Les Roberts – “Day 7: Brutal Triage”

Difficult report and thoughts from on-the-ground in Freetown, Sierra Leone.

“If you think about it a few steps removed from West Africa, this is freakin’ wild. We are primarily trying to facilitate people to die without infecting others….We are about to assist thousands and thousands of people to die an excruciating death at home without even the most mild of pain relief. We are going to set up treatment facilities in hundreds of villages for one of the most deadly of diseases to be largely run by volunteers who will be lucky to get 3 days of training. Dozens, perhaps hundreds of them will die.

The Program on Forced Migration and Health at Columbia University

Les Roberts – Freetown, Sierra Leone – October 11th, 2014

Day 7: Brutal Triage

The prediction landscape is looking bad.   The official numbers reported are laboratory confirmed cases.   Typically, we think people need 7-10ish days to become symptomatic. Typically people have symptoms for 7 days before they get into a health facility. A month ago, it was one day, now it typically takes 4 days from when a patient is sampled to when the patient is told the result of their test (and lots get lost and mislabeled….).   Thus, the numbers that you hear about new cases today reflect the transmission dynamics from over 2 weeks ago…..and we thought the doubling time of the outbreak was 30 days, it seems to be less than that here.   We knew the ~350 confirmed cases last week were an undercount….we now think there are 7-900 in reality.   The need for hospital beds…

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