Report from the World Health OrganizationDuring the past weeks, a WHO team of emergency experts worked together with President Ellen Johnson Sirleaf and members of her government to assess the Ebola situation in Liberia.Transmission of the Ebola virus in Liberia is already intense and the number of new cases is increasing exponentially.The investigative team worked alongside staff from the Ministry of Health, local health officials, and other key partners working in the country.All agreed that the demands of the Ebola outbreak have completely outstripped the government’s and partners’ capacity to respond. Fourteen of Liberia’s 15 counties have now reported confirmed cases.Some 152 health care workers have been infected and 79 have died. When the outbreak began, Liberia had only one doctor to treat nearly 100,000 people in a total population of 4.4 million people. Every infection or death of a doctor or nurse depletes response capacity significantly.Liberia, together with the other hard-hit countries, namely Guinea and Sierra Leone, is experiencing a phenomenon never before seen in any previous Ebola outbreak. As soon as a new Ebola treatment facility is opened, it immediately fills to overflowing with patients, pointing to a large but previously invisible caseload.Of all Ebola-affected countries, Liberia has the highest cumulative number of reported cases and deaths, amounting, on 8 September, to nearly two thousand cases and more than one thousand deaths. The case-fatality rate, at 58%, is also among the highest.Situation in Montserrado countyThe WHO investigation concentrated on Montserrado county, which includes Liberia’s capital, Monrovia. The county is home to more than one million people. The teeming West Point slum, which has no sanitation, little running water, and virtually no electrical supplies, is also located in Monrovia, and is adjacent to the city’s major market district.In Montserrado county, the team estimated that 1000 beds are urgently needed for the treatment of currently infected Ebola patients. At present only 240 beds are available, with an additional 260 beds either planned or in the process of being put in place. These estimates mean that only half of the urgent and immediate capacity needs could be met within the next few weeks and months.The number of new cases is moving far faster than the capacity to manage them in Ebola-specific treatment centres.For example, an Ebola treatment facility, hastily improvised by WHO for the Ministry of Health, was recently set up to manage 30 patients but had more than 70 patients as soon as it opened.WHO estimates that 200 to 250 medical staff are needed to safely manage an Ebola treatment facility with 70 beds.The investigation team viewed conditions in general-purpose health facilities as well as Ebola-specific transit and treatment facilities.The John F Kennedy Medical Center in Monrovia, which was largely destroyed during Liberia’s civil war, remains the country’s only academic referral hospital. The hospital is plagued by electrical fires and floods, and several medical staff were infected there and died, depleting the hospital’s limited workforce further.The fact that early symptoms of Ebola virus disease mimic those of many other common infectious diseases increases the likelihood that Ebola patients will be treated in the same ward as patients suffering from other infections, putting cases and medical staff alike at very high risk of exposure.In Monrovia, taxis filled with entire families, of whom some members are thought to be infected with the Ebola virus, crisscross the city, searching for a treatment bed. There are none. As WHO staff in Liberia confirm, no free beds for Ebola treatment exist anywhere in the country.According to a WHO staff member who has been in Liberia for the past several weeks, motorbike-taxis and regular taxis are a hot source of potential Ebola virus transmission, as these vehicles are not disinfected at all, much less before new passengers are taken on board.When patients are turned away at Ebola treatment centres, they have no choice but to return to their communities and homes, where they inevitably infect others, perpetuating constantly higher flare-ups in the number of cases.Other urgent needs include finding shelters for orphans and helping recovered patients who have been rejected by their families or neighbours.Last week, WHO sent one of its most experienced emergency managers to head the WHO office in Monrovia. Coordination among key partners is rapidly improving, aiming for a better match between resources and rapidly escalating needs.Implications of the investigationThe investigation in Liberia yields three important conclusions that need to shape the Ebola response in high-transmission countries.First, conventional Ebola control interventions are not having an adequate impact in Liberia, though they appear to be working elsewhere in areas of limited transmission, most notably in Nigeria, Senegal, and the Democratic Republic of Congo.Second, far greater community engagement is the cornerstone of a more effective response. Where communities take charge, especially in rural areas, and put in place their own solutions and protective measures, Ebola transmission has slowed considerably.Third, key development partners who are supporting the response in Liberia and elsewhere need to prepare to scale up their current efforts by three- to four-fold.As WHO Director-General Dr Margaret Chan told agencies and officials last week in New York City and Washington, DC, development partners need to prepare for an “exponential increase” in Ebola cases in countries currently experiencing intense virus transmission.Many thousands of new cases are expected in Liberia over the coming three weeks.WHO and its Director-General will continue to advocate for more Ebola treatment beds in Liberia and elsewhere, and will hold the world accountable for responding to this dire emergency with its unprecedented dimensions of human suffering.Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)
Jerome was a two-time winner of the Best Maintenance Feature competition at the Aerospace Journalist of the Year Awards and was also a former contributor to Air Transport World and Aviation Week & Space Technology.His book on the windshear-related crash of Delta Air Lines Flight 191 was a best-seller, and the subsequent television film – Fire & Rain – premiered on the USA Network.Chandler who is an air safety expert has appeared on NPR, PBS’s Nova series, CNN, ABC, MSNBC and the National Geographic Channel.Aviation safety is more than academic for Jerry. Two relatives have perished in separate commercial airline crashes over the years, one in the infamous Braniff Electra tragedy of September 1959.Jerry passed away on August 15, 2019.Read his tribute here.
“If you believe in yourself, then anything can happen,” she said. “But of course semis is, ‘Wow.’”She’s the first Belgian since Kim Clijsters in 2012 to reach the semifinals in Australia, and knew she had plenty of support at home.FEATURED STORIESSPORTSWATCH: Drones light up sky in final leg of SEA Games torch runSPORTSLillard, Anthony lead Blazers over ThunderSPORTSMalditas save PH from shutout“Kim, thanks for watching, I knew you sent me a message before the match — don’t be too stressy,” said Mertens, who trains at Clijsters’ academy. “I’m trying to be in your footsteps this week.”The No. 37-ranked Mertens successfully defended her Hobart International title — she decided last year to target that title instead of entering Open qualifying — two weeks ago, and has now won five matches at Melbourne Park. 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His fine of $45,000 nearly equals his first-round prize money of 60,000 Australian dollars ($47,900).Zverev’s fine was the largest ever assessed to a player for an on-site Grand Slam offense. Other players have been fined larger amounts following a Grand Slam tournament, such as Serena Williams’ $82,500 fine in 2009 for her tirade at a U.S. Open line judge.Italian player Fabio Fognini was fined $96,000 last year after insulting a chair umpire at the U.S. Open, an amount that could be reduced to $48,000 if he doesn’t have any further offences over the next two years.The new rule came in response to a rash of first-round retirements at Wimbledon last year. View comments 2 ‘newbie’ drug pushers fall in Lucena sting Mertens dominated against Svitolina, who also entered her first quarterfinal in Australia on a nine-match winning roll after winning the Brisbane International two week ago.Svitolina had won their only previous tour-level match, but had no answers on Rod Laver Arena and later said hip trouble had been bothering her all year.“She played great from the beginning of the year,” Svitolina said. “But, you know, when I give her opportunities to play and to play a good level, then of course she’s going to play. She’s going to go for shots.“Now she’s in semifinal. Now she’s not just a player that’s up and down. She’s quite consistent, and we can see this.”Mertens raced out to a 5-2 in the first set before Svitolina got her only service break. The second set was no contest. Mertens won a 27-point rally while holding serve in the fourth game, then hit a backhand winner into the open corner to break Svitolina in the next game for a 5-0 lead.ADVERTISEMENT Belgium’s Elise Mertens celebrates after defeating Ukraine’s Elina Svitolina in their quarterfinal at the Australian Open tennis championships in Melbourne, Australia, Tuesday, Jan. 23, 2018. (AP Photo/Dita Alangkara)MELBOURNE, Australia — A year after opting out of qualifying for the Australian Open, Elise Mertens has reached the semifinals in her debut at the season-opening Grand Slam.Mertens upset fourth-seeded Elina Svitolina 6-4, 6-0 on Tuesday to extend her winning streak to 10 matches and be the first woman through to the semifinals at Melbourne Park.ADVERTISEMENT NEXT BLOCK ASIA 2.0 introduces GURUS AWARDS to recognize and reward industry influencers