The Ebola outbreak is threatening the stability of affected and neighbouring countries in West Africa and swift action is needed to scale up the “massive” response that will be required to tamp it down, the head of the U.S. Centers for Disease Control and Prevention said yesterday.
The director of the U.S. health agency, Dr Thomas Frieden, who had just returned from a tour of West Africa, said he expected the number of Ebola cases to accelerate in the next two weeks and urged governments to respond.
He said the outbreak now affecting Guinea, Sierra Leone, Liberia and Nigeria is “threatening the stability” of affected and neighboring countries.
“The challenge isn’t knowing what to do. The challenge is doing it now,” Frieden said in a conference call with reporters.
“We’ve seen outbreaks of Ebola before. This is the first epidemic spreading widely through many countries, and it is spiraling out of control,” said Frieden, who recently returned from a trip to the region. “It’s bad now, much worse than the numbers show. It’s going to get even worse in the very near future.”
Making it worse, Frieden said, is that other countries are turning their backs on those coming from countries where the outbreak is strongest, even if they don’t realise it.
Measures to restrict flights and border crossings into the countries facing the outbreak were designed to contain the spread, but are having a paradoxical effect, he explained.
“This is making it really hard to get help in and to respond effectively to the outbreak,” he said on CNN’s “New Day.”
“What we’re seeing is a spiraling of cases, a hugely fast increase in cases, that’s harder and harder to manage,” he said. “The more we can get in there and tamp that down, the fewer cases we’ll have in the weeks and months to come.”
Frieden sounded the same alarm last week during a visit to Liberia. The sooner the world unites to help West Africa, the safer the world will be, he said.
The CDC director said it was upsetting during his visit to see the shortage of hospital beds and the lack of a rapid response needed to prevent a single cluster of Ebola from becoming a large outbreak.
There is widespread transmission in Liberia and strong signs it will happen in Sierra Leone in the near future, he said.
Frieden said more resources, expertise and a unified response are needed.
“The number of cases is increasing so quickly that for every day’s delay it becomes that much harder to stop it.”
The challenge, particularly in Liberia and Sierra Leone, is getting the health-care system up and running again to deal not only with the Ebola virus, but other illnesses that are adding to the burden, Frieden said.
The CDC director said the bulk of the response will come from the affected countries themselves, assisted by medical experts from elsewhere who can provide training.
“This is not just a problem for Africa,” Frieden said. “This is a problem for the world, and the world needs to respond.”
Failing to control the virus makes it more likely that Ebola will expand to additional countries, and that Ebola could mutate in ways that make it easier to spread, Frieden said. While the risk of such mutations is low, “it’s probably not zero.”
Doctors Without Borders, one of the leading humanitarian agencies fighting the epidemic in West Africa, said Tuesday that “the world is losing the battle” to contain Ebola.
“Leaders are failing to come to grips with this transnational threat,” said Joanne Liu, president of Doctors Without Borders, in a statement. “States have essentially joined a global coalition of inaction.”
The group called on countries with the capacity to handle biological disasters – such as pandemics or bioterrorist attacks – to send more boots on the ground, in the form of trained civilian or military medical teams.
“Funding announcements and the deployment of a few experts do not suffice,” Liu said. “The clock is ticking and Ebola is winning. The time for meetings and planning is over. It is now time to act. Every day of inaction means more deaths and the slow collapse of societies.”
Doctors Without Borders estimates that its hospital in Monrovia, the capital of Liberia, needs another 800 beds. The hospital now has 160 beds.
“Every day, we have to turn sick people away,” said Stefan Liljegren, a Doctors Without Borders coordinator in Liberia, in a statement. “I have had to tell ambulance drivers to call me before they arrive with patients, no matter how unwell they are, since we are often unable to admit them.”
Frieden, who visited the Ebola wards himself, said wearing multiple layers of “personal protective equipment” – or moon suits – is “roasting hot” in the tropical climates of West Africa. “Sweat pours down into your goggles and eyes,” Frieden says. Doctors wearing two sets of gloves have trouble even drawing blood, he said.
“As bad as the situation is now, everything I’ve seen suggests that it will get worse,” Frieden says.
The World Health Organization last week announced that the Ebola outbreak could grow to 20,000 cases and take another six to nine months to contain.
“In some ways, the most upsetting thing I saw was what I didn’t see,” Frieden said of his trip to West Africa. “I didn’t see enough beds for treatment. One facility with 36 beds, that just opened, had 63 patients. Some were laying on the ground. … I didn’t see data coming in from large parts of the country. I didn’t see the rapid response that is needed to keep a single cluster from becoming a large outbreak.”
A separate Ebola outbreak is occurring in the Democratic Republic of Congo in central Africa. Tests on the viruses in circulation there show that the outbreak is a “distinct and independent event, with no relationship to the outbreak in West Africa,” the World Health Organization said yesterday.
FAO says Ebola endangers food security
The world’s worst Ebola epidemic has endangered harvests and sent food prices soaring in West Africa, the U.N. Food and Agriculture Organisation (FAO) said on Tuesday, warning the problem would intensify in coming months.
The FAO issued a special alert for Liberia, Sierra Leone and Guinea, the three countries most affected by the outbreak, which has killed at least 1,550 people since the virus was detected in the remote jungles of southeastern Guinea in March.
Restrictions on people’s movements and the establishment of quarantine zones to contain the spread of the hemorrhagic fever have led to panic buying, food shortages and price hikes in countries ill-prepared to absorb the shock.
“In the three countries severely affected by Ebola, the agriculture and food security situation is really deteriorating,” said Vincent Martin, head of an FAO unit in Dakar that is coordinating the agency’s response.
“People either cannot afford to buy food or it is not accessible anymore,” he said in an interview, adding that the food crisis could hinder containment of the disease, which is typically spread via the bodily fluids of the sick.
Rice and maize production will be scaled back during the fast-approaching main harvest season as migration and movement restrictions cause labour shortages on farms, the FAO said.
Cash crops like palm oil, cocoa and rubber will be seriously affected, squeezing the purchasing power of many families, who will also lose income and nutrition due to the ban on bush meat.
The price of cassava at a market in the Liberian capital Monrovia rose 150 percent in the first weeks of August, the FAO said, adding that currency depreciation in Sierra Leone and Liberia was likely to force prices up further.
Border crossing closures and the reduction of trade through seaports have tightened food supplies in the three countries, which are all net cereal importers, and propelled prices upwards, exacerbated by higher transport costs.
The U.N. World Food Programme and the FAO have approved an emergency programme to deliver 65,000 tonnes of food to 1.3 million people affected by Ebola over a three-month period.
Food is to be shipped to Ebola patients, suspected cases living in isolation and to communities within the badly-affected border zone of Guinea, Liberia and Sierra Leone that has been surrounded by a “cordon sanitaire” to prevent the further spread of the disease.
In a sign of the lack of provisions within treatment centres, a man escaped from an Ebola treatment centre in Monrovia this week and walked through a market in search of food.
“Sometimes you have an area right next to a quarantined area where there is food but you can’t get it there,” Martin said.
Liberia, where cases are increasing fastest, said in August that it has only enough rice stocks to last for about a month.
The WFP says it needs to raise $70 million to pay for its emergency programme. In addition to this sum, the FAO is seeking to raise $20 million to help isolated populations grow their own crops and support themselves, Martin said.
“Delivering food directly to the population is not sufficient. What the FAO is proposing is to see how we can help restore their livelihoods and help them cope by providing tools to produce good and nutritious food,” he said, and raising chickens or short-cycle crops could form part of the solution.
