Will the legacy of Ebola help Liberia fight coronavirus?

Ebola tore through the tattered health care systems of Sierra Leone, Liberia and Guinea from 2014 and 2016, killing more than 11,000 people CREDIT: Getty

As coronavirus cases begin to soar in Africa, some have raised hopes that the west African nation of Liberia could learn from its hard-won fight against the Ebola virus to fend off the new threat. But while some lessons have been learned, a baffling decision from the government may hamstring Liberia’s response.

Ebola

During the 90s and early 2000s, Liberia and neighbouring Sierra Leone suffered some of the most devastating civil wars in recorded history. 

Twelve years after the fighting stopped, Ebola struck. The disease tore through the tattered health care systems of Sierra Leone, Liberia and Guinea killing more than 11,000 people from 2014 to 2016.  Liberia, with its tiny population of 4.5m, was hit hardest with close to 5,000 deaths. 

Complete meltdown was only averted by an unprecedented international response costing billions of dollars and countless acts of heroism from local health workers, who faced almost certain death if they were infected. 

All three countries trained thousands of community health workers to go into hard to reach areas, check for symptoms and educate local populations.  These workers made up the backbone of complex networks which tracked the disease and isolated the infected.

The new threat to Liberia

Now four years on, Liberia is scrambling to fend off the coronavirus pandemic.  After detecting their first case of coronavirus in March, the Liberia authorities reportedly reopened five Ebola intensive care units and started screening new arrivals on international flights.

On April 11, President George Weah declared a state of emergency and locked down in the capital, Monrovia, warning that coronavirus posed the greatest threat to his country since Ebola.

Experts and officials say there are some significant advantages from the last epidemic. 

Dr Matshidiso Moeti, head of the World Health Organisation (WHO) in Africa, told The Telegraph, that old Ebola laboratory networks in west Africa meant that they could move very quickly to increase capacity for testing for coronavirus. 

Dr Moeti also said that one of Ebola’s important legacies is that west African governments try to act on a community level and use civil society effectively to mobilise people. 

Last week, Francis Karteh, Liberia’s chief medical officer, echoed this sentiment. “We already had our contact tracing teams set, the community teams were still intact, and we only needed to reactivate them,” he told  AFP news agency.

Dr Mosoka Fallah, Director General of Liberia’s General National Public Health Institute, told The Telegraph, that he was ‘cautiously optimistic’ in part because of the experience of Ebola. 

Currently, Liberia’s laboratories are managing about 75 tests a day and planning to get to about 150 tests a day, he says. For Dr Fallah this is significant. “Before Ebola, we did not have a platform to test for viral diseases.”https://cf-particle-html.eip.telegraph.co.uk/13b5940f-9536-42ad-897e-5ef8a85a9382.html?ref=https://www.telegraph.co.uk/global-health/science-and-disease/will-legacy-ebola-help-liberia-fight-coronavirus/&title=Will%20the%20legacy%20of%20Ebola%20help%20Liberia%20fight%20coronavirus?

A baffling decision 

However, there are fears that the Liberian government may now be squandering the Ebola-era advantages the country has for its fight against coronavirus.

According to an investigation by FrontPage Africa, the country’s most reputable newspaper, the government has bizarrely sidelined 2,000 highly skilled and well connected Ebola-era community health workers. Instead of using seasoned veterans, the government is reportedly recruiting and training 6,000 new contact tracers. 

“I do not see any possible reason for not employing [the 2,000 health workers]. They are trained and they beat Ebola and have also proved highly effective against outbreaks of Lassa fever and cholera,” says Dr Dougbeh Chris Nyan, an award-winning Liberian infectious diseases specialist.

These 6,000 recruits have no confirmed training and have not been tested for coronavirus and “the government is just sending them out into communities,” adds Dr Nyan. “It is just out of order.” 

Details about why the government has chosen to use new recruits are still emerging but in all likelihood, there is a highly politicised reason behind the decision. 

For now, the situation looks increasingly grim. Any headstart Liberia had from having relatively little international air travel is fading fast. The government’s initial lockdown of the capital was roundly condemned as chaotic and the virus has spread out of the capital into 7 out of Liberia’s 15 counties. Doctors and nurses have reportedly not had enough PPE equipment to protect themselves from the virus. 

Liberian authorities have now recorded 150 confirmed cases and 16 deaths, an extremely high death rate. Dr Fallah says that his team’s cars are running out of fuel trying to track the cases down. 

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