Ebola Response Delays Leave Thousands at Risk
Health teams face significant challenges in tracing and monitoring thousands of potential contacts, grappling with resource shortages and deep-seated community mistrust amplified by past outbreaks. The global response, meanwhile, has been hampered by the U.S. withdrawal from WHO...
A swift response is crucial in battling an Ebola outbreak, yet efforts to contain the rapidly spreading epidemic in the Democratic Republic of Congo are severely delayed. Thousands exposed to the virus remain unlocated, posing a significant threat.
An analysis of discussions from a World Health Organization (WHO) and Africa Centres for Disease Control meeting reveals just how far behind the response has fallen.
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The outbreak, attributed to the Bundibugyo strain, which currently lacks an approved vaccine or treatment, has resulted in approximately 220 deaths and over 900 cases, according to WHO data. The virus has also crossed into Uganda, where seven cases have been confirmed.
Health teams face significant challenges in tracing and monitoring thousands of potential contacts, grappling with resource shortages and deep-seated community mistrust amplified by past outbreaks. The global response, meanwhile, has been hampered by the U.S. withdrawal from WHO and widespread funding reductions affecting international health initiatives.
As documented in a recent virtual coordination meeting, only about 7% of 1,261 identified contacts were traced and monitored. By midweek, WHO estimated this number to exceed 2,000.
‘Outpacing the response’
“The outbreak is outpacing the response,” remarked WHO Director-General Tedros Adhanom Ghebreyesus. “Attacks on health facilities make tracking cases and their contacts nearly impossible.”
In eastern Congo, particularly affected areas have seen attacks on hospitals and the destruction of isolation tents by mobs retrieving loved ones’ bodies, often oblivious to the infection risk.
Efforts to contain the outbreak and trace those at risk are thus severely hindered, exacerbated by ongoing conflict and fragile health infrastructure. A consensus at the meeting identified reaching more contacts as a top priority, although resources are limited.
“No vaccine exists. No therapy exists. The virus circulated undetected for six weeks. Cross-border spread is confirmed. Health care workers are dying,” a presentation by WHO Africa stated. “Every day without a fully resourced response is a day the outbreak gains ground.”
Professor Salim Abdool Karim, a leading epidemiologist advising Africa CDC, reflected on the outbreak’s acceleration: “If you had to choose a bad place for this to happen, it would be Ituri.”
Despite Congolese officials’ experience—this marks the 17th outbreak since 1976—shortages, including the absence of suitable tests to identify the Bundibugyo strain, delayed early detection.
“There are very few people on the ground, and other issues persist, like obtaining fuel for vehicles. It goes on and on,” Karim noted.
U.S. missing
Sources, including a U.S. official and a WHO collaborator, indicate that prior collaboration with the U.S. often expedited solutions. The absence of U.S. involvement following its January exit from WHO, coupled with international aid cuts, complicates the current response.
Amadou Bocoum, CARE’s country director, reported his emergency response team had been reduced by a third. Marion Koopmans, a Dutch virologist on WHO’s emergency committee, called the search for potential cases and contacts a “hell of a job.”
Ebola is transmitted through direct contact with infected individuals’ bodily fluids, contaminated materials, or the bodies of those who have died from the virus. Exposed individuals must be monitored for 21 days. If they show symptoms, immediate isolation is necessary.
“We’re reverting to basic Ebola outbreak responses,” said Dr. Alan Gonzalez of Médecins Sans Frontières, prompting a global appeal for additional staff in Congo.
Overcoming psychological barriers remains a significant challenge. “People are afraid,” explained Mamadou Kaba Barry of the Alliance for International Medical Action, noting cases are often hidden due to mistrust.
He, along with many others, fears a recurrence of the devastating 2014-2016 West Africa outbreak that saw over 28,000 cases and 11,000 deaths.
“In West Africa, some hid, thinking, ‘What’s the point of dying if my family can’t reclaim my body?’” he recounted, emphasizing that important lessons remain unheeded.
“We never get used to Ebola. It’s always frightening.”
