Projected treatment capacity needs in sierra leone

Area of Science:

• Epidemiology
• Public Health
• Infectious Disease Modeling

Background:

• The West Africa Ebola Virus Disease (EVD) outbreak necessitates international intervention to reduce transmission.
• The Centers for Disease Control and Prevention (CDC) model suggests 25% of patients in Ebola Treatment Units (ETCs) and 45% in community isolation are needed to control the epidemic.
• Estimates of required personnel and treatment capacity are vital for an effective international response in Sierra Leone.

Purpose of the Study:

• To estimate the personnel and treatment capacity needed to meet CDC targets for EVD control in Sierra Leone.
• To provide data-driven targets for the international response to the EVD outbreak.

Main Methods:

• A compartmental SEIR model was developed and fitted to WHO and local data.
• The model incorporated a reproductive number that changed every 8 weeks to forecast EVD progression.
• A 2.5x correction factor for underreporting was applied, and personnel needs were estimated based on CDC isolation targets.

Main Results:

• As of December 4, 2014, an estimated 810 active EVD cases were in treatment, with an additional 3751 unreported cases.
• To meet CDC targets, 1140 cases required ETCs and 2052 required community isolation on that date.
• Projections indicated a need for up to 3183 personnel within 56 days if transmission rates remained high.

Conclusions:

• Massive international support is essential to break EVD transmission chains in Sierra Leone.
• Failure to rapidly deploy sufficient treatment facilities and personnel risks overwhelming the healthcare system.
• Alongside isolation and treatment, supporting vaccine development is a viable control strategy.