Ebola virus epidemic in West Africa

"Fabian Leendertz, a veterinarian at the Robert Koch Institute in Berlin, will bring his expertise in spillover events. In April 2014, Leendertz visited Meliandou village in Guinea, months after a two-year-old died of Ebola — the first person reported to be infected in West Africa. Work by Leendertz, including interviews with locals and environmental sampling, suggests that the outbreak started in bats that lived in a hollow tree where the children used to play. The tree was burned down days before his arrival and no Ebola virus was detected in nearby bats, which he says highlights the difficulties of pinning down an outbreak’s beginnings."

"When Ebola ripped through communities in West Africa between 2014 and 2016, Tolbert Nyenswah saw at first hand how health workers extinguished the epidemic by finding and quarantining contacts of those who caught the disease. The former director of Liberia’s public-health institute thought contact-tracers would again rise to the challenge this year, keeping COVID-19 in check as it swept the globe. “Contact-tracing is one of the greatest tools that countries should deploy and use effectively to contain the outbreak,” he says."

"At the moment, our big problem is finding the patients in a timely way and convincing them to come to the treatment center. If you don’t have a carrot to hang out there and bring people in, then you can’t contain it."

"West Africa is experiencing the largest, most severe, most complex outbreak of Ebola virus disease in history."

"The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long."

"[The WHO panel] concluded unanimously that it would be acceptable on both ethical and evidential grounds to use as potential treatments or for prevention unregistered interventions that have shown promising results in the laboratory and in animal models but have not yet been evaluated for safety and efficacy in humans, provided that certain conditions are met. In reaching these conclusions, the panel members were mindful that this is a departure from the well-established, historically evolved system of regulation and governance of therapies and interventions. Ethical and scientific criteria must guide the use of unregistered interventions. The ethical criteria include transparency about all aspects of care, so that maximum information is obtained about the effects of the interventions, fair distribution in the face of scarcity, promotion of cosmopolitan solidarity, informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity and involvement of the community."

"You’ve got to balance the compassionate-use aspect with trying to figure out whether it works."

"I'd say we have a couple of people who've recovered, they've gotten excellent medical care and the specific therapy, ZMapp … may have had a role in it but we don't know."

"It would have been the front-page screaming headline: ‘Africans used as guinea pigs for American drug company’s medicine’"

"I think that this is very unfortunate for perceptions of global justice."

"Some people look at the word 'expedited' as very favorable. Who wouldn't want something expedited? It can be very hard to say that's not a good thing to do. But history says a lot of time when we rush things through, people are harmed."

"You really worry how people in a vulnerable population will understand the risks. Do you think you can give informed consent, or are you likely to be coercive? How would I explain the risk of a brand-new drug to an African patient?"

"What if it had killed both of them? It is only because it worked, seemingly very well, that people are screaming, 'How come people in Africa didn't get it?'If the first people (to receive doses of ZMapp) would have been Liberian, headlines would have screamed, 'Experimental drug tested on poor Africans,'"