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An Ebola Healthcare Worker Returns Home to West Virginia

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The week a healthcare worker in West Virginia completes his 21-day monitoring period after a month in Liberia.

Scott Laney – Epidemiologist (NIOSH)

Epidemiologist Scott Laney works for the National Institute for Occupational Safety and Health in Morgantown. NIOSH is a branch of the Centers for Disease Control and Prevention and sends people all over the world to investigate diseases.

Scott Laney came to Morgantown six years ago to investigate the respiratory health of coal miners, but as things continued to escalate with the Ebola epidemic in Africa, he felt duty-bound to volunteer in relief efforts.

Laney has a background in infectious diseases, and molecular epidemiology and tumor virology. Before being recruited to NIOSH in 2008, he was part of then joined the Epidemic Intelligence Service in 2006, a CDC-program.

He volunteered in August. Two weeks later, he was on a plane to Liberia.

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Credit Scott Laney / CDC
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CDC
Laney putting together chlorine handwashing buckets for affected communities.

Liberia

Laney spent the first three or four days in the capital city of Monrovia designing case-control studies for healthcare workers—to help figure out how exactly so many healthcare workers are falling ill. Then he spent much of October in the rural western county of Bong.

A letter home: “… I am currently working in one of the most impacted areas in Western Africa where prior to my arrival no one had yet visited. My focus has been centered around the village of Mawah in Bong county – an isolated community that is far off the beaten path and virtually inaccessible. This village of 850 people housed a traveler from Monrovia some time back for one evening as he was passing through by foot. This individual had Ebola and an incredible outbreak occurred as a result. In the last month numerous people have died and I have arranged transport by ambulance  of 25 more in the last 10 days…”

Laney’s work was part of the effort to get a real idea of how many people are being affected by the disease.

QUICK FACT: In March of this year, the first Ebola infection was recorded in Liberia. To date, the CDC reports, over 6,000 cases and over 2,000 deaths.

Laney would go out to visit communities and log records of all of his experiences—everything from cultural interactions and observations, to observing burial techniques.

Laney Log: 10-7-14 … The stories I heard to today are too countless to tell but this village is hypervigilant. They have been strictly instructed not to accept any outsiders into the village. There are multiple road blocks and men at these locations making sure that does not happen. I asked Dr. Freeman what would happen if a visibly sick individual approached the village and he said the guards were instructed to tell them to go away by any means necessary. At night a family of 6 from the bush – two of which were ill – were taken in by a community member in Bong mines. The community threatened to burn his house down if he did not send them away. Fortunately, ambulances were in route and these two patients were taken to an ETU. The father and children were sent back to the bush. …At the river we heard a rumor that a party of individuals were suggesting that someone should go to Mawah and poison the water to kill the villagers so no one from there could enter into other communities…

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Credit Scott Laney / CDC
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CDC
From Laney Log: …We returned to observe the burial of the body. I witnessed the removal of the body and burial and the donning and doffing of PPE by the burial team. It was no where near as elegant as the IMC teams response at the stadium but the few breaches were addressed and I provided guidance on the issues moving forward….

Laney says he encountered a culture steeped in a terrifying epidemic with all the tragedy and discord that comes with it. But the only thing about his experience that surprised him was discovering, upon his return home 21-days ago, how the American public and politicians were responding to people like him, healthcare workers returning home.

A Return Home

Laney returned home October 17th.

He was screened before he left Liberia, then upon entering the U.S., then again at the CDC. Finally he made his way home to his young family in Preston County. He didn’t have too difficult a time. But the story is different for many colleagues.

The CDC just released recommendations detailing appropriate measures to take to monitor health workers who have worked around Ebola. For the past 21 days, Laney has been recording and reporting daily temperature and symptom assessments.

An email from CDC: Dear Anthony "Scott" Laney, Thank you for taking the time today to discuss the CDC active monitoring protocol and for your recent service to the CDC Ebola Response. This email confirms the 21-day monitoring activities and documentation we discussed on the phone.   Your monitoring timeframe ends on 11/8/14. We ask that you: •          Monitor and record your temperature twice a day (morning and evening). •          Monitor yourself for unexplained fatigue, severe headache, muscle pain, weakness, diarrhea, vomiting, stomach pain or unexplained bleeding or bruising. We request that you also send your temperature and your symptom assessment to the CDC IMS Employee Active Monitoring email box by completing the information in the boxes below and replying to this email by noon each day until your end date of 11/8/14….

Another email from the CDC: Dear CDC staff, Thank you for your service to the Ebola response.  We have received feedback that some employees and family members of employees have encountered difficulty going to school or work due to restrictions imposed upon them based upon fear.  In order to ease your transition back to your home and workplace and to alleviate employer and school fears, we have drafted three letters for CDC employees returning from Ebola-related deployments: 1.       A letter for family and close contacts; 2.       A letter for persons determined to be at no identifiable risk, to be distributed to all employees determined to be at no identifiable risk after completion of the post-deployment risk assessment; (most of you are not in this category.) 3.       A letter for persons determine to be at low (but not zero) risk, to be distributed to all employees determined to be at low (but not zero) risk – typically, these would be employees deployed to Liberia, Sierra Leone, or Guinea. …

In West Virginia:

Laney also points out that his community in West Virginia, especially in Preston County, has been a reliable source of comfort and encouragement. He says he hopes that attitude persists for other West Virginian healthcare workers who will soon also be returning home.

As to whether or not Laney will return to continue public health efforts in Africa—he says it’s possible he’ll go back the spring.