The death toll of the West African Ebola outbreak is nearing 2,000 and the scale up required to control the rampaging virus is three to four times what’s currently in place, United Nations officials are warning.
The epidemic is the most severe in Ebola’s nearly 40-year history and is unlike anything experts experienced with past outbreaks, Dr. Margaret Chan, director-general of the World Health Organization, the UN’s public health arm, told reporters in a press briefing Wednesday.
The number of confirmed cases now stands at 3,500 in Guinea, Sierra Leone and Liberia, including more than 1,900 deaths. “The outbreaks are raging ahead of control efforts in these countries,†Chan warned.
Officials said it would cost at least $600 million US to get the epidemic under control. “We are not in a position where we can afford to lose even a day,†said Dr. David Nabarro, senior UN system co-ordinator for Ebola.
Chan said stigma, inside and outside affected areas, is undermining efforts to contain the largest outbreak of Ebola on record.
“There is a lot of misunderstanding, a lot of rumour, a lot of denial within communities that Ebola is not real, (that) this is something being given to them from outside,†Chan said, adding that UNICEF and other aid organizations are working hard to get the correct information out and encourage people to come forward for treatment.
Half those infected will survive the disease, she said. “It’s important not to send the wrong message that, ‘you’re going to die.’â€
Dr. Keiji Fukuda, assistant director-general for health security for the WHO travelled to Monrovia last week, where he met with dozens of community and traditional leaders. He said communities lack essential needs, such as treatment and isolation beds, ambulances, and trucks to transport bodies, gloves and personal protective equipment, money to pay salaries, hazard pay and other incentives for front line workers, and infection control practices.
The bulk of infections are occurring among families and people caring for loved ones. “There are not enough beds for people to go to if they are ill; there are not enough ambulances to transport people when they’re ill,†Fukuda said. Sick people aren’t seeking treatment because they feel “there are no real benefits,†he said.
An estimated 200 to 250 people are needed to care for 80 patients, Fukuda said. As the outbreak grows larger, several thousand people would be needed to care for the ill, as well as several hundred international workers to provide expert training and support.
Fukuda said affected communities want clear information. “They want to understand what is going on, how are decisions made, why are they being made. They want to understand how to do things.
“Many people understand that it is now unsafe to touch someone who has died. They understand that if somebody is sick they can get infected from them. But what they don’t understand is, what do we do?†he said.
Communities feel stigmatized and isolated, he added. “They want to know that other people know what they are going through.â€
The Ebola virus is spread via direct contact with blood, secretions and other bodily fluids of infected people.
Symptoms include flu-like illness — sudden fever, profound weakness, muscle pain, headache and sore throat — followed by vomiting, diarrhea, impaired kidney and liver function and sometimes internal and external bleeding.
On Thursday and Friday, experts from around the globe, including the Public Health Agency of Canada, Health Canada and the University of Toronto, will gather in Geneva to discuss how unlicensed, experimental Ebola vaccines and treatments should be used in the outbreak.
On Tuesday, the head of the medical aid organization Medecins San Frontieres/Doctors Without Borders denounced world leaders for their “lethally inadequate†response to the outbreak.
The humanitarian organization has been battling the West African outbreak since March and its teams are stretched to their limits, said MSF president Dr. Joanne Liu. Field hospitals are being forced to turn the sick away; in Sierra Leone, “highly infectious bodies are rotting in the streets,†the organization said in a statement.
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