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Freetown - Two of the West African nations hardest hit by Ebola were bracing for new caseloads on Monday after trying to outflank the outbreak with a nationwide check-up and a large new clinic.
Sierra Leone was expected to announce a sharp increase in Ebola patients on Tuesday following a nationwide effort to identify new cases, while Liberia opened its largest treatment centre yet.
Both countries have poor health systems, weakened by the loss to Ebola of many of doctors and nurses. The World Health Organisation estimated last week that they have only about 20% of the beds they need to treat Ebola patients.
Still, identifying the sick is fundamental to containing the disease, and Sierra Leone went to an extreme unseen since the plague ravaged Europe during the Middle Ages, ordering an entire nation's people to remain at home while teams went door to door handing out soap and information.
More than 1 million households were checked for Ebola and told how to prevent its spread, authorities said.
Hundreds of new cases
Officials had previously predicted that they would find hundreds of new cases during the three-day shutdown, and government spokesperson Abdulai Bayraytay said Sierra Leone was preparing tents for use as temporary treatment centres before announcing their findings on Tuesday.
In Liberia, meanwhile, ambulances rushed to fill the nation's largest new treatment center, a 150-bed hospital on the outskirts of Monrovia that opened on Sunday, run by the Health Ministry, WHO and a team of Ugandan doctors.
By Monday, the new clinic had admitted 112 people, though only 46 of those have tested positive for Ebola, said Assistant Health Minister Tolbert Nyenswah. The rest were being held for observation and treated for other diseases, like malaria.
Ebola, transmitted through bodily fluids, is now blamed for the deaths of more than 2 800 people in West Africa, according to new figures released on Monday by the WHO.
More than 5 800 are believed to have been sickened. Most of the infections have been in Liberia, but the disease, which was first identified in Guinea, has also spread to Nigeria and Senegal.
Food shortages
At least 77 bodies were buried during Sierra Leone's shutdown and half tested positive for Ebola, Bayraytay said. Officials were waiting on laboratory tests for the other half. The disease is thought to have killed more than 600 people in the nation of 6 million.
Lockdowns are hard to enforce, and being stuck at home for three days caused much frustration and some food shortages. By themselves, they aren't likely to contain an outbreak. But they can certainly help send a public health message, said Joe Amon, director of health and human rights for Human Rights Watch.
The teams reached about 75% of the nation's 1.5 million households, the Health Ministry said, carrying bars of soap and information about the disease. Rumours that the soap had been poisoned served to show how important these education efforts are, authorities said.
Sierra Leone residents overwhelmingly complied by staying in their homes, but in one incident health workers trying to bury five bodies 20km east of Freetown were attacked on Saturday. After police reinforcements arrived, the health workers completed the burial.
No approved treatments
Nearly 350 health workers in West Africa have been infected, and more than half of those have died. A Spanish priest who became infected while serving as a medical director for a hospital in Sierra Leone was flown back to Spain on Monday.
There are no approved treatments or vaccines for Ebola, but drug makers are rushing to test experimental therapies. The small supply of one drug, ZMapp, was exhausted after being used on a few patients.
On Monday, Tekmira Pharmaceuticals of Canada said its experimental Ebola treatment had been used on a number of patients, and that regulators in the U.S. and Canada had approved its use in more after results showed the drug had been well-tolerated.
Tekmira said there were limited supplies of its TKM-Ebola drug and because it has not been used in an actual study, the company acknowledged that it is impossible to tell if it had any effect.
Officials at Nebraska Medical Centre said an Ebola-infected American being treated there, Dr Rick Sacra, was treated with TKM-Ebola.
