Ebola Bundibugyo: The Friday Numbers

From today’s briefing:

• Cummulative cases: 104.
• Deaths: 23.
• Contacts (people with significant exposure to the virus by caring for someone sick): 328
• Contacts checked today to make sure they are not sick: 155 (65%, pretty amazing considering the topography)
• Medical Staff: ever increasing. 4 MOH nurses and 1 doctor with experience from the Gulu epidemic in 2000, and 3 MSF nurses, expected imminently
• Admissions: 3 at Bundibugyo hospital, one of which died right away. 0 in Kikyo
• Census on the Isolation wards: 24 in Bundibugyo, 16 in Kikyo
• Healing, or nearly ready for discharge: 4 in Bundibugyo, 2 in Kikyo, plus Dr. Sessanga who has essentially discharged himself from his self-imposed isolation. Scott saw him today and took a lab tech to get his blood sample for the CDC. This is hopeful. People do recover. One of the epidemiologists said she counts only 4 deaths among 18 admissions, which is less than a quarter, similar to the deaths among the confirmed positive lab samples in the original batch that led to the identification of the epidemic (2 of 8).
• AWOL: still 5. One of those went to their other home in Kasese district. Four are at home in Bundibugyo. Because this strain may be a bit less severe people may try to manage without admission, which can lead to more contacts and further spread. The surveillance team finds the lack of contact stability very challenging. They are trying to document and follow EVERY contact, which is tricky if people move around. Imagine a place with no addresses, no mail, no phones, no Social Security numbers, no credit cards, no drivers’ licenses, no ID’s, few taxes . . . And then you’ll realize how hard it is to keep track of people. They can easily disappear.
• People sitting in the meeting when these numbers were announced and debated: 54. The RDC continues to provide strong leadership, marshalling the troops, holding the meetings together.
• Classic Bundibugyo: WFP cautioned against giving food to all contacts. . . . Lest everyone begin to complain of being a contact and so overwhelm the surveillance teams.
• More classic Bundibugyo: a religious group who meets on Friday mornings slaughtered two sheep in Nyahuka today, and told their members that everyone who ate a piece of the sacrificed goat would be protected from the virus. The DDHS himself brought up the claims of herbal medicine specialists entering the district with Ebola cures, not to refute them, but to ask the group what they thought. Given the fear surrounding this disease, and the fairly high recovery rate, there will no doubt be many claiming to have a cure for the right price.
• Controversies: should local eating establishments be closed? The group debated this a lot. Consensus: no. Maybe a few placed that had poor hygiene . . .but most should stay open. There is an odd tension. They want to scare people enough that they change behaviours regarding contact with sick patients, and burials. Yet they don’t want to scare people to the extent that society grinds to a halt. After all, all these experts have to eat somewhere too. These meetings spend a lot of time on things like money and food . . .
• Non-Ebola patients in Nyahuka: 0. No admissions. No outpatients. The stigma and fear factor skyrocketed after Jonah died. We have all sensed the quietness, the eeriness of the town. Today a church leader reprimanded children around Scott Will’s house telling them they could get sick from him and die, so go home. We are beginning to realize that the three of us (Scott, Scott Will, and me) are considered unclean. And not without reason. I think that we have to live with that. It is logically inconsistent to send our kids away and then feel disgruntled that others avoid us. It is hard for people to realize that as long as we have no symptoms we are not dangerous. At least the MSF and CDC people aren’t afraid of us!
  

• Time between Dr. Matthew Lukwiya, the doctor who was in charge of one of the main hospitals in Gulu affected by Ebola in 2000, and Dr. Jonah Kule’s death: 6 hours short of an exact 7 years. Dr. Jonah died at 7:30 pm Dec 4, 2007; Dr. Matthew died at 1:20 am Dec 5, 2000. That is one of the most distressing aspects of this disease, to take out the two men who laid down their lives to save others.