The Ebola epidemic in west Africa poses a catastrophic threat to the region, and could yet spread further
The Economist, October 18
ON MARCH 25th the World Health Organisation (WHO) reported a rash of cases of Ebola in Guinea, the first such ever seen in west Africa. As of then there had been 86 suspected cases, and there were reports of suspected cases in the neighbouring countries of Sierra Leone and Liberia as well. The death toll was 60.
On October 15th the WHO released its latest update. The outbreak has now seen 8,997 confirmed, probable and suspected cases of Ebola. All but 24 of those have been in Guinea (16% of the total), Sierra Leone (36%) and Liberia (47%). The current death toll is 4,493. These numbers are underestimates; many cases, in some places probably most, go unreported.
This all pales, though, compared with what is to come. The WHO fears it could see between 5,000 and 10,000 new cases reported a week by the beginning of December; that is, as many cases each week as have been seen in the entire outbreak up to this point. This is the terrifying thing about exponential growth as applied to disease: what is happening now, and what happens next, is always as bad as the sum of everything that has happened to date.
Even if treatment centres are hugely expanded, people’s behaviour changes radically and a vaccine proves effective, the damage already done to the region is huge. The patterns of work and food supply are already disrupted. Some farmers have abandoned their fields because they wrongly fear being infected by water in irrigation channels; some in cities are panic-buying. Salaries to public employees are not secure. The World Bank warns that Liberia’s rubber production, a big export earner, could fall drastically.
For now mounting deaths, understandable confusion and increasing economic dislocation have not caused widespread civil unrest. But many fault their governments for not protecting or preparing them better for the epidemic, and the grudges that animated past civil wars and coups sleep lightly. Few diplomats see a return to the bad old politics as out of the question; Filipino UN peacekeepers in Liberia have been withdrawn by their government. If civil order breaks down, the epidemic will get still worse.
Even if things do not fall apart, there is the most uphill of struggles ahead. Dr Piot cautions that an Ebola outbreak is an all-or-nothing affair; it is only over when the last patient is either dead or fully recovered. When it has struck on this scale, the challenges that remain after that will still be huge; whole public-health infrastructures will need rebuilding. But first there is a mountain to climb.
Bloomberg: What’s Ebola? Mumbai Takes Crash Course as Virus Spreads
(Dallas) Star Telegram: First round of Ebola contacts to resume their lives