![]() The spread of Ebola to dense urban communities made it difficult or impossible for contact tracing to work due to the large number of responders needed to trace contacts when many people are infected. Under contact tracing, a patient admitted to a hospital is asked about their recent direct contacts, and those contacts are monitored or isolated for the incubation period of the disease EbolaFAQWHO EbolaCDC. Contact tracing is the accepted method for public health control of infectious diseases EbolaFAQWHO and has been the subject of theoretical and empirical studies browne2014model eames2003contact tsimring2003modeling kiss2005disease kiss2006infectious klinkenberg2006effectiveness rivers2014modeling burkeEpstein fraser2004factors riley2006smallpox huerta2002contact. The initial medical response to Ebola in 2014 focused on caring for individuals in hospital settings and using contact tracing as the primary preventative measure ContactTracingWHO. Our results suggest that the multi-scale approach can be used to further evolve public health strategy for defeating emerging epidemics. We also find the travel restriction to be effective at reducing the risks associated with compliance substantially below the 40% level, shortening the outbreak and enabling efforts to be focused on affected areas. ![]() Simulations with a 50% compliance rate are consistent with the case counts in Liberia during the period of rapid decline after mid September, 2014. In our simulations, 40% of individuals conforming to these policies is enough to stop the outbreak. Our analysis shows the policies to be effective even at a relatively low level of compliance. We consider the development of multi-scale public health strategies and simulate policies for community-level response aimed at early screening of communities rather than individuals, as well as travel restriction to prevent community cross-contamination. Limited availability of contact information made contact tracing difficult or impractical in combating the outbreak. ![]() The 2014 Ebola outbreak in West Africa raised many questions about the control of infectious disease in an increasingly connected global society.
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