FREETOWN, Sierra Leone — Acknowledging a major “defeat” in the fight against Ebola, international health officials battling the epidemic in Sierra Leone approved plans on Friday to help families tend to patients at home, recognizing that they are overwhelmed and have little chance of getting enough treatment beds in place quickly to meet the surging need.
The decision signifies a significant shift in the struggle against the rampaging disease. Officials said they would begin distributing painkillers, rehydrating solution and gloves to hundreds of Ebola-afflicted households in Sierra Leone, contending that the aid arriving here was not fast or extensive enough to keep up with an outbreak that doubles in size every month or so.
“It’s basically admitting defeat,” said Dr. Peter H. Kilmarx, the leader of the federal Centers for Disease Control and Prevention’s team in Sierra Leone, adding that it was “now national policy that we should take care of these people at home.”
“For the clinicians it’s admitting failure, but we are responding to the need,” Dr. Kilmarx said. “There are hundreds of people with Ebola that we are not able to bring into a facility.”
The effort to prop up a family’s attempts to care for ailing relatives at home does not mean that officials have abandoned plans to increase the number of beds in hospitals and clinics. But before the beds can be added and doctors can be trained, experts warn, the epidemic will continue to grow.
C.D.C. officials acknowledged that the risks of dying from the disease and passing it to loved ones at home were serious under the new policy — “You push some Tylenol to them, and back away,” Dr. Kilmarx said, describing its obvious limits.
But many patients with Ebola are already dying slowly at home, untreated and with no place to go. There are 304 beds for Ebola patients in Sierra Leone now, but 1,148 are needed, the World Health Organization reported this week. So officials here said there was little choice but to try the new approach as well.
“For the first time, the nation is accepting the possibility of home care, out of necessity,” said Jonathan Mermin, another C.D.C. official and physician here. “It is a policy out of necessity.”
Faced with similar circumstances in neighboring Liberia, where even more people are dying from the disease, the American government said last month that it would ship 400,000 kits with gloves and disinfectant.
“The home kits are no substitute for getting people” to a treatment facility, said Sheldon Yett, the Unicef director for Liberia. “But the idea is to ensure that if somebody has to take care of somebody at home, they’re able to do so.”
More than 4,000 people have died from the outbreak in West Africa, but the United Nations funding appeal remains woefully short, with countries pledging only one-fourth of the $1 billion that the world body says it needs to contain the disease, the United Nations deputy secretary general, Jan Eliasson, told the General Assembly on Friday.
Britain has pledged to get an additional 400 beds into urban areas around Sierra Leone by sometime next month. More rudimentary holding centers for patients awaiting space in hospitals are planned by the government here. And promises of international aid have increased substantially since the outbreak was first identified in neighboring Guinea in March.
But on Friday, Sory Sesay, 2, lay face down on a bench at his home, an arm dangling, his eyes open, listless and apathetic.
What remained of his family was sitting immobilized on the front porch with him at their house in Waterloo, just outside Freetown, Sierra Leone’s capital. All of them were sick: his father, who had already lost his wife and daughter; his 11 year-old brother; and a 16-year-old neighbor, whose mother had already died.
They had no painkillers, no rehydrating solution, and only a sack of rice to eat.
“The government has not yet come in to assist us,” said Sheka Dumbuya, the local community leader. “Mr. Sesay is actually traumatized. We took them the day before yesterday to the health center, but there is no space for them.”