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Lessons to learn from Ebola

Benita van Eyssen
March 13, 2020

As COVID-19 spreads in Europe, the experts who beat Ebola in West Africa reflect on what they learned. China and Italy are to the pandemic what Guinea, Sierra Leone and Liberia were to the epidemic of 2014–2016.

Coronavirus und Ebola

On March 9, Italy — the worst-hit by coronavirus outside of China — extended its lockdown to the entire country in a bid to curb the spread. That decision in the European country of 60 million resonated with many in West Africa.

When Sierra Leone found itself in the grip of Ebola in September 2014, authorities imposed an unprecedented 72-hour nationwide lockdown. The government recruited and deployed scores of health teams door to door, or "Ose to Ose Ebola Tok" in Krio.

"Italy could learn some good lessons from what we got from the lockdown during the Ebola outbreak," said Harold Thomas who was in one of the teams that went house to house in Freetown, bearing information and soap.

The lockdown was a chance for "the entire population to reflect on the magnitude of the problem, and collectively look at ways to put it to an end," he told DW. "Coronavirus now, if we compare it to Ebola, is a droplet infection and social distancing is overly important."

Read more:  Coronavirus latest: EU vows 'whatever necessary' to support European economy 

A Stop Ebola billboard in Sierra Leone
The West African Ebola epidemic claimed nearly 4,000 lives in Sierra Leone Image: picture-alliance/AP Photo/A. Marrier d'Unienville

Chain of transmission

The September 2014 Ebola lockdown was the first of several in Sierra Leone. It was intended to help cut down the transmission rate, as authorities in Wuhan, China and Italy are trying to do.  "People will cut down on a number of activities that will predispose them to infection," says Thomas.

The coronavirus pandemic has prompted Freetown resident Ishmael Alfred Charles to reflect on a time when his country faced the spread of a potentially deadly virus too.

"What they basically need to do is to be able to identify who the person that tested positive has been in contact with, where that person was, and who they had links with," Charles told DW. Tracing contact persons is key to preventing the spread of the virus, he believes.

DW's Abu-Bakarr Jalloh was in Sierra Leone during the first lockdown. By the time it was imposed, Ebola had already spread across the country, he says.

"In hindsight, it was already late. You start taking measures when the chain of transmission is still intact," he says. "If you allow this chain to break and then start containing people, it means you are just being reactive. This is what Italy did not learn from the Ebola epidemic West Africa."

"If there was mandatory containment right from the beginning, Italy could have contained coronavirus. Germany is making the same mistake."

Read more: What you need to know about the coronavirus

Liberia leeres Klassenzimmer einer Schule in Monrovia
Liberia shut its borders and schools while Sierra Leone declared a state of emergency in a bid to contain Ebola in 2014Image: picture-alliance/dpa/A. Jallanzo

Prevention, prevention — first

On the final day of that first lockdown — Sierra Leone's politicians said health teams had called on 75% of households and hailed the unprecedented intervention. The public had been overwhelmingly receptive to their advice although some suspicion persisted and many people fled across the border to places such as Liberia and Guinea.

Dr. Doddy Ngwasi worked in Guinea at the height of the epidemic. The Congolese Ebola specialist has spent the past two years at the epicenter of the Ebola epidemic in northeastern Democratic Republic of Congo. In facing the threat of coronavirus, the principle of "prevention first," should be of utmost importance, he says.

"We have to take care of coronavirus as we did with Ebola virus. We have to follow all prevention methods. It means, to avoid contact — as with Ebola, to wash hands — as with Ebola, to avoid public places. We must do the prevention and control before getting to hospitals."

Read more: Coronavirus: How can I protect myself from infection?

Learning, virus to virus

Dr. Gabriel Gorbee Logan is regarded as an Ebola hero in Liberia because of his work at the forefront of the bid to contain the 2014 to 2016 epidemic. He was recently appointed as assistant minister for curative services at the health ministry and has been keeping a close eye as coronavirus spreads in other parts of the world. Liberia, is one of a shrinking number of countries in sub-Saharan Africa with no confirmed cases of the virus that is leaving a trail of infections and deaths in places such as China and Europe.

A man in a labcoat and facemask sitting at an airport coronavirus screening machine |
Prompt lockdowns and screening proved invaluable in helping thwart the spread of Ebola Image: Getty Images/L. Dray

"What we have to understand is that in the context of this disease, there is no safe haven irrespective of how sophisticated your health system can be. There are diseases that can create serious challenges to any health system in the world. On such is the coronavirus," Logan told DW.

"The lesson for me is that people need to learn, this time around, that sharing information is key." Restrictions on the movement of people, especially when high risk destinations are involved, is important too.

"In Liberia, for every 10 people going out of the country, at least five are traveling to China for business. If it's a high risk area and you need to limit. But still, controlling people's movements is a challenge," says Logan. "So if people are to still move in the midst of this deadly virus, then people around the world should be taught to be sincere when they move from one country to another."

That would mean making themselves available for screening and testing. "I am saying that because with some of the countries, you just walk through from one border to the other. Some countries have several border points, and that is why I think it we should share information as much as possible."

Beware of fake news

Patrick Faley, a Liberian Ebola survivor remembers the denial and false information that circulated in communities during the epidemic. "To try to get around the coronavirus we have to learn from these mistakes," he says. "I can remember one time I was at home, quarantined, when on the radio I heard that Ebola has no cure and when it catches you, you die."

"Just a single case in Liberia, took away so many lives," he recalls. That was at a time when false information and preventative measures such as travel restrictions and screening at airport and borders were not yet in place. "Once you are infected, be truthful to the world that you have it. The media message should be one that gives truth and hope and governments should make sure that health facilities are equipped."

Murtala Kamara in Freetown and Evelyn Kpadeh in Monrovia contributed to this article.

Benita van Eyssen is a digital content planner, producer and editor@benita_v_eyssen
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