While researchers scramble to develop treatments, diagnostics and vaccines for the fight against Ebola, America's top infectious disease doctor says the most powerful tool against the outbreak is basic medical care.
Drugs under development will not be a big part of the solution, said Anthony Fauci, longtime director of the U.S. National Institute of Allergy and Infectious Diseases. They are too early in development for enough doses to be manufactured, even if they are shown to be safe.
The real area of focus, he said, should be setting up medical infrastructure in the affected countries to provide sick people with basic medical support such as replacement fluids and blood. That will have a much bigger effect on health than a few batches of experimental medications, he said.
"That's the way you help people," he said. "The idea of 'What are we going to do with these four treatment courses we have?' is almost irrelevant of the big picture of the lives that you can save mainly by getting people into proper care."
There are no drugs or vaccines approved for treating or preventing Ebola. Supportive therapy, such as replacing fluids, particularly when it is done shortly after infection, can significantly improve survival from the disease.
In some Ebola outbreaks, as many as 90% of those infected have died, but the death rate is about 55% in this outbreak, which began late last year and has sickened 1,711 and killed 932 in Guinea, Sierra Leone, Liberia and Nigeria, according to the World Health Organization.
Excitement over possible drug treatments ramped up last week after two Americans who caught the virus while treating patients in Liberia received an experimental Ebola therapy called ZMapp, which had been tested only in animals. Both patients have been transported to the USA and are recovering, though it is unclear whether the drug made the difference.
They received the kind of fast and attentive care that Fauci advocates for everyone — but that is extremely difficult to provide under the circumstances in West Africa.
When asked why the two Americans would need to be evacuated when they were receiving care in a specialized facility, Fauci referenced the overwhelming demand on West African hospitals: "Sure, there's infrastructure for taking care of two people, but what happens when there's 150 people in there?"
Medications are promising and will hopefully help in outbreaks, Fauci said, but they can't be made in enough quantities to benefit current patients.
For ZMapp, it "will take two to three months to just get a real, very modest number of treatment courses," in which each patient would require three doses of the drug, he said. "You'll never have enough to give it to everybody — you won't even come minutely close to that."