a reply to: SubTruth
I've been wondering the same thing... is it getting better in Africa?
Just looking at the charts and the numbers, it would appear so and I hope that it is. But when you look deeper, even WHO believes that they cannot
rely on the numbers reported to them to be accurate, especially the numbers reported by Liberia and especially in Monrovia, Liberia. Liberia has also
muzzled journalists, some of whom are complaining that they are not allowed to verify the numbers of new cases, deaths, etc.
I think you can get a pretty good picture of how things stand in Africa from the latest WHO situation report. It's only 12 pages, and you can skim
it pretty quickly even if you have limited time:
WHO Situation report - 22 October 2014 (PDF)
My best guess, and I think WHO's best guess, is that it's getting better in some areas within the affected countries but not in others, and the
sheer number of cases now makes it very difficult to contain and to treat or even isolate people, as there are not enough beds in treatment
facilities. The UN, the CDC, and others estimate that they need to have treatment center beds to isolate 70% of cases by December to bring the Ebola
epidemic under control and eventually end the epidemic.
Senegal and Nigeria are the two big success stories in Africa. Senegal only had one reported case, but they managed to contain it and prevent it from
spreading. Nigeria had 20 cases, but they managed to contain it and prevent it from spreading. In both countries, more than 42 days have passed with
no new cases reported since the end of the last known case, so the Ebola outbreaks in both have been declared over now.
If the reports are accurate for Senegal and Nigeria, the biggest lesson here seems to be that it is possible to contain Ebola if you catch it early
and do excellent isolation, monitoring, and contact tracing.
Guinea appears to be doing the best of the three most affected countries. That's still not great though, because the spread continues at
approximately the same exponential pace as since the beginning. But that rate is slower than in Sierra Leone or Liberia, and Guinea has 61% of the
estimated number of treatment center beds needed. Not 70% yet, but much closer than in Sierra Leone or Liberia.
Sierra Leone is in bad shape, with the spread continuing at the same relatively high rate it has been for the last 4 months or so. They only have 29%
of the estimated number of treatment center beds needed, far short of the needed 70%. That means about 71% of the cases are outside of treatment
facilities and may not be sufficiently isolated.
Liberia is the hardest hit country of all. Looking at the growth over the last 4-6 weeks the rate appears to have slowed. And since they have the
largest number of cases and deaths, this makes the entire epidemic look like it is improving in most of the charts I've been doing.
But WHO thinks that it has not actually slowed down at all in Liberia. They say that it's grown to a point where Liberia can no longer keep up with
reporting and confirming cases and deaths accurately. Or perhaps that is a diplomatic way of saying what others have said, that cases and deaths in
Liberia may now be purposely under-reported to avoid panic. The recent clamp down on journalists reporting on Ebola in Liberia probably says a
Liberia only has an estimated 23% of the treatment center beds they need, far short of the needed 70%. That means at least 77% of cases are outside
of treatment facilities and may not be sufficiently isolated. So it does seem unlikely the growth of Ebola in Liberia would slow down yet.