Lesson 1: Epidemics depend on context. “The outbreak of Ebola is a symptom; the root cause is political instability,” said @Tedros.
Many places are unstable. DRC is very. Since 2017, in Kivu provinces alone, 3860 people have been killed & 5274 abducted. kivusecurity.org
Many governments, including DRC, ignore or fuel conflict & poverty in east DRC. When the president barred eastern cities from voting “due to Ebola” the link between politics& the virus hardened. Next came attacks.
Does politicization of a virus in an election yr sound familiar?
Lesson 2: Mistrust results in avoidance of ‘health authorities'. To gain trust, the wisest Ebola responders used ⭐️conversations⭐️
They tried to see the world from the perspective of the people they wanted to help.
For example: Here’s @SoceFallBirima listening to complaints from angry motorcyclists who have blocked the road in protest.
Here is @AnokoJulienne visiting communities deep in the forest, rightfully suspicious of outsiders. Ebola discoverer @MTamfum frequently speaks at churches
Conversations are hard! They don’t turn a profit for tech companies or branding agencies. But ads & posters aren't enough.
I see many people in parts of Brooklyn not wearing masks in shops. Fines would be cruel w/poverty rising.
Where is outreach, empathy & support in the US?
Thanks @WHO for dedication in DRC & transparency. @Tedros is pushing for universal healthcare. Without it, we won’t detect emerging epidemics quickly. Without it, SO many people die from preventable causes. Without it, communities mistrust ‘health authority.’
Massive thanks to the photographer who traveled w/me & took gorgeous photos @wesselsjohn1 (pictured at a checkpoint waving); my editors at Nature @bmaher@lmorello; and @pulitzercenter, which has consistently supported my need to report on the ground and not at the desk.
Thanks for coming to my Twitter talk. I’ll end the way I ended my trip to DRC, with a trip to see bonobos. Thanks again to @AAASKavli & hurray for my talented colleagues listed here. Check out their work! sjawards.aaas.org/news/2020-aaas…
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☹️One of the most upsetting CDC reports yet: Wedding leads to 177 Covid cases & 7 deaths among people who weren’t even there.
Aug 7. Wedding w/55 guests in a Maine town with no corona.
A guest goes to a school meeting. Others go to jobs at a nursing home & jail, with symptoms.
Wedding screened for fever but guests don’t wear masks indoors. Wedding hosts don’t give health dept a list of phone # of guests. So contact tracing isn’t fast enough to stop spread.
After 23 days health dept determines that 30 of 55 guests were positive. By then it’s too late.
Because of the wedding:
-120 staff & residents of a care facility & correctional facility were infected & scared & may have long term health issues.
✈️NEW flight report on corona transmission on flights:
13 people appear to have been infected on a 7-hr flight to Ireland this summer, leading to 59 cases as passengers visited friends & family. The plane was at 17% capacity & required masks.
Why do researchers think infection occured in ✈️?
-5 show symptoms w/in 4 days of flight & have no other exposure; 8 could have gotten it during layover but seat map suggests in-flight
-Sequencing finds that the virus is 99% similar despite travelers coming from diff continents.
Impressive contact tracing made this possible. European CDC has a guidance to alert all flight passengers when there is a positive case on board. Perhaps @CDCgov might consider such a thing given that people will be traveling during the holidays, and staying with loved ones.
Psst: It is your civic duty to watch "Totally Under Control." We must hold leaders accountable.
I've interviewed some of the scientists in the film & dozens more this year. Here are my thoughts after viewing @undercontrolmov from @alexgibneyfilm. 🧵
Spot-on portrayal of how the CDC & FDA stood in the way of testing in Feb @undercontrolmov, including @RickABright asking Azar for 10 billion to ramp up testing & drug/vaccine R&D around Jan 20. He’s later told that was an offensive ask.
But...
But the big question remains unanswered: Who at the CDC/FDA/HHS said DON'T push hard on testing?
Tho @RickABright says Kadlec told him there was “no reason for concern” in Jan & @scottjbecker@APHL admits it was hubris to not use the German test vetted & distributed by WHO.
With 5.7 million cases in the US, we should have a good sense of how often people are infected in grocery stores, on planes, at protests, on construction sites.
Data on #Covid transmission is critical as people socialize & schools & businesses open.
eg in #NewZealand, the country's daily dashboard suggests people get tested if they went to locations linked w/current outbreaks. health.govt.nz/our-work/disea… Screenshot from today
The daily dashboard from the @KoreaCDC reveals that 50 people from a 915-person #COVID outbreak at Sarang Jeil Church in Seoul have left for other districts; that 22 venues, listed, have since had transmission that traces back to that outbreak & MUCH MORE
We spoke with researchers who ran simulations like Dark Winter, Atlantic Storm, Crimson Contagion, Clade X, Event 201. They foresaw a lot of problems happening now. But most thought we were better than anywhere else because of technological capacity, medical & science excellence.
As a long-time government researcher told me: "You need gas in the engine and the brakes to work, but if the driver doesn't want to use the car, you're not going anywhere." nature.com/articles/d4158…
I spent months in SierraLeone during the biggest #Ebola outbreak in history & I've just caught up with doctors I met who are now fighting #coronavirus. Lots of interesting comparisons to that outbreak -- and to the USA -- in my latest piece @NatureNews. nature.com/articles/d4158…
Some African researchers I talked w/were surprised that the CDC—so helpful during #Ebola—seems sorta powerless in the US. “I was shocked to see the US struggling to understand what contact tracing is, to organize a response, to put in place risk communication,” said @NyenswahG.
Another twist is that because many cases are mild or asymptomatic due to the young population in Liberia, SierraLeone & Guinea (3% of people >65), a lot of people might be taking this less seriously than public health authorities wish. (Btw this photo is worth 1000 words.)