Dr. Kent Brantly, a U.S. medical missionary who contracted Ebola in July while working as a doctor in Liberia and survived the deadly disease after treatment at Emory University Hospital in Atlanta, appeared at a joint Senate hearing today examining the Ebola outbreak.
In testimony prepared for the hearing, Brantly described the challenges and difficulties of working in what was already a "woefully inadequate healthcare system of a country still struggling to recover from a brutal civil war." He "witnessed the horror that this disease visits upon its victims — the intense pain and humiliation of those who suffer with it, the irrational fear and superstition that pervades communities, and the violence and unrest that now threatens entire nations."
When he fell ill on July 23, "I came to understand firsthand what my own patients had suffered," Brantly said. "I was isolated from my family and I was unsure if I would ever see them again. Even though I knew most of my caretakers, I could see nothing but their eyes through their protective goggles... I experienced the humiliation of losing control of my bodily functions and faced the horror of vomiting blood—a sign of the internal bleeding that could have eventually led to my death."
Treating Ebola patients, he said, "is not like caring for other patients. It is grueling work. The personal protective equipment we wore ... becomes excruciatingly hot, with temperatures inside the suit reaching up to 115 degrees. It cannot be worn for more than an hour and a half."
Brantly's hospital, the ELWA Hospital in Monrovia, was the capital's only Ebola treatment center when the disease broke out and was quickly overwhelmed. In the month and a half he was treating Ebola cases there, he told the panel, there was only one survivor.
"The disease was spiraling out of control," he said, "and it was clear we were not equipped to fight it effectively on our own. We began to call for more international assistance, but our pleas seemed to fall on deaf ears."
The laboratory his hospital relied on to confirm the presence of Ebola in patients "was 45 minutes away and inadequately staffed," he said. "A patient would arrive at our center in the afternoon and their blood specimen would not be collected until the following morning. We would receive results later that night at the earliest. Turnaround time to positively identify Ebola cases was anywhere from 12 to 36 hours after blood was drawn"—a potentially life-threatening delay. Patients languished in the isolation unit while waiting for diagnosis, potentially infecting others while they waited.
Brantly criticized the World Health Organization's response to the Ebola outbreak as "painfully slow and ineffective ... It is imperative that the U.S. take the lead instead of relying on other agencies." The military, he said, is the "only force capable of mounting an immediate, large-scale offensive to defeat this virus before it lays waste to all of west Africa." Given the dearth of commercial flights into Ebola-affected countries, one of the most important things the military can do would be to establish an "'air bridge' for the delivery of critically needed personnel and supplies... we cannot turn the tide of this disease without regular flights of personnel and large cargo loads of equipment and supplies."
Brantly also emphasized the need to "consider the role of home care as we seek to stop the transmission of Ebola," urging training and supplies for home caregivers, especially since "many infected people are choosing to suffer and die at home anyway. The least we can do is to try to give their caregivers the information and resources to protect themselves from this deadly virus."
One of the most moving parts of his testimony was the story of a patient in Liberia named Francis.
"Initially, the lab told us that he was positive for Ebola, but the written report we received said 'Negative,'" Brantly said. "Everything about his clinical case said that he was infected, so we made plans to retest him. We then received word that there was a typo on the first report and that his test was indeed positive.
"Like most patients at first, he was fearful, but he eventually shared the story of how he contracted the disease. 'Doc, I remember who the man was,' he said. 'His condition worsened in his home, and his wife made the decision to take him to the hospital. Everyone around them fled, so I helped his wife carry him to the taxi.' On his way to the hospital that man died. Had someone come alongside Francis with training and some basic personal protective equipment, his family might still have their husband, father and son, and the world might still have this Good Samaritan."
Brantly said that he was one of the luckiest ones, receiving "the best care possible in Liberia ... and world-class treatment" in the United States. But, he warned, the outbreak is "a fire straight from the pit of hell. We cannot fool ourselves into thinking that the vast moat of the Atlantic Ocean will keep the flames away from our shores."