Ebola continues

The lead doctor at JFK hospital in Liberia died of it, and a Liberian flew to Lagos and died of it there. Two Samaritan's Purse missionaries have caught it. In Liberia they're taking some actions:

All borders of Liberia will be closed with the exception of major entry points including the Roberts International Airport, James Spriggs Payne Airport, Foya Crossing, Bo Waterside Crossing, Ganta Crossing. At these entry points, preventive and testing centers will be established, and stringent preventive measures to be announced will be scrupulously adhered to;

A new travel policy by the Liberia Airport Authority covering inspection and testing of all outgoing and incoming passengers will be strictly observed;

Restrictions on public gatherings such as solidarity marches, demonstrations, promotional advertisement are to be restricted;

Hotels, restaurants, entertainment centers and video clubs are to play five-minute film on Ebola awareness and prevention;

Government vehicles will be commandeered, as appropriate, to provide needed logistics support to the health delivery system;

Without those kinds of border assurances I'd bet that within a week or two EU or US airports would stop admitting Liberians/Sierra Leoneans/etc from anywhere. Even with border checks, they'll probably stop soon anyway, or only allow in after a week's observation. The Xray machine at the Roberts airport didn't work and the baggage search wasn't particularly efficient; will medical checks be any better?

Sierra Leone's Sheik Umar Khan treated over 100 ebola patients before contracting the disease himself. That suggests a 1% failure rate of the systems they have in place: bleed-through, airborne spittle, a stray fly that got past the screens, needle sticks, sloppy laundry--something. The safety suits are horribly hot: you last 40 minutes or so in the tropics, and I assume getting them off and on is tricky. (BTW, if you look at the pictures of the isolation units you see open concrete block, but you don't see the screen over the holes. They're not crazy, it's a camera lighting problem. And even with the "window" blocks, it gets hot and stuffy indoors.)

I'd put trying to understand how the system failed as one of the top medical priorities; something the US/EU should throw effort into ASAP for their own self-interest. That 1% doesn't seem high, but with hundreds of patient contacts the probabilities start to look ugly--and you lose your doctors and nurses. Top priority is border control testing, of course, and third would be trying to get tribal-custom friendly protocols for caring for the sick and dead back in the villages.

That last idea is scary. Just suppose that they worked up some cheap and easy protocols like my WAGs about making an isolation hut of mats, some sort of easily draining "bed" of rags and leaves, soaking all rags (and the deceased's body later) in bleach, and setting fire to the isolation hut afterwards and burying the ashes. Some such protocols might help reduce the transmission rate, and if they were custom-friendly and in the native languages and if you had teams go out to explain how to do it and distribute bleach...

Now your team visits a village where it turns out somebody has ebola right now. You have to demonstrate the procedures that you know aren't nearly as effective as the hospital's. They're better than what the villagers will do otherwise, but will they believe you if you refuse to do them yourself? That's going to take some courage.

UPDATE: It looks like Canada is not taking this seriously.