Home' Trinidad and Tobago Guardian : January 10th 2015 Contents A24
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Called to the Bar of Trinidad and Tobago as an Attorney at Law.
A practicing Attorney in the jurisdiction of Trinidad and Tobago, with at least three (3)
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BY: 13th January 2015
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When she was an undergraduate at
Princeton University, books like The
Hot Zone and Virus Hunters captivated
Rebecca Levine, inspiring her to
become a disease detective.
Fifteen years later, Lt Rebecca Levine,
a newly minted officer with the US Pub-
lic Health Service, stepped off a plane
in West Africa to fight Ebola, ready to
implement the key strategy she d been
taught: contact tracing.
The process that s helped stop diseases
like Sars and smallpox seems simple:
Find everyone who had close contact
with infected individuals and track them
for 21 days. If any of these contacts
comes down with the disease, isolate
them from the community and repeat
the process by tracking the contacts
But tracing works only if you have a
list of the contacts and their addresses.
When Levine arrived at a Ministry of
Health office in Sierra Leone, she found
that the database she needed was "pretty
much in shambles."
Many contacts addresses were miss-
ing or were vague like "down by the
farm road." In all, only 20 per cent to
30 per cent of the contacts in the data-
base had a usable address.
That meant the local contact tracers
weren t able to do their jobs properly.
"They were really unfamiliar with
what contact tracing was," she said.
"And they didn t have the resources
According to the United Nations, only
16 of 44 zones in West Africa have suf-
ficient contact tracing.
This inability to do complete contact
tracing is a major reason---perhaps the
major reason---that the Ebola outbreak
continues to spiral out of control, accord-
ing to public health officials and experts.
Top WHO officials have said there
aren t enough contact tracers to get the
job done, and the organisation forecasts
an "exponential increase" in the number
of Ebola cases in the coming weeks.
Donald Thea isn t surprised that the
system is breaking down in many areas.
An infectious disease epidemiologist at
the Boston University School of Public
Health, he s worked in Africa for more
than 25 years.
Like Levine, he often found that peo-
ple had no address---or had one that
even locals couldn t decipher. Residents
moved a lot, and when they did, many
times they took their doors and locks
with them to save money. They wouldn t
change the number on the door, so the
streets ended up with a mishmash of
Add that to the fact that people are
often uncooperative with the tracers,
sometimes even throwing stones at
health care workers. They fear that they
or their loved ones will be put in the
hospital; they ve seen firsthand that
people who go there often don t return.
"The community perceives this as a
death sentence," he said. "Relinquishing
your loved one is tantamount to death."
And health care workers have very
little to offer people as an incentive to
"With smallpox, we could offer people
a vaccine, a carrot in essence to induce
them to be cooperative. With Ebola, we
have nothing," Thea said.
In Sierra Leone, Levine, an officer
with the Epidemic Intelligence Service
at the Centers for Disease Control and
Prevention, remembers the words of her
agency s director, Dr Tom Frieden. Bat-
tling Ebola is like fighting a forest fire:
Miss even just one contact, and you
could be leaving behind a burning ember
that will reignite the outbreak.
When Levine arrived in Sierra Leone
on August 17, she brought software on
a thumb drive to manage cases and con-
tacts. The software was designed by the
CDC and was far more effective at
organising thousands of names than the
unwieldy Excel spreadsheet that the
local health care workers had been using.
With the help of other organisations,
she also got the workers more computers
and training in how to do contact tracing.
Now, hundreds of contact tracers are
assigned to go out into the neighbour-
hoods in her district every day.
She says the death and illness all
around her spur her on. (cnn.com)
The reason Ebola isn't being stopped
This September 30, 2014 file photo shows Nowa Paye, nine, as she is taken to an ambulance after showing
signs of Ebola infection in the village of Freeman Reserve, about 30 miles north of Monrovia, Liberia. AP PHOTO
YOUR DAILY HEALTH
News and Advice
"With smallpox, we could offer
people a vaccine, a carrot in
essence to induce them to be
cooperative. With Ebola, we
have nothing." ---Donald Thea.
Final-stage trials of experimental
Ebola vaccines will begin in January
or February in the worst-hit West
African countries as scientists and
drugmakers race to block the deadly
disease, the World Health Organi-
sation said on Thursday.
If effective, the shots will be avail-
able for deployment a few months
Nearly 90 experts from vaccine
manufacturers, regulatory agencies
and health ministries met at WHO
headquarters to review data from initial
safety trials and finalise plans for piv-
otal Phase III clinical trials in Liberia,
Sierra Leone and Guinea.
"It is my understanding that no
major safety signals have been reported
to date," WHO director-general Mar-
garet Chan told the talks in opening
remarks obtained by Reuters.
"We all want the momentum and
sense of urgency to continue," she
said. "Too many health care workers
are still getting infected, including
nationals and doctors and nurses from
foreign medical teams."
The meeting is discussing three dif-
ferent large-scale clinical trial designs
using the most advanced vaccines to
fight a disease that has killed more
than 8,000 people in the past year.
WHO: Pivotal Ebola vaccine
trials to start this month or next
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