As COVID-19 spreads more and more every day in Europe, the experts who beat Ebola in West Africa shared what they learned. Right now, China and Italy are to the pandemic what Guinea, Sierra Leone, and Liberia were to the Ebola epidemic of 2014-2016.
On March 9, Italy, which is the worst-hit country by the coronavirus outside of China, extended its lockdown to the entire country, as a way to stop the spread. That decision made by Italy resonated with many in West Africa.
The same situation happened in Sierra Leone back in September 2014 in the grip of Ebola, when authorities decided to impose 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.
Additionally, 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 said. “Coronavirus now, if we compare it to Ebola, is a droplet infection and social distancing is overly important.”
Chain of transmission
The September 2014 Ebola lockdown was just one of the first of several in Sierra Leone. The decision of a nationwide lockdown was intended to help cut down the transmission rate, exactly what the authorities in Wuhan, China, and Italy are trying to do at this moment.
“People will cut down on a number of activities that will predispose them to infection,” says Thomas.
The coronavirus pandemic has made Freetown resident Ishmael Alfred Charles to remember the 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.
Abu-Bakarr Jalloh was also 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.”
On the last day of that first lockdown, Sierra Leone’s politicians said health teams had called on 75% of households and praised the record-breaking intervention. The public had been extremely receptive to the advice they were given, even though some suspicion persisted and many people moved across the border to places like Liberia and Guinea.
Dr. Doddy Ngwasi worked in Guinea when the epidemic happened. The Congolese Ebola specialist has spent the past two years at the epicenter of the Ebola epidemic in the 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 the 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.”
Learning, virus to virus
Dr. Gabriel Gorbee Logan is seen as an Ebola hero in Liberia because of his work at the forefront of the bid to help stop the transmission of the 2014 to 2016 epidemic. He was recently named the assistant minister for curative services at the health ministry and he has been very attentive 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.
“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 we should share information as much as possible.”
Beware of fake news
Patrick Faley, a Liberian Ebola survivor remembers the denial and all the false information that spread 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 the 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.”