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Time to prepare for the Ebola challenge

Tony Travers
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The role of directors of public health will be crucial in any outbreak

The steady and ominous march of the Ebola virus is increasingly likely to test medical and public health services in the UK. Already there is evidence of cases in the United States and Spain.

The British authorities have been holding ‘drills’ to test readiness for an outbreak in this country. Hospitals in Newcastle, Sheffield, Liverpool and London have been made ready to expect what might, according to chief medical officer Dame Sally Davies, be a “handful” of cases.

Dame Sally’s job description states she is “the UK government’s principal medical adviser and the professional head of all directors of public health in local government. Hers will be a pivotal role if Ebola arrives in any part of the country.

Previous CMOs, notably Sir Donald Acheson who held the job when AIDS first came to prominence, have been a crucial element in balancing the requirement to take action with the need for proportionality.

People in Britain, as in other developed countries, have been told Ebola can easily be controlled by standard hygiene procedures. But if cases do emerge here, there is always a risk public opinion will demand drastic action. The health authorities and ministers would then have to hold the line against lurid headlines demanding over-the-top responses.

Local government now has health responsibilities. Directors of public health will be the local outposts of any national effort. Although the threat of pandemics is by no means new to Britain, each one is different. The challenge for the authorities is to understand and then communicate to the public the real seriousness of the situation.

For the time being, and with luck this will continue, the base advice to UK citizens is to ‘keep calm and carry on’. In fact, there have been virtually no medical emergencies since 1945 in which this advice would not have been appropriate.

Polio, smallpox and a host of other viral horrors have been eradicated from Britain within the lifetime of many LGC readers. This country has an excellent record in handling public health challenges.

Having said this, local government should probably prepare for a worsening of the Ebola challenge. Preparedness is part of good public health.

Tony Travers, director, Greater London Group, London School of Economics

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