The Ebola Strategy Roadmap that was coordinated by The World Health Organization (WHO) emphasizes the importance of mobilizing and sustaining health workers and support staff that run treatment facilities. So far there have been 366 cases of Ebola amongst health workers in Liberia. Providing training for health workers is key to improving the safety of the workers, as well as reducing the overall Ebola transmission. The Ministry of Health’s (MoH) goal is to have 100% of Health Care Workers (HCW) certified in at least one Ebola training course. This goal is based off the 3500 individuals that MoH has determined work directly with Ebola patients or are responsible for the cleaning and maintenance of facilities. Courses are being held on different dates across the country but priority for the trainings is being given to:
1. Liberian health workers
2. Individuals who will conduct trainings for Liberian Health Workers
3. Medical Staff who actually work in Ebola Treatment Units
4. Medical Staff who are working in underserved communities
The pie chart below is based on data from our internal sources and shows the percentages of trainings that were completed by health care workers. We did not receive details on the curriculum of the training courses, so we are unable to explain the difference between the phases. However, we do know that the training courses build on one another and were created in a partnership between MoH and WHO. Therefore, we can presume that the course phases will follow the priorities that WHO discussed in their strategy roadmap, including: the proper use of Personal Protection Equipment and Sanitation. The following pie chart shows that 56% of HCWs completed their phase 1 and 2 trainings and an additional 21% have fully completed their training. Based on this information the MoH will reach its goal of having 100% of health care workers trained in at least one Ebola course by Dec 31st.
As the health care workers complete these new Ebola trainings we hope to see a downward trend of cases. For the week of December 1st through December 7th, there were five counties that had zero suspected cases of Ebola, these included: Lofa, River Cess, Grand Gedeh, River Gee and Maryland. The following chart shows the updates on numbers of suspected and probable cases for the different counties across a two week period. When comparing the two weeks there are minor fluctuations in the number of suspected cases. Montserrado County currently has the highest number of suspected cases.
Looking at the number of suspected cases is important, because its shows the effectiveness in the health workers ability to identify potential Ebola cases. Additionally, these numbers include people that may not have laboratory test results back. Depending on the patients location the lab results can take a few days to recieve. For example, on December 5th there were 45 probable or suspected cases across Liberia, and 5 cases were confirmed positive, but there were 54 lab tests completed. Then on December 7th there were 10 probable or suspected cases, and 7 of these cases were confirmed positive, but it was reported that there were 59 lab tests completed. For December 7th this leaves a total of 49 more lab tests completed than there were probable or suspected cases reported. The high variation between the suspected and confirmed cases and the lab result number makes it difficult to tell how many actual cases are happening on a given day. There are several different possibilities for the cause of these variations, including the delay in laboratory test results, but because of these variations the total number of suspected and probable cases pictured above provides a good overview of the progress in the different counties over time. As the health worker trainings are completed we anticipate seeing a reduction in the error margin between suspected and confirmed cases.