20,000 Ebola cases later...

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The Ebola crisis is real and has never gone away, especially since the quiet suggestion from the White House to stop reporting on it, which was echoed by the Associated Press. The December 28th update from the UN’s World Health Organization reports that 20,171 people have been infected with the virus including 7,890 deaths. One thing to be noted about the reports is that the numbers of probable and suspected cases have “not been reported”, which is an important gauge for region since time-intensive testing is problematic in the region. It has been said that the true number of cases could be as high as 2.5 times current estimates, referring to a possible correction factor noted by the WHO and CDC.

RT.com “The situation is catastrophic. There are several villages and communities that have been basically wiped out. In one of the villages I went to, there were 40 inhabitants and 39 died,” Zachariah told the agency. “Whole communities have disappeared but many of them are not in the statistics. The situation on the ground is actually much worse.” But the real total could be up to 20,000 people dead, Zachariah argues. “The WHO says there is a correction factor of 2.5, so maybe it is 2.5 times higher and maybe that is not far from the truth. It could be 10,000, 15,000 or 20,000.”

The true numbers are hard to determine and the confusion was suggested as a reason that the reporting method for cases was changed at the end of October.

Reuters It said the revision was caused by a change in the source of the data. Previously it had combined patient databases and country reports from health ministries and WHO offices, but it had switched to relying entirely on the country reports. It did not explain the reason for the change, but graphs in the WHO’s update suggest it is taking a conservative approach, since numbers in patient databases appear to have fallen below those in situation reports in recent weeks. The WHO has previously said it was working to improve the quality of the data and warned that could lead to upward or downward revisions.

What can be gleaned from the UN reports is questionable as they are still clinging to the stated goal of “containing” Ebola by Jan 1 2015, when the numbers alone suggest that is unrealistic.

UN WHO Ebola Roadmap Interventions in the three countries continue to progress in line with the UN Mission for Ebola Emergency Response aim to conduct 100% of burials safely and with dignity, and to isolate and treat 100% of EVD cases by 1 January, 2015.

There may be progress in Liberia in some ways as the graph shows a decline in weekly cases reported, after initially leading the outbreak.

Despite the report listing only 92 cases in the past 3 weeks, Liberia continues to be plagued by the virus as it has been reported that a fourth UN worker has tested positive for the virus. Last week, officials decided to quarantine around 2000 people in Margibi County after discovering significant exposure to the community from a confirmed Ebola death. Family members dressed up the corpse of a woman who died from Ebola and sat her upright during a ride in a taxi in an attempt to quietly bury her.

Liberian Observer The Margibi health authorities received a call that a body had been transported from Monrovia for burial, according to the Director of Community Health for Margibi County, Mr. Joseph J. Korhene. He said that the health team and Ebola Task Force, on arriving at the scene on December 18, took a specimen of the corpse that confirmed it to be Ebola positive. Mr. Korhene, who spoke to this paper on December 23, said that before the health team arrived in Lofe Town, the family had already finished the wake-keeping, which brought together people from eight surrounding villages. He said the infected corpse was that of a woman who had died in the Bushrod Island community near Monrovia. Mr. Korhene who declined to reveal the identity of the deceased said that her family knew that she had died of Ebola but had decided to bury her without the involvement of the Ebola Task Force anyway. “The family did it intentionally because after the lady died of the Ebola virus, they decided to bring the body here to Margibi. Knowing that the police would arrest them, they dressed the lady up as if she were living and sat her in the car between two of her relatives,” Mr. Korhene disclosed. He said that the driver who transported the Ebola infected body to Margibi was traced en route to Bong County with the vehicle. He was arrested and brought back to Lofe town, where he was placed under quarantine with community residents and others who attended the wake of the Ebola victim.

The upward trends in Sierra Leone and Guinea are evident, with 1321 of the listed 1419 recent cases, covering the last 21 days.
Sierra Leone’s 21 day surge of almost 1000 cases starts on basically the same day that the country passed Liberia in overall cases after another similar wave. The problem has been exacerbated there with the recent death of another doctor in the country, which makes 11 deaths of 12 cases. Another UN report also noted that 5,000 additional volunteers are needed for contact tracing and the country also needs about 600 more available beds in Ebola care facilities. There is some help arriving for Sierra Leone specificially in the form of motorbikes equipped with coolers that will be used to transport samples for testing. Reports noted that nearly 100 have already been delivered of the 400 bikes reported in the deal on December 4th.

UN.org

Four hundred motorbikes equipped with cooler boxes will help speed up deliveries of blood samples to laboratories from remote areas of Guinea, Liberia and Sierra Leone and reduce the waiting time for Ebola test results, thanks to a donation today from Germany to the United Nations.

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In Accra, Ghana, this morning, German Ambassador to that country, Ruediger John, stopped by the UN Humanitarian Response Depot to officially hand over 400 motorbikes. The will be used to bring blood samples to laboratories for Ebola testing from the most affected areas of Sierra Leone, Liberia, and Guinea.

The head of the UN Mission for Ebola Emergency Response (UNMEER), headquartered in Accra, Anthony Banbury, thanked the German people for their donation. “It’s really been a great partnership. It’s an excellent example of international collaboration,” he said.

UNMEER spokesman Ari Gaitanis said: “Using these bikes will help cut down transport times, in some areas quite dramatically, given some of the terrain involved.”

The region is also receiving some added help from London ambulances that have been taken out of service for emissions and efficiency.

BBC Video
Old London Ambulances are to be used in the fight against Ebola in west Africa.
They are being shipped out with the help of two London charities who say the vehicles will provide life-saving support.
Dr Raffaella Gabassi, founder of Smiling World Foundation, and Mark Whitfield, from Global Aid Vehicles, said the mission was made possible by the efforts of the Sierra Leone High Commission in the UK and Ireland.
They talk to Emilia Papadopolous about the project.

Earlier this week, a health worker was isolated in the UK after testing positive for the virus when returning from Africa.

BBC Ms Cafferkey was part of a group of up to 50 NHS healthcare workers who returned to the UK at the weekend after volunteering in Sierra Leone. Scotland’s First Minister Nicola Sturgeon said she was “doing as well as can be expected in the circumstances”. Ms Cafferkey, who had been working with Save the Children in Sierra Leone, arrived in Glasgow on a British Airways flight on Sunday but was placed in an isolation unit at Gartnavel Hospital on Monday morning after becoming feverish. Ms Sturgeon told journalists that as a precaution, Health Protection Scotland has traced and contacted, or left messages with, 63 of the 70 other passengers who were on the same flight from London to Glasgow as the patient.

With that said, the outbreak is not over.

On the aid front, discussions of forgiving debt owed by Liberia, Sierra Leone and Guinea have continued and the International Monetary Fund may be the mechanism.

Business Insider In mid-December, a UN commission also urged serious consideration for eliminating at least some of the debts of the three countries. And the United States, the IMF’s largest shareholder, has taken a stand on the issue as well, exhorting the crisis lender to wipe out around a fifth of the $480 million in debt owed it by the trio. Such a move would free resources to restart economic activities in the countries where the disease has taken more than 7,800 lives, US Treasury Secretary Jacob Lew said. Meeting in Australia in mid-November, the heads of the G20 group of leading economies stepped up the pressure when they said that the IMF’s promise of $300 million to help fight the epidemic should include debt alleviation.

For whatever curiousity or skepticism remains, the comprehensive StormCloudsGathering video answers many of those questions.

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