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Lebanese face ‘imminent’ Ebola danger

 

 

BEIRUT: The health minister warned Monday that Lebanon faces an “imminent danger” posed by Ebola due to the country’s expat community in West Africa, and gave big private hospitals a three-week deadline to prepare quarantine units.

Wael Abu Faour pledged to build isolation chambers in the country’s major public hospitals and detailed for the first time tight measures imposed in air and seaports as well as surveillance of travelers from nations affected by the deadly virus.

But he also said hospitals and medical staff in Lebanon were ill-equipped and mostly untrained in the necessary protocols in handling suspected Ebola patients, promising to train health care workers.

“Lebanon, unfortunately, is more exposed than other nations, as we have very large Lebanese communities in infected countries, and these communities are made up of third generation immigrants and … consist of large families,” Abu Faour said at a news conference at Lebanese University.

“It is not a choice – the safety of the Lebanese is at stake,” the health minister said after meeting dozens of hospital staff to discuss the measures.

Lebanon has not yet had any Ebola cases. A number of patients with preliminary symptoms similar to Ebola have been hospitalized but later found to be ill with malaria.

The highly contagious Ebola virus has killed more than 4,500 people in West Africa since December. Liberia and Sierra Leone, both of which have significant Lebanese communities, as well as Guinea have experienced widespread transmission of Ebola. Nigeria, which experienced localized outbreaks but was declared free of Ebola Monday, also has a large Lebanese community.

Most Lebanese families in the affected countries have already returned to Lebanon, though some businessmen continue to travel to and from the affected zones.

Abu Faour outlined a raft of travel, surveillance, training and medical measures that collectively form the country’s most serious effort yet of dealing with the potential fallout from the Ebola crisis.

Lebanese diplomatic missions in Sierra Leone, Liberia and Guinea have introduced tougher visa restrictions including medical tests for non-citizens traveling to the country.

Abu Faour said airlines have agreed to distribute questionnaires to patients flying in from affected areas asking for information on possible symptoms, and those arriving at Rafik Hariri International Airport and the Beirut and Tripoli ports are undergoing temperature tests.

In addition, since Ebola symptoms can take up to 21 days to appear, individuals arriving from affected areas have to provide contact details to the Lebanese authorities and ministry staff will contact them on a regular basis to check for symptoms, Abu Faour said.

Individuals suspected of having Ebola can be taken to the airport isolation unit and from there to Rafik Hariri Hospital’s isolation chamber, which can hold two patients but will be soon be expanded, he said.

Abu Faour pledged to build isolation units in the coming days and weeks at the public hospitals of Nabatieh, Sidon, Tripoli, Dahr al-Basheq and Baalbek.

At the moment, the only hospital equipped to handle Ebola patients is Rafik Hariri Hospital. The AUB Medical Center is also in the process of preparing its own isolation unit.

Abu Faour also ordered that all private hospitals with over 100 beds prepare a quarantine unit to hold potential or suspected Ebola patients. There are 24 such hospitals throughout Lebanon.

Sleiman Haroon, the head of the Association of Private Hospitals, said the hospitals will need three weeks to have the new units in place. The heads of private hospitals are set to meet Wednesday with the health minister to coordinate the new plan.

“We hoped that we’d not be in this situation as hospitals, but we are forced to adapt,” Haroon told the gathering of health care staff.

Haroon said the new isolation chambers will present a technical challenge in addition to procuring equipment that will be needed to operate them, and will add to the financial burden of hospitals. In addition, hospitals will have to offer incentives to medical staff in order to entice them to work on patients with a highly contagious disease, and who may die.

Lebanese medical personnel will also need protection suits in case they have to treat Ebola patients. Some suits have been distributed to Lebanese hospitals following training regimens that were held with the Health Ministry in collaboration with the World Health Organization on handling the aftermath of chemical, radiological and biological attacks that occurred around the time of the chemical weapons attacks in Syria.

But Abu Faour said the biggest challenge is training medical staff in identifying and handling Ebola cases, many of whom lack the knowledge to receive such patients. Most emergency departments also do not have the facilities yet to isolate potential Ebola victims.

A recent ministry survey of health care workers that asked what they would do if confronted with an Ebola patient showed that most would not know how to handle the individual, and would opt to refer them to other hospitals.

In addition, Abu Faour said there is a lack of awareness among the public about the disease in general.

The ministry held a training session in Sidon Monday for medical staff in the south, and will hold another Tuesday for Beirut and Mount Lebanon. The government has also distributed 80 protective suits to health facilities around the country.

A key debate in Abu Faour’s meeting with hospital staff was over whether patients ought to be treated in various locales around the country or if they should be housed in a centralized facility. While using multiple hospitals is more convenient, it could spread the risk of infection over a wider geographical area, while a central location would have problems transferring patients who prefer to seek out nearby facilities.

Still, Abu Faour said the measures will only ameliorate the risk, saying Lebanon’s health infrastructure is not equipped to handle such a crisis.