BERLIN — Back on March 26, just days after global health officials determined that a rash of deaths along the borders of Guinea, Sierra Leone and Liberia was the result of the deadly Zaire strain of the Ebola virus, the Klinikum St. Georg in Leipzig, Germany, announced that it had a ward ready to deal with the disease.
Months later, on Oct. 14, a 56-year-old Sudanese United Nations health care official died in that unit. He had contracted Ebola while working in Liberia, had arrived in a sealed container and was treated around the clock for a week by doctors and nurses in sealed outfits in that sealed ward.
Hospital and Leipzig city officials admit that while the ward was secure — helping to prevent the disease from spreading — there was very little they could do for the man himself.
Which is the story of Ebola and the West. There’s a lot teeth gnashing over how — away from the hot zone of West Africa, and with the vast wealth available to the medical communities of the United States and Europe — to best deal with the threat of a disease that has killed half of those infected: 9,200 are known to have been infected, and 4,550 are known to have died.
World Health Organization officials are fearful that by December the number of those infected might be increasing by 5,000 to 10,000 a week and the lethality could be 70 percent.
The United Nations has said that keeping this outbreak from breaking out further will cost $1 billion. Treatment for a single patient in Germany is reported to have cost more than $2.5 million, including for a scanner and mobile X-ray device that had to be junked after the patient vomited on them.
European medical experts admit that no two of the 11 cases to date in Europe — 10 evacuees from the hot zone and a nurse who was infected in Spain while treating one of them — have been treated identically.
In Germany, St. Georg clinic director Bernhard Ruf said the challenge was to do everything possible to help the patient while making sure the staff stayed safe from the contagion.
“We don’t think you can deny any intensive medical care options to Ebola patients,” he said. “In the absence of an approved drug, treatment mainly consists in trying to control symptoms. The infection is often accompanied with organ failure, which needs to be treated symptomatically. Respirators and, if needs be, dialysis, are important measures to deal with these symptoms.”
But Dr. Ruf said the outbreak highlighted the limitations of German preparedness.
“We set up the quarantine centers around Germany about 10 years ago, when the main worries were new influenza strains and SARS,” he said, referring to severe acute respiratory syndrome. “We did not envisage having to deal with Ebola cases. Treating Ebola presents challenges.”
The Leipzig clinic is part of a network of high-end hospitals around Germany that have a total of 50 beds in securely isolated wards ready to treat the disease. Dr. Ruf said that because of the intensive care required, however, Germany really could treat only about 10 Ebola patients at a time in those 50 beds.
Thus far, three of the beds have been used. The case in Leipzig ended in death. A case in Hamburg ended in recovery; a Senegalese aid worker was released after five weeks of treatment. A case in Frankfurt looks hopeful; a Ugandan doctor who was infected while working in Sierra Leone is receiving treatment. German privacy laws have kept their identities secret.
The Hamburg case is intriguing. Media reports indicate that doctors there took a simple approach to Ebola treatment: fluids, pain medications and a high level of security to make sure the staff and population stayed safe. They avoided experimental drugs.
Germany, considered to be among the most well-prepared European nations to handle this crisis, hasn’t planned how to deal with Ebola should the disease spread through its population. Its treatment plan involves patients coming in limited numbers, and in controlled situations.
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Sia Furler