From the New York Times, August 28, 2014:
The World Health Organization warned on Thursday that the Ebola epidemic in West Africa, already the largest outbreak ever recorded, is going to get much worse over the next six months, the shortest window in which it might conceivably be brought under control. By then, the organization said, the virus could infect more than 20,000 people, almost seven times the current number of reported cases.
It is a frightening prospect that requires an urgent infusion of aid from public and private donors around the world. The situation as described by the health agency is so dire and the resources needed so daunting that it is hard to see how they can be supplied anytime soon.
The agency issued a road map listing tasks that must be carried out by countries with Ebola cases, nearby countries, the international community and nongovernmental organizations if the epidemic is to be contained.
A top official said the road map would require at least 750 international and 12,000 local health workers on the front lines delivering care. How can impoverished countries whose health workers are falling ill and dying or fleeing in fear possibly supply that many caregivers? If they cannot muster those workers, it seems inevitable that wealthier nations will need to step in with more personnel, but they, too, may have difficulty recruiting people.
The World Health Organization is belatedly catching up to a warning issued in June by Doctors Without Borders, a group that has been delivering care in some of the hardest hit areas, that said the epidemic was out of control. On Thursday, the health agency said that the reported death toll had risen to 1,552, from 3,069 cases of infection in four West African countries — Guinea, Liberia, Sierra Leone, and Nigeria — and that the actual toll could be up to four times higher because many cases go undetected or unreported. That suggests there could already be up to 12,000 cases.
A top American official on the scene in West Africa said the situation is far worse than anticipated and raised concerns that, with each passing day, the virus might spread to additional countries. More than 40 percent of the total number of reported cases have occurred in the past three weeks. Most of those cases are concentrated in a few localities, offering hope that the outbreaks can be contained if more resources are sent to those places.
The road map could cost almost half-a-billion dollars over the next six months, not including broader support to provide food, sanitation and other necessities or to strengthen systems in afflicted countries that are so overwhelmed with Ebola cases that they can’t provide basic health services. Some local workers have shown immense courage in tending to the sick, but they need more protective gear, disinfectants, tents and body bags to prevent infection, which the health agency intends to deliver.
In a detailed timeline, the organization says its goal is to reverse the trend in new Ebola cases within three months and stop all residual transmission in six to nine months. It also hopes to stop any new transmissions in a country within eight weeks of a first case being identified. That seems achievable with a vigorous effort to trace and isolate anyone who has come into contact with an infected person although some contacts in a large country or city will probably be missed.
The World Health Organization emphasized the importance of preventing the spread of the virus to other nations by screening travelers at international airports, seaports and major land crossings to bar travel by people with illnesses that could be Ebola. Some airlines have canceled flights to the afflicted countries. But that is an overreaction, if good screening programs are established. It will be critical to keep air and shipping links operating to deliver medical supplies and other essential goods.
Read the article at NyTimes.com here.