We are at a point in the SL outbreak where, in the most affected districts, there is a need to make an extra effort to isolate and treat as many cases as possible. In Port Loko, this is prompting the rapid takeover of schools, by the Ministry of Health, to house upwards of 50 patients. We all hope that these units will be able to provide care to cases and the safe environment for staff that we aim for in the smaller CCCs. There are still many infected persons in the communities who have nowhere to go and too few case investigators and contact tracers. We can only hope that, as isolation resources improve, as investigators catch up and get cases into care, and when all contacts can be followed up, the trends will improve. Liberia seems to have reached that stage, although no one here quite knows why. In the months after the outbreak finally wanes, there will be a need for rapid response teams to investigate and respond to new outbreaks – blips, as the curve goes down. In the newer outbreak in Koinadugu, the situation appears to be getting under control for now. New cases are occurring, but contacts are being followed twice daily to see who develops symptoms. I flew up there today by helicopter. (This was a great change from hours and hours on the road.) From today’s mission, a base camp for staff will be set up. Oxfam and Medicos del Mundo were along and they will take over the facilities from WHO very soon. We will then be ready to respond, as necessary, to outbreaks of Ebola in new locations. A possible flare up in another district was being investigated this weekend.

Whereas the international community has been criticized for its response to the events, it is interesting to see an influential Nigerian virologist not mincing his words in an analysis of Africa’s readiness and reaction to the epidemic.

Meanwhile, the over-reaction continues. A colleague was due to return to teach at Columbia University in NY State. He will not be allowed into the institution for three weeks. Another is returning to New York to spend US Thanksgiving with her family. Two of her relatives and their families are not attending the celebrations because she will be there.

I know that the security forces (army and police) do not like public gatherings and had heard that the massing of runners on the beach at weekends is sometimes stopped. This morning I could not get to the seaside. I was told that running alone was OK, but running with others was definitely not! I found an alternate route through the very varied neighbourhood of Aberdeen.

On a lighter note, last Saturday evening, during yet another raging thunderstorm, I heard bagpipes playing, or I thought I did. I decided that this must be on a TV somewhere. I later discovered that one of the WHO staff brings his pipes with him on missions and he was playing outside under a canopy facing the bay. The fishers who go out at that time had stopped in their boats to listen.

I had heard that avocados were coming into season. One of the field epidemiologists bought two off the street on her way home. She tried to eat them later but they were obviously not ripe. Two days later, someone else was buying oranges from the same seller who remarked that she had realized later that the avocados that she had sold to “his friend” were not ready to eat and insisted that he take a ripe one back for her.

One of my colleagues is from France. On Thursday, he walked into the office and asked “When is next Sunday?” I replied, November 23. He then asked, “Well, what is Nov 16?” I said, this Sunday. He was visibly rattled. He had been trying to book a flight for next Sunday, assuming that was in 3 days time. Such is the English language.

Normally, I cannot abide thinking of Christmas before December 1. This year, I am definitely looking forward to it as it means I will be with Lois and the rest of the family.