As the death toll from Ebola nears the 5,000 mark, authorities in affected countries are striving to contain the virus. But a new study claims that in Montserrado, Liberia – an area badly hit by Ebola – the control measures put in place may not be enough to do so.
The research team, including senior author Alison Galvani, professor of epidemiology at Yale School of Public Health in New Haven, CT, publish their findings in The Lancet Infectious Diseases.
According to the most recent figures from the World Health Organization (WHO), more than half of recorded Ebola deaths so far have occurred in Liberia. Over the past week, Monrovia – the capital city of Liberia and a part of Montserrado – has seen the highest Ebola transmission rate, alongside the capital of Sierra Leone, Freetown.
Last month, it was announced that the US would be overseeing the construction of 17 new Ebola treatment centers in Montserrado with the aim of treating and isolating 1,700 patients. As of October 15th, however, a report from WHO revealed that of 28 treatment centers planned to be constructed in Liberia overall, only six are fully operational.
In order to address the lack of available beds in treatment centers, the Liberian Ministry of Health and Social Welfare began distributing home-based kits to protect individuals against Ebola. In addition, the ministry sent out instructions on how infected individuals can isolate the virus within their home.
Furthermore, measures have been put in place to increase detection of potential Ebola-infected patients, by tracking individuals that have come into contact with infected patients, for example.
For their study, Prof. Galvani and colleagues used a mathematical model to estimate the number of Ebola cases and deaths that could have been avoided in Montserrado had these strategies been implemented earlier, as well as the number of cases that these strategies could avoid in the future.
Their calculations were based on the estimate that one Ebola-infected patient in Montserrado would infect 2.49 other people.
The team estimates that had all of the aforementioned strategies been put in place 2 weeks earlier – at the beginning of October – up to 137,432 reported and unreported Ebola cases could have been prevented.
What is more concerning, however, is that the researchers estimated that with current control efforts, there will be up to 170,996 total reported and unreported Ebola cases and 90,122 deaths in Montserrado by December 15th, 2014. Of these, the team says 42,669 cases and 27,175 deaths will have been reported by then.
By expanding these strategies from October 31st – to include 4,800 extra hospital beds, increasing the speed of Ebola detection five-fold and increasing allocation of home-based protective kits – the researchers estimate that up to 97,940 Ebola cases could be prevented by December 15th.
They point out that delaying the expansion of these strategies by just 2 weeks – until November 15th – would almost halve the number of potentially avoidable cases to 53,957.
Commenting on their findings, Prof. Galvani says:
“Our predictions highlight the rapidly closing window of opportunity for controlling the outbreak, and averting a catastrophic toll of new Ebola cases and deaths in the coming months.
While the window of opportunity for timely control of the Ebola outbreak has passed, the risk of catastrophic devastation both in West Africa and beyond has only just begun. While vaccines to prevent Ebola remain unavailable, our study urges a rapid and immediate scaling-up of all currently available non-pharmaceutical intervention strategies to minimize the occurrence of new cases and deaths.”
In an editorial linked to the study, Prof. David Fisman and Ashleigh Tuite, of the Dalla Lana School of Public Health at the University of Toronto, Canada, say that the main message of these findings is that international authorities should waste no time in up-scaling strategies to contain Ebola.
“Researchers have asserted that the epidemic is proceeding in virus time, with a response on bureaucrat time,” they add. “From a global perspective, controlling the Ebola epidemic in West Africa is not only a humanitarian duty but also a matter of crude self-interest. The report […] shows that intervention will only be meaningful if it is timely, and so far it has not been.”
Medical News Today recently published a feature looking at whether the Centers for Disease Control and Prevention (CDC) are doing enough to prevent an Ebola outbreak in the US, after 3 cases of the virus were confirmed in the country.