Better get creative

The world seems to have noticed that the sky might actually be falling.

President Obama announced today that the US would take the lead in supplying personnel and equipment to address the Ebola epidemic that continues to spread faster every day.

Promises of 3000 troops, mainly for logistics, and hundreds of beds’ worth of field hospitals will no doubt be welcome. Britain and France also responded, in a small way. France is sending 24 doctors.

Yet.

Liberia alone is expecting 1,000 new cases next week, and they are out of beds. This matters not just for immediate humanitarian reasons, but to get the infected out of their communities and into isolation. At least half will die, if the trends continue, and the bodies must be disposed of as well.

In contrast, US military officials are talking about two weeks before the first troops arrive and begin constructing a few hundred beds.

On its present trajectory, the epidemic doubles every three to four weeks. There are very likely to be tens of thousands of infections in the coming months. And while there is no way to gauge the actual probability, the chance of a mutation that leads to airborne transmissibility, or unknown carriers leaving the continent, increases with each new infection.

Granted, it is probably impossible to ramp up a response much quicker. But that means bigger plans need to be put into action, if we are to have a chance to get ahead of it.

As quoted by the Times:

Beth Bell, the director of the National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention, said at a Senate hearing that while Ebola did not currently pose a significant public health threat to the United States, “there is a window of opportunity to control the spread of this disease, but that window is closing.”

(See also It hasn’t gone away.)

It hasn’t gone away

Although the media seem to have lost interest in West Africa, this chart may jog your memory:

Ebola cases reported - CDC

No?

It’s a chart of reported cases of the Ebola virus since the year it was discovered. Stunning, isn’t it.

This chart, however, is something of a lie. That’s because the 2014 epidemic – and I use the word advisedly – is far from over. Despite the media fatigue. At the end of August the World Health Organization predicted that the present epidemic would ultimately infect more than 20,000 people. Epidemiologists at Virginia Tech forecast something quite a bit more dire, “hundreds of thousands” of cases over 12-18 months.

Here is a map showing the extent of the epidemic to date, not including the latest cases reported from the Democratic Republic of the Congo:

640px-2014_Ebola_virus_epidemic_in_West_Africa

Case numbers aside, the epidemic has already spread 1,500 miles, give or take.

Think about that for a moment. In a few months, and despite poor transportation, the epidemic has covered the ground from Dallas to New York, and will probably infect over 20,000 people. The question is, will it really stop there?

Ebola is a virus, and viruses are funny things. They can mutate rapidly. There is a remote (but no one knows how remote) chance the thing could mutate in a way that enables some form of airborne transmission, instead of its present transmission through contact with bodily fluids. And of course with something that covers this much ground and involves so many people, there is a less remote chance that it will spread much further, via air or ship transport.

Even without mutations or escape routes off the continent, the number of cases is still growing geometrically. Newsweek quotes Anthony Fauci of NIH as saying that the virus is “completely out of control”.

One might think that the international community would announce threat level red and launch the moral equivalent of war to contain it. The most acute shortage is trained personnel. The actual response? Cuba is sending 165 doctors and nurses. Cuba. That’s the largest contingent to date. The U.S. has promised a 25-bed field hospital.

If you thought the media silence meant that the epidemic was over, you may be in for a very rude awakening. We all might.