Quarantine works against Ebola but over-use risks disaster
Surveillance, a more Ebola-educated populace and targeted quarantine measures have meant Uganda had only 149 cases with thirty-seven deaths, one case and death, and thirty-one cases with twenty-one deaths in subsequent outbreaks in 2007, 2011 and 2012.
Nigeria has also demonstrated the efficacy of a contact tracing and isolation approach. Despite being one of the most populous countries in Africa and having cases introduced into Lagos, a city of 21 million people, its last case was seen on September 5.
Removing infected and potentially infectious people from the community clearly helps reduce the spread of disease, but it still requires a place for people to be isolated and treated. That’s what’s missing in countries still in the midst of the epidemic, and also what continues to drive it.
Too much of a good thing
While quarantine is an important weapon in our arsenal against Ebola, indiscriminate isolation is counterproductive.
The World Health Organization has warned that closing country borders and banning the movement of people is detrimental to the affected countries, pushing them closer to an impending humanitarian catastrophe. Stopping international flights to the affected countries, for instance, has led to a shortage of essential medical supplies.
Still, this didn’t stop Sierra Leone from imposing a stay-at-home curfew for all of its 6.2 million citizens for three days from 19 to 21 September. Results from this unprecedented lockdown are unverified, with reports of between 130 and 350 new suspect cases being identified and 265 corpses found. But in a country where the majority of people live from hand to mouth with no reserves of food, the true hardship of the measure is difficult to quantify.
In addition to the three-day lockdown, two eastern districts have been in indefinite quarantine since the beginning of August. On 26 September, Sierra Leone’s president, Ernest Bai Koroma, announced that the two northern districts of Port Loko and Bombali, together with the southern district of Moyamba, will also be sealed off. This means more than a third of the country’s population will be unable to move at will.
Sierra Leone’s excessive quarantine measures are having a significant impact on the movement of food and other resources around the country, as well as on mining operations in Port Loko that are critical for the economy.
The country had one of Africa’s fastest-growing economies before the outbreak, with the IMF predicting growth of 14 percent. The World Bank estimates the outbreak will cost 3.3 percent of its GDP this year, with an additional loss of 1.2 percent to 8.9 percent next year.
Rice and maize harvests are due to take place between October and December. There’s a significant risk that the ongoing quarantines will have a significant impact on food production.
Quarantine is an excellent measure for containing infectious disease outbreaks, but its indiscriminate and widespread use will compound this epidemic with another humanitarian disaster.
Grant Hill-Cawthorne is Lecturer in Communicable Disease Epidemiology at University of Sydney. This story is published courtesy of The Conversation (under Creative Commons-Attribution/No derivatives).
