The Ebola epidemic in west Africa may have reached a turning point, according to the director of the Wellcome Trust, which is funding an unprecedented series of fast-tracked trials of vaccines and drugs against the disease.
Writing in the Guardian, Dr. Jeremy Farrar says that although there are several bleak months ahead, “it is finally becoming possible to see some light. In the past 10 days, the international community has belatedly begun to take the actions necessary to start turning Ebola’s tide.
“The progress made is preliminary and uncertain; even if ultimately successful it will not reduce mortality or stop transmission for some time. We are not close to seeing the beginning of the end of the epidemic but [several] developments offer hope that we may have reached the end of the beginning.”
Farrar’s comments come as the WHO confirmed that the number of Ebola cases in Liberia has started to decline, with fewer burials and some empty hospital beds. But the WHO warned against any assumption that the outbreak there was ending.
“I’m terrified that the information will be misinterpreted,” said Dr Bruce Aylward, assistant director-general in charge of the Ebola operational response. “This is like saying your pet tiger is under control. This is a very, very dangerous disease. Any transmission change could result in many, many more deaths.”
Data appears to show that the number of burials and lab tests requested for the virus are down and the numbers of empty beds in treatment centres are up - there have been reports of as many as a hundred. Aylward said huge efforts to educate and inform the community on the risks of Ebola and how to avoid infection and bringing in safe burial practices may have made the difference.
But infections could shoot up again, as they did in Guinea. “The danger is that instead of a trend that takes us down to zero, we end up with an oscillating pattern,” he said. Getting to zero will involve grindingly hard work, identifying every Ebola case and tracing all the contacts. Without that effort, Ebola will remain at a lower but still dangerous level.
There have now been 13,703 cases, said Aylward, and he expected there would have been over 5,000 officially recorded deaths, although that number is not yet confirmed. Many cases and deaths are unrecorded. The death rate is 70%, although slightly better in treatment centres.
I'd like to be optimistic, but telling people that things are looking up as the tally skyrockets to nearly 14000 cases sounds to me like whistling past the graveyard.
I suspect any empty treatment beds have more to do with people finally giving up on going to them at all, as it's a known death sentence, and electing instead to simply die in place at home, thus condemning their families and neighborhoods to more Ebola, indefinitely.
More new Ebola cases in the last 30 days than the total of all cases in the prior 9 months, and spreading it to 3 more countries for the first time, doesn't strike me as an epidemic that anyone's getting any sort of handle on.