Is the UK prepared for an outbreak of Ebola?

Alok Jha

Former Science Correspondent

Alok Jha tested the protective suits being worn by healthcare workers battling the Ebola outbreak. Credit: ITV's Tonight
  • Tonight: Ebola - Are We Prepared? is on ITV at 7.30pm

It takes almost half an hour to put on the personal protective equipment (PPE) you need to go into an Ebola-affected area. A base layer, two layers of coveralls, five layers of gloves, airtight goggles and a breathing mask, all carefully tucked in and every seam sealed with thick tape.

Within minutes of being inside the suit, I was unbearably hot. It was difficult to breathe and my goggles became fogged. The gloves constricted my hands so that I could barely move my fingers. I couldn't imagine working in this suit, though healthcare workers wearing PPE suits will have to do just that when treating patients in the searing heat of Sierra Leone and Liberia. This is how they reduce their exposure to the Ebola virus.

James Milnes helps Alok Jha put on his PPE suit and explains how medics communicate while wearing them:

An hour later, I was desperate to cool down and regain the ability to breathe freely. But it takes as long to get out of the PPE suit as it does to get into it – each of my layers is methodically removed and binned by another person who is themselves kitted out in full PPE. The aim is to keep the material from the contaminated outer layers from reaching me or anyone around me.

Intact skin can prevent a person from getting infected with Ebola but the virus can also enter through the eyes, nose and the mouth. PPE suits protect those parts of the body and keeps everything else covered so that the virus cannot get in through any unseen cuts in the skin.

The slow, deliberate process of putting on and taking off the PPE suit will have to be carried out by doctors and nurses several times a day in the busiest clinics in the UK and in West Africa. Because they are so uncomfortable, workers can only stay inside them for an hour a time. Oversights, faulty equipment or mistakes in any part of intricate procedure, particularly by stressed and tired workers, can be dangerous. It is thought that such procedural errors may have contributed to the nurses in Spain and the USA becoming infected.

As the outbreak continues in West Africa, there will inevitably be further cases of Ebola in the UK, Europe and North America. But none of the scientists we spoke to for Tonight believed that any of those places were at risk of an epidemic on the scale occurring in West Africa.

Leading epidemiologist David Heymann explains why Ebola does not spread as easily as other viruses:

For a start, Ebola is a deadly disease but it does not spread easily. “It's a very difficult disease to contract by casual contact,” says David Heymann, a leading epidemiologist at the London School of Hygiene and Tropical Medicine. That means exchanging handshakes or being in the same room as someone who has Ebola, but does not have symptoms, is not likely to give you the virus. Only when the infected person gets feverish or begins to vomit or bleed do they become infectious.

The virus itself could mutate to become more deadly but Heymann allays any concerns that it could become airborne. “Some scientists have said this, this is quite irresponsible,” he says.

Health workers in Sierra Leone spray themselves with chlorine disinfectants after removing the body an Ebola victim. Credit: Reuters/Josephus Olu-Mammah

Modern healthcare systems in the UK are equipped to identify and isolate patients with Ebola and prevent the virus from spreading further – though these will only be effective at stopping the virus if safety protocols are properly followed and PPE suits are worn and taken off methodically in the highest-risk areas.

To stop the epidemic from reaching the UK, it might seem sensible to close borders to the affected countries. But that can be counter-productive and only serves to give people a false sense of security, says Jeremy Farrar, the director of the Wellcome Trust and an infectious disease scientist. “The best way of protecting London or Washington is to focus our resources in West Africa, that's not just morally right and the right thing to do for the people of West Africa, it's also in self interest,” he says. “That will be the way we will protect Britain, by controlling the epidemic in West Africa.”

Infectious disease scientist Jeremy Farrar on the biggest fear surrounding the Ebola epidemic:

The international response to West Africa's Ebola epidemic has so far been slow and Farrar says the outbreak is now out of control. “The time to act is early in that epidemic when you first start to see cases,” he told me. “If you are acting when there are 50 cases, if you are acting when there are 100 cases, it is completely different to when you're acting when there are 10,000 cases and this has spread across borders, it's spread out of West Africa to the rest of the world. Then the actions that you need are on an unimaginable scale compared to when you are talking about only 50 or 100 individuals.”

Despite the slow response, Farrar says the outbreak is controllable. The UK Government has already led a coalition of other governments and NGOs to pledge support to Sierra Leone, one of the worst-affected countries, with promises of medical facilities, healthcare workers and logistical support. The US government is leading similar efforts in neighbouring countries. The job now is to make sure the promised help gets to where it is needed, fast.

  • Tonight: Ebola - Are We Prepared? is on ITV at 7.30pm