A glimmer of hope in Africa: Is Liberia getting Ebola under control?
In the Ebola crisis, one seizes on hope where one finds it. At the moment, its unlikely location is Liberia, where World Health Organization officials are cautiously -- very cautiously, hinting that the wave of cases there may be ebbing.
“It appears that the trend is real in Liberia and that there may indeed be a slowing of the epidemic there,†Bruce Aylward, WHO’s assistant-director general in charge of the operational response to Ebola, said at a news conference Wednesday, according to Jon Cohen of Science magazine. Aylward observed that treatment units in several places in and around the capital, Monrovia, have empty beds.
On the surface, that conforms to findings by some observers on the ground. “In August, the streets of Monrovia were strewn with bodies and emergency Ebola clinics were turning away patients,†writes Helen Epstein, a public health expert at Bard College, in the New York Review of Books blog. “Today, nearly half of the beds in those treatment units are empty. I’ve been here a week and have yet to see a single body in the street. Funeral directors say business is off by half.â€
Liberian authorities assert that the number of people who become infected after coming into contact with Ebola sufferers is sharply lower (see accompanying graphic). They take the trend as a sign that a public education program warning about contact with infected patients is taking hold. “There was a rapid scale up in safe burial practices in the month of September,†Aylward said, according to Science’s report.
There’s reason to be very careful about drawing conclusions from these observations. As is noted by neuroscientist Sheri Fink, a respected writer on health affairs, it’s possible that many deaths are being concealed from health authorities, or that the decline in cases seen around the capital isn’t matched by what’s happening in the remote upcountry.
Experts are also wary about declaring victory because that might undermine the response by the outside world, which would be disastrous. The epidemic hasn’t shown signs of diminishing in Sierra Leone or Guinea, neighboring countries that share the Ebola outbreak’s epicenter with Liberia. Even a minor setback could lead to a surge of new cases in all three countries. As of Wednesday, the count from the outbreak zone places total cases at 13,703 and total deaths at 4,922, according to WHO and the Centers for Disease Control and Prevention.
The three countries will continue to need intensive help and rebuilding even as the epidemic wanes. Conditions will continue to encourage the disease’s spread: “The entire country of Sierra Leone has fewer than 100 registered doctors,†write Chinese researchers George F. Gao and Yong Feng in Science.
“West Africa needs doctors to run treatment and holding centers; virologists to do laboratory diagnostics; epidemiologists ... public health workers ... and educators.... Only when this is implemented are we likely to see the transmission chain cut.â€
Liberia, Epstein reports, “seems to be falling to pieces. Shops are shuttered, schools and hospitals are closed ... mines, factories and oil wells have been abandoned in panic.†Economic growth, the World Bank reports, could be zero next year.
So: Accept the hopeful signs, but don’t place much weight on them. Ebola won’t be eradicated from the region any time soon, and even once it is, its effects will live on.
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