Dr Kevin De Cock interview and PDF transcript

[00:00:00] Description of early 2014 outbreak in border region Guinea–Sierra Leone. Mentions colleague Joel Montgomery deployment Liberia for epidemiologic assistance and training. Notes early belief outbreak controlled, followed by new cases mid–late May. While in Atlanta late June–early July, queries colleagues about seriousness of situation. Notes CDC request from Liberian Chief Medical Officer for assistance, leading to his deployment mid July. [00:03:00] Describes pre existing perception of Ebola: zoonotic infection, natural reservoir in animals, bats, 25 recognised outbreaks, 2500 total cases, case fatality rate 30–90 per cent, furthest west previous case Côte d’Ivoire 1990s. Identifies new features in 2014 outbreak: location far west, simultaneous involvement of three countries, presence in capital cities. [00:06:00] Describes first deployment mid July to mid August: rapid escalation, overwhelmed two Ebola treatment units Liberia, patients dying in hospitals, houses, streets. Notes case of Liberian Patrick Sawyer travelling to Nigeria and sparking secondary cluster. Notes infections among American Samaritan’s Purse workers; first infections in US citizens. [00:10:30] Describes outbreak severity prompting global attention, including UN Security Council discussions. Mentions role of Liberian events in global perception shift. [00:12:30] Outlines initial epidemiologic tasks: verify outbreak, confirm etiology, describe cases in time/place/person. Describes need to assess who performs Ebola testing and where labs located. Notes meeting Minister of Health Walter Gwenigale, request for CDC help with laboratory. Describes absence of CDC lab personnel but coordination role with NIH and USAMRIID technical advisors. [00:17:00] Explains advisory role in Liberia, need for diplomacy, notes Liberian government willingness to accept advice, special Liberia–US relationship. Describes importance of these factors for outbreak control. [00:20:10] Describes debates before West Point events (which occur shortly after his departure 15–16 August). Notes discussions on patient care capacity, need for simpler care levels given staff shortages, debates on quarantine and movement restrictions, community initiated isolation. Notes government reversal of West Point decision after violence.[00:30:00] Emphasises need for field visits. Describes visiting Ebola treatment unit day one; meeting Kent Brantly pre illness. Describes sending staff to affected and unaffected counties to check spread. Notes failed attempts to reach Lofa County via UN helicopters. Mentions fire at Ministry caused by disgruntled relative of Ebola victim. Details introduction of incident management system (IMS). Notes initial chaotic Ebola Task Force meetings. Describes work with Satish Pillai to propose IMS based on CDC emergency operations model; Minister accepts. Notes creation of smaller “Gang of Six” advisory group. [00:39:00] Discusses Liberia’s faster progress to zero cases compared Sierra Leone/Guinea. Attributes factors: IMS, leadership, technical assistance, data driven decision making, public acceptance of cremation requirement, reduced physical contact, reduced travel, community initiated quarantine, differences in geography and transport. [00:43:40] Reflects on community sensitisation importance and personal underestimation of its role. [00:48:10] Discusses weak health systems Liberia/Sierra Leone/Guinea, limited surveillance, limited laboratory capacity, low number doctors, lack of resources compared with Nigeria’s polio eradication infrastructure. [00:51:00] Outlines lessons: need for system strengthening (surveillance, labs, epidemiology workforce, health information, operational research), importance of global interconnectedness, significance of local health architecture, long term CDC presence. [00:56:00] Provides dates of three deployments: mid July–mid August; early November–just before Christmas; early March–early April. Describes investigation of final Liberian Ebola case due to probable sexual transmission from survivor with PCR positive semen 199 days after illness. Ends with brief acknowledgment he is speaking from Kenya.[01:00:53] End of interview. This content summary was created from the interview transcript in November 2025 using M365 Copilot Chat. The content summary was then reviewed against the audio by the cataloguer.

09/07/2015

42.2 MB 1 windows media audio file, 1 transcript

Copyright in this interview is held by Wellcome Collection.

PDF transcript created by archivist for preservation and access reasons. See OH3/28/2 for original Microsoft Word format version of transcript.