Focus fight against Ebola in Africa, Fauci tells Club Luncheon

The battle against Ebola should be waged in western Africa, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told a Club Luncheon Nov. 21.

The battle against Ebola is making progress there, especially in Liberia, where the number of new cases is coming down, thanks in part to the efforts of the U.S. military to build new hospitals in the region.

“Just because numbers are going down in a particular country is no reason to think that we have won this battle,” Fauci said. “The downtick in numbers has not diminished at all our efforts.”

Even so, with at least 14,000 cases and 5,700 deaths so far, the outbreak centered in Liberia, Sierra Leone and Guinea has claimed more lives than all 24 previous epidemics combined, he said.

Rich countries should do more to help poor countries develop a public health infrastructure, he said, adding that the wealthy nations would indirectly benefit if the chances of an epidemic spreading across borders are reduced.

“The problem is West Africa,” Fauci said. “They are the ones that are suffering. They are the ones that have the disease. They best way to protect Americans, or anyone else throughout the world, is to completely suppress the outbreak in West Africa so that there isn’t any risk of it."

Fauci said Ebola is transmitted by direct contact with a sick person’s bodily fluids. But fear was driven by the public’s “extrapolation” that what happened in western Africa would happen in the U.S.

“That’s not just not the case,” he said.

That’s because the U.S. has the resources to perform what he called the three hallmarks of epidemic containment: identify, isolate and contract trace. Relatively wealthy Nigeria was able to perform those steps and contain the epidemic, he pointed out.

And he said he opposed banning travel to the three African countries housing the Ebola outbreak.

“How do you balance the issue of keeping America safe, at the same time as you don’t do something that might be so draconian, for example, as to cut off a nation from help?" he said. "Namely isolate them, which we know from the talking to leaders of those countries, that to them would be devastating."

Fauci said he regretted the death of Ebola patient Thomas Eric Duncan at a Dallas hospital.

“Sick African man just got back from Liberia where there is a major Ebola epidemic," he said. "You would think you would want to put the person in a hospital, at least isolate them. He went home for two days and came back in an ambulance, very, very sick. Could that have impacted his ultimate course, of course."

Fauci described the importance of wearing personal protective equipment and handling it correctly.

“When I took off my material, I had a trained person watching me to make sure that I did it correctly," he said. "And they have the authority to stop when you do it and say, ‘Oops. You’re making a mistake. Sstop.’ Bottom line answer: You have to train people.”

Fauci said the National Institutes of Health is testing a vaccine and hopes to expand the trial into western Africa by te end of the year. Because Ebola was so rare before, there was little market for therapies and vaccines, Fauci said.