For many in San Francisco, Thanksgiving weekend was a time to catch up with family, gorge on turkey and spend hours plunked in front of a television watching football.
But some 7,000 miles away in West Africa, the hot spot of the world's worst Ebola outbreak was about to shift from Liberia to Sierra Leone for the first time since the epidemic began early this year.
“Nobody realized it was getting really bad,” said Dr. Dan Kelly, a UC San Francisco clinician who has immersed himself in the outbreak and traveled to Sierra Leone about half a dozen times since the summer to provide health care training.
“It wasn't until … around Thanksgiving and early December that it spiraled out of control,” he said.
As of Dec. 19, Sierra Leone had seen 8,759 Ebola cases, whereas Liberia was at 7,819. However, Liberia has still recorded more Ebola-related deaths than any other country affected by the virus, at 3,346 (Sierra Leone had 2,477 deaths, and Guinea was at 1,550).
Among the pockets of Sierra Leone getting worse this month was the Kono District, where Kelly co-founded the health care organization Wellbody Alliance in 2006. The first Ebola case was confirmed in the region in July, and the number of those infected has since spiraled out of control.
“Because health care providers were scared, patients were basically sentenced to death,” Kelly said of when Ebola exploded at Koidu Government Hospital in the Kono District. “It was inhumane the way [patients were getting care].”
Kelly said no one knows for sure why Sierra Leone recently became the latest hot spot for Ebola, but a lack of Ebola treatment units in parts of the country is at least partly to blame.
“We saw hundreds of Ebola cases in [the Kono District] before anyone started talking about an ETU,” Kelly said. Ebola treatment units in Liberia, however, have increased even in areas that have seen just a few cases, which has likely helped to quell the spread of the virus there, he added.
Kelly spent his most recent trip in Sierra Leone continuing to provide infection control training to health care workers and informing the World Health Organization and the national government about the resources needed to combat Ebola in parts of Sierra Leone. He said agencies quickly responded and began sending in help.
“It certainly was heartening to see the influx of international resources come into Kono, but I recognize that we have a long way to go,” said Kelly, who returned to San Francisco on Dec. 22. Since his return, he reports his temperature daily to the Public Health Department and monitors himself for any other possible Ebola symptoms.
Vaccines are the next step to stopping the Ebola outbreak, Kelly emphasized. Within the next few months, Kelly plans to help launch an Ebola vaccine preparedness study along with one of a few companies seeking to develop a vaccine.
“With clinical care and control-and-care measures, we can kind of get things more under control, but we'll continue to see scattered smatterings of Ebola cases pop up until we have a vaccine and immunize a large portion of the population,” Kelly said.
Kelly is one of about a dozen UCSF health care workers who have traveled to West Africa to help with the Ebola epidemic. This month, Time magazine named Ebola fighters as its Person of the Year.