EbolaWest Africa Ebola cases to rise to 20,000; in Liberia virus uncontainable: WHO

Published 29 August 2014

The World Health Organization (WHO) yesterday warned the number of Ebola cases could rise to 20,000, while doctors in Liberia say the virus is now spreading so rapidly that the Ebola epidemic, at least in Liberia, can no longer be contained by the resources available in the country. WHO says the outbreak is accelerating throughout west Africa, where the number of deaths yesterday crossed the 1,500 mark, with 1,552 confirmed deaths. The number of those infected reached 3,069 – but health specialists say the numbers of those infected could be two to four times higher. The health care infrastructure in Guinea, Liberia, and Sierra Leon is so poor, and large parts of each country have no meaningful health care system at all, that reports of those infected with the Ebola virus and those who died from it must be considered as underestimates.

The World Health Organization (WHO) yesterday warned the number of Ebola cases could rise to 20,000, while doctors in Liberia say the virus is now spreading so rapidly that the Ebola epidemic, at least in Liberia, can no longer be contained by the resources available in the country.

The Guardian quotes WHO to say the outbreak is accelerating throughout west Africa, where the death yesterday crossed the 1,500 marked, with 1,552 confirmed deaths. The number of those infected reached 3,069 – but health specialists say the numbers of those infected could be two to four times higher.

The health care infrastructure in Guinea, Liberia, and Sierra Leon is so poor, and large parts of each country have no meaningful health care system at all, that reports of those infected with the Ebola virus and those who died from it must be considered as underestimates.

[It] is a scale that I think has not ever been anticipated in terms of an Ebola outbreak,” said Bruce Aylward, assistant director general of WHO.

He said the increase came from cities including the Liberian capital Monrovia, where a slum was quarantined last week, leading to food shortages and civil unrest.

It’s really just some urban areas that have outstripped the reporting capacity,” he said. Up to now most efforts have concentrated on rural areas close to the Guinea border. His remarks come as Medecins sans Frontieres (MSF) said it was struggling to cope with the caseload in Monrovia. MSF has just opened a new Ebola hospital in the Liberian capital and after one week it is already at capacity of 120 patients.

The number of patients we are treating is unlike anything we’ve seen in previous outbreaks,” said Lindis Hurum, MSF’s emergency coordinator in Monrovia. “This is not an Ebola outbreak, it is a humanitarian emergency and it needs a full-scale humanitarian response.”

The Ebola outbreak started in Guinea in March. The Guardian notes that it is 26th outbreak of Ebola since 1976, when the virus was first identified, but is widely recognized to be out of control.

It is simply unacceptable that, five months after the declaration of this outbreak, serious discussions are only now starting about international leadership and co-ordination,” said MSF director of operations Brice de la Vigne.

MSF said its facilities in Liberia are so overwhelmed they can no longer administer intravenous treatments. MSF has five field hospitals in west Africa, providing medical care that corrupt and dysfunctional governments do not offer. MSF said that most of the medical facilities in Monrovia have shut down after the staff abandoned them for fear of contracting the virus. The fact that so many medical facilities have shut down and the staff has dispersed is creating a secondary health crisis in Liberia: expectant mothers, malaria patients, and others needing attention now go untreated.

Tom Dannatt is founder of British charity Street Child, which has 650 volunteers in two of the worst stricken countries, Sierra Leone and Liberia. He told the Guardian that the catastrophic spread was not the resultof the strength of the virus, but rather the consequence of a lack of “anti-Ebola measures” being put in place. He added that a food aid program to help feed those in quarantined areas in eastern Sierra Leone is completely inadequate.

They are providing food for a standard World Food Program five heads per household. But in Sierra Leone there are 12 to 15 people living in the majority of households,” said Dannatt.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases told the Guardian that containment could be achieved by “low tech public protection measures.”

What we have here is porous borders, poverty and big cities. It is the perfect storm. What we need is a massive influx of resources from WHO, from the U.S., from the U.K.,” he said.

Aylward said WHO is launching a new $489 million initiative to try to contain Ebola within six to nine months.

He said it would require the assistance of 750 international workers and 12,000 national workers.