Training and fielding survivors could, in fact, be the much-needed “tipping point” in the battle against the outbreak and its spread, say Joshua M. Epstein, Ph.D., Lauren Sauer, M.Sc., and their colleagues in a commentary published in the online edition of the journal Nature on, Dec. 17.
“There are no known cases of an Ebola survivor being re-infected with the disease, suggesting that those who recover may indeed be immune. These people might safely provide an invaluable resource to help care for those who are infected,” notes Epstein. “What is needed is a widespread, systematic approach to training and getting survivors actively responding to Ebola.”
Efforts by those who have recovered from the virus could dramatically cut down on the transmission of the Ebola virus, serving both to contain its spread and more quickly extinguish the outbreak, note Epstein and Sauer.
In the commentary, the authors call their proposed solution “MObilization of REcovered” individuals, or MORE. The researchers calculate that if Ebola cases ultimately reach 50,000, the potential pool of recovered responders could exceed 6,000 individuals.
Modeling of infectious disease outbreaks and epidemics shows that reducing virus transmission can “tip” outbreaks into decline, thus helping bring them to a close, says Epstein, director of the Johns Hopkins Center for Advanced Modeling in the Social, Behavioral and Health Sciences, and a professor in the Johns Hopkins University School of Medicine’s Department of Emergency Medicine.
“The approach we are recommending could have broad benefits,” says Sauer, a faculty member in the Johns Hopkins University Department of Emergency Medicine and Center for Refugee and Disaster Response at the Bloomberg School of Public Health. “For individuals, it could be a source of jobs and a means to psychological recovery; for the community, it could help reduce the stigma of Ebola faced by survivors; and for countries, it could slow the epidemic and improve the overall public health infrastructure.”
Other highlights of the commentary:
- Many tasks that could help bring the Ebola epidemic under control require only limited training, such as supply management, contact tracing and housekeeping. But some survivors could be trained to work in “hot zones,” such as burial sites and patient care wards.
- If shown to have immunity, survivors trained to care for patients would not be burdened by having to wear the protective clothing and equipment required of other health care workers to protect them from infection. As a result, they could care for the sick for longer periods than those who must wear protective layers, which can quickly cause heat exhaustion.
A critical priority should be to establish “precisely which individuals have protective immunity.” To gather that information, large-scale epidemiological studies are needed.
Epstein and his Center for Advanced Modeling in the Social, Behavioral and Health Sciences team are developing advanced computer models that reflect social networks, geography and even human fear in an effort to predict the effectiveness of MORE.
Epstein, author of the recently released book on advanced modeling, Agent_Zero: Toward Neurocognitive Foundations for Generative Social Science, says the center hopes to use the models to develop and recommend intervention strategies that would stem further outbreaks of Ebola, but he hopes they also would be useful in a broad range of disease outbreaks and epidemics.
“The Ebola outbreak is giving us an opportunity to study and model a whole host of similar highly infectious diseases. We want to help develop public health strategies that could contain and end future deadly outbreaks,” says Epstein.
Other co-authors of the commentary are Richard Rothman, Julia Chelen, Erez Hatna and Jon Parker of Johns Hopkins; and Lewis Rubinson of the University of Maryland.