A MARTÍNEZ, HOST:
For more on this outbreak, we've called Dr. Craig Spencer. He helped fight a different strain of Ebola during the West Africa epidemic in 2014, which is when he got the disease. He's now associate professor of public health at Brown University and an emergency medicine physician with the Brown Pandemic Center. So Dr. Spencer, what concerns you the most about this new Ebola cases?
CRAIG SPENCER: What concerns me the most is we learned too much too quickly for this to be anything but really bad. You heard that the number of cases that were reported right when this was first declared was remarkably high. This already makes it, on Day 1, one of the largest Ebola outbreaks ever recorded. We also heard really quickly that there were cases in Uganda, so hundreds of kilometers away, which - when I hear that, I worry about all the transport that patients took in between the outbreak...
MARTÍNEZ: Yeah.
SPENCER: ...Zone, where they got to in the capital of Uganda, health clinics, healthcare providers and others that may have been exposed. And also, there are cases in many places around the region, quite far from each other, which shows that there's been a lot of spread probably going on for a lot longer than we know.
MARTÍNEZ: So is it fair to say that you're concerned about things and areas that maybe we don't know are dealing with this?
SPENCER: I think there's a lot we still don't know. Look, this was declared just a few days ago. And the day after, we had the WHO declare a public health emergency of international concern. That is incredibly fast, for all the reasons that were already outlined - the delays in us picking this up. This is a different strain. This is an incredibly difficult place to work. I've worked in eastern Congo. There's a lot of conflict. The health infrastructure is not particularly strong. There's a lot of mistrust of outsiders. And this is unfortunately the perfect environment for something like Ebola to spread without being picked up promptly, and that's exactly what happened here.
MARTÍNEZ: I mentioned how you have had it. What was that like?
SPENCER: Well, it was the worst 19 days of my life. I can tell you that much. Ebola is not a kind disease. It is a disease of compassion in that it primarily infects people who take care of others, so close family members or healthcare workers. I was infected at some point while caring for patients in West Africa. But I was lucky to be treated in the United States, where I received incredible care. I was lucky to survive, which the overwhelming majority of patients unfortunately don't.
And I had to contrast my own experience of receiving incredible care with the care that we were able to provide in Guinea, Liberia and Sierra Leone just over a decade ago. That wasn't the quality of care that any of us wishes that we could have provided. And that makes me particularly concerned for the outbreak here in Congo, where the health infrastructure is unfortunately very weak.
MARTÍNEZ: What did that change for you, though, Doctor, having it, as opposed to how you felt or thought about Ebola before having it?
SPENCER: What changed for me was I was incredibly grateful to receive such amazing care, but I recognize that we should be able to provide the same type of care to all the Ebola patients anywhere around the world. And I'm remarkably concerned right now. This is going to be - this would have been a tough outbreak to manage in the best-case scenario, but we are dealing with arguably the worst-case scenario. We have humanitarian crisis and conflict and instability and a big outbreak that has multiple chains of transmission that we have truly no idea yet on how big it is, how bad it is and exactly where it's at. This is going to make this really, really, really hard to trace down and to get under control, and I'm afraid that we have many tough weeks and likely months ahead.
MARTÍNEZ: Are there enough doctors and nurses to fight this if it continues to spread?
SPENCER: Like, it - training and being capable and feeling confident in taking care of Ebola patients requires a lot. Not just the actual training itself, but it's physically and mentally demanding. It's really, really hard to see a lot of your patients, despite everything that you can do, the supportive care we can give - so hard to see so many patients die. That was really tough for me. That was really tough for a lot of my colleagues a decade ago. And even if we had the right numbers, I'm worried we don't have enough personal protective equipment. We don't have enough high-quality places where we can provide the type of ICU and really intense care that we need to save lives. As of right now, there's not enough of all of that.
MARTÍNEZ: Yeah. And with the U.S. Agency for International Development - USAID - being shut down by the Trump administration, and also the CDC's work abroad and withdrawing World Health Organization funds, I mean, how does that affect this work on the outbreak?
SPENCER: Those all have dramatic impacts. Look, we lost a lot of CDC staff, and a lot of our CDC staff are now in Nebraska, helping with hantavirus. We lost USAID. That was responsible for helping be our eyes and ears and detecting outbreaks like this. And we withdrew from the WHO, which is already pretty thin in terms of dealing with hantavirus and other outbreaks. Those cuts over the last year have definitely had an impact, and unfortunately, we're seeing the fallout from that right now.
MARTÍNEZ: Dr. Craig Spencer of the Brown Pandemic Center. Doctor, thank you.
SPENCER: Thank you. Transcript provided by NPR, Copyright NPR.
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