.html
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Old 09-22-2014, 10:16 PM   #67
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Outbreak Far Worse than Reported
http://www.nytimes.com/2014/09/23/wo...a/23ebola.html
...
Since the beginning of the outbreak more than six months ago, the Sierra Leone Health Ministry reported only 10 confirmed Ebola deaths here in Freetown, the capital of more than one million people, and its suburbs as of Sunday — a hopeful sign that this city, unlike the capital of neighboring Liberia, had been relatively spared the ravages of the outbreak.

But the bodies pouring in to the graveyard tell a different story. In the last eight days alone, 110 Ebola victims have been buried at King Tom Cemetery, according to the supervisor, Abdul Rahman Parker, suggesting an outbreak that is much more deadly than either the government or international health officials have announced.

“I’m working with the burial team, and the first question I ask them is, ‘Are they Ebola-positive?’ ” said Mr. Parker, adding that the figures were based on medical certificates that he had seen himself. The deaths are carefully recorded by name and date in a notebook headed “Ebola Burials.”
...
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Old 09-23-2014, 07:53 AM   #68
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Video from CNN, posted by Pixie at PFI. As she says in her post there, not for the faint of heart as it shows patients (including a child) too weak to get from the ambulance to the new 120 bed unit in Liberia. They are left on the ground behind the ambulance. The unit became full the day it opened.

http://edition.cnn.com/video/?/video...intl% 3Dfalse
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Old 09-23-2014, 08:25 AM   #69
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Not for the quick to anger either. I'd like to bitch slap the WHO person to whom she's showing the video. "That's why we urge patients to come earlier - so they're not this weak, blah, blah..." You need somewhere to GO.

They also made patients wait while they did the official opening ceremony.

Don't get me started.
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Old 09-23-2014, 08:40 AM   #70
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I'm sure for the WHO person, there was nothing shocking at all, as this is his reality every day. I'm sure they get a very casual attitude to people suffering and dying in droves if they see it day in and day out. Not excusing him, just thinking about what your mindset gets to be after a while in Hell.
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Old 09-23-2014, 10:39 AM   #71
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Quote:
WHO revises up number of health workers killed by Ebola in Sierra Leone

Reuters - Thirty more health care workers have died of Ebola in Sierra Leone than previously thought, the World Health Organization said on Tuesday, suggesting the risk to medical staff may have been understated.

A WHO update published on Monday put the number of dead health care workers in Sierra Leone at 61, out of a total of 96 who had fallen ill with the disease.

An update last week said 74 health care workers had caught Ebola in Sierra Leone as of Sept. 14 and 31 had died.


The revised figure means almost six out of 10 health workers who caught the disease in Sierra Leone have died, rather than four out of 10 as previously thought.

WHO epidemiologist Eric Nilles said the additional deaths were found during a "retrospective evaluation" that aimed to improve the overall quality of data published by the WHO.
http://www.courant.com/health/sns-rt...923-story.html
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Old 09-23-2014, 01:47 PM   #72
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Wait I thought travel restrictions were bad? Only applies to Western countries I guess. (anyone notice that Ivory Coast has been very aggressive on their border and to date have no reported cases??)

Quote:
Sierra Leone seals borders with Liberia and Guinea to stop Ebola

FREETOWN, Tue Sep 23, 2014 11:29am EDT

(Reuters) - Sierra Leone's army has "sealed off" the borders with Liberia and Guinea in a bid to halt the spread of Ebola, the army spokesman said on Tuesday.

The spokesman told Reuters that troops had been sent to all border crossing points.
http://www.reuters.com/article/2014/...140923?rpc=401
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Old 09-23-2014, 08:45 PM   #73
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This seems a little strange?!

Suppose the US and Canada both had raging Ebola outbreaks . Further, suppose each country had the same rate per capita of infection. Why would he US seal the border with Canada? Why spend valuable resources (Army, etc. ) to enforce a sealed border that would not change anything?

Is SL trying to keep out reporters and the outside world or are they trying to protect their neighbors who have problems that are equally bad?
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Old 09-24-2014, 09:30 AM   #74
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Quote:
SLeone says 300 sick or dead found in Ebola lockdown

By AGENCE FRANCE PRESSE | September 24, 2014

FREETOWN, September 24- Sierra Leone said on Wednesday around 100 bodies and 200 patients had been collected from homes during its three-day lockdown to stem the deadly Ebola epidemic raging in west Africa.

Almost six million people across the country were confined indoors for 72 hours from Friday while 28,000 volunteers went door-to-door, giving out advice and identifying new suspected cases and deaths that had been kept from the authorities.

“Over 92 bodies were discovered nationwide during the three-day lockdown of the country,” Karamoh Kabbah, the deputy minister for political affairs, told a news conference in the capital Freetown.

He said 77 of the bodies had been collected in the Western Area, a division including the city of 1.2 million and its immediate surroundings.

“Over 200 suspected cases were identified… of which, so far, 130 have been confirmed positive,” he added.
http://www.capitalfm.co.ke/news/2014...bola-lockdown/
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Old 09-24-2014, 09:42 AM   #75
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This article sounds like things are even worse.

Quote:
Ebola epidemic: house-to-house search in Sierra Leone reveals 358 new cases

Teams of volunteers also find hundreds of unburied corpses, according to leaked email from senior American diplomat

Lisa O'Carroll
theguardian.com, Wednesday 24 September 2014 09.14 EDT


Door-to-door searches during a three-day curfew in Sierra Leone identified more than 350 suspected new cases of Ebola, according by the top US diplomat in the country.

Charge d’affairs Kathleen Fitzgibbon said teams of volunteers had also discovered 265 corpses, of which 216 have since been been buried, in an email to organisers of the curfew that has been seen by the Guardian.

Fitzgibbon said the home visits had identified a preliminary 358 new suspected cases, with 85 patients sent to treatment centres.
http://www.theguardian.com/world/201...a-leone-curfew
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