Dev Lall

I question the wisdom of our fight against Ebola

I have to question the wisdom of the ‘brave’ nurses, GPs, psychiatrists and emergency medicine consultants who have travelled to Sierra Leone to ‘fight’ the ebola virus.

While I may jest about the role of psychiatry in tackling this illness of circulatory failure and wonder if they will require boxing gloves to fight the virus – in a ‘wham’, ‘boom’, cartoonesque way – my message is a serious one.

I believe, in doing so, they are risking the lives of themselves and others.

The first rule of resuscitation in an emergency situation (as I’m sure will be covered in the training) is to check it is safe to approach. You are no help as a rescuer if you too succumb to the insult.

Just as pet owners drown when attempting to rescue their dogs from the sea, so too will nurses and doctors become infected with ebola virus and suffer a horrible illness. As the emergency doctors at the Hillingdon hospital noted, it is almost impossible to remove personal protective equipment (PPE) without touching the contaminated outer surface.

But whether these health professionals become infected or not, they will return to the UK at some point.

The over-arching rule in medicine is first do no harm. Infected or at risk of being so, the incubation period of the disease is 2 to 21 days and men can continue to harbour and transmit the virus for 7 weeks through their semen.

This undoubtedly puts our country at risk as well as the family and friends of these individuals. As screening for potential ebola victims is instituted at our international airports it seems ludicrous to encourage ways for the pathogen to enter the country by sending people to the area primarily affected by it and contradicts attempts to enclose and contain those infected.

From a risk assessment point of view, travelling to West Africa is foolhardy. Once infected, mortality from the ebola virus is over 50%. Not good odds, and further, as with many statistics, it is hard to translate population risks to individuals. Individuals either have it or do not have it and were this group of 30 to become infected, only 15 could expect to survive.

What about charity, I hear you say? What about compassion?

Charity begins at home and as healthcare professionals we are employed and paid to direct our compassion towards our own patients who desperately need it. Hardly a day passes without headlines publicising ‘a shortage of nurses’ or ‘a shortage of GPs’ and ‘unattainable waiting list targets’.

Back at home, who is left to care for the sick and dying here, but the colleagues of those who down tools and deem the need of another to be much greater. I asked an elderly patient who looked to be in severe pain and discomfort, what I could do to improve how she felt. She replied simply: “Help me brush my teeth,” as she lay with a fractured neck of femur.

The ethos of the NHS is to help as many people as possible, as far as is possible, to make best use of our resources in aid of common good. Surely it is not right to send a few to a far flung land to care for the dying and have to pay the price of containing the risk they pose on their return?

Bookmark and Share

One Response to “I question the wisdom of our fight against Ebola”

  1. Dr M Daly says:

    Having an excolleague who has worked in Sierra Leone for many years who is there at present, I know that the situation for many people there resembles that of London during the Plague. It is not supportible for us to turn away from this. MSF and other agencies have been doing their best since the disease emerged again last spring, but the situation is so dire now that there is a clear need for volunteer medical and nursing staff. We need to support and applaud those who are undertaking this and as is happening we need to ensure that there is medical care and rapid transfer available to them if needed.
    Vaccines and treatments need to be trialled as soon as is possible.
    We need not to complain if colleagues are risking their lives – surely we can manage to work extra hours for something as important as this?
    If Ebola cannot be controlled in West Africa, it will certainly come repeatedly to Europe – there is every reason as well as the humanitarian one, to try to mobilise all possible resources to control this disease.
    I think we don’t need to take the hysterical view of some US states as regards infection risk from returning health workers. We need to bear in mind that what is required to contract this disease is direct contact with bodily fluids. Returning health workers are likely to be giving high priority to the safety of others being fully aware of the risks which they and their colleagues have taken.

Post a Comment

Enter this security code

Submit Comment for Moderation