Ebola Outbreak in DRC Reportedly Peaks, Because Apparently Viruses Also Get Tired
Congolese authorities say the Ebola outbreak has peaked as cases drop from 120 to 80 a day, which is progress, in the way that a smaller hurricane is progress.
Authorities in the Democratic Republic of the Congo have announced that the Ebola outbreak ravaging parts of the country has reached its peak. For the first time since the epidemic was declared in May, the numbers of people becoming infected is slowing down, according to officials - a development that would be more reassuring if the word "peak" didn't sound like something you'd say about a mountain you're still standing on.
Stressing that strict adherence to preventive measures needed to be kept in place - because of course they did - Samuel Roger Kamba, the Congolese health minister, said there was a decline in transmission of the Bundibugyo variant of Ebola. "We are fighting a very dangerous virus that is killing many of our people. Today, we can say that the outbreak is under control," he said. "At one point, we were recording about 120 cases per day; today, we're seeing about 80 per day. So the number of new cases is decreasing every day." Eighty a day: technically an improvement, spiritually still a lot of Ebola.
"It has been more than 22 days since 10 of the 62 health zones have reported new cases. And so we can now definitively remove six health zones from the list because they have gone more than 42 days without new cases, and we can remove four health zones that have gone more than 21 days without a new case," Kamba said, deploying the kind of meticulous counting that suggests someone has been refreshing the dashboard at 3 a.m.
Last week, the Sud-Ubangi region, on the DRC's borders with Congo-Brazzaville and Central African Republic, became the sixth province to report the disease. The Bundibugyo virus outbreak was declared by Congolese authorities on 15 May and is concentrated primarily in Ituri province, where ongoing conflict has created challenging conditions for those responding to the disease. It is the 17th outbreak of Ebola in the DRC since the highly contagious disease was first identified and named in 1976 - a milestone nobody asked the country to keep re-achieving.
No effective treatment for the Bundibugyo variant has been found so far but there are clinical trials in the region. The DRC received more than 70,000 doses of the Ervebo vaccine last month, which is the only approved treatment for the more common Zaire Ebola virus - meaning the vaccine is helpful, just not for this particular letter of the alphabet. According to the latest data from the Congolese health ministry, the number of confirmed cases stood at more than 7,200, including more than 3,475 deaths, as of 14 September.
While welcoming the progress made, Iracan Gratien de Saint-Nicolas, an MP for Bunia, warned against what he called "triumphalism" and stressed that efforts must intensify to show people that the disease was under control. Gratien Iracan called for lessons to be learned from failures in epidemiological surveillance that contributed to the rapid spread of the disease. The MP also expressed some scepticism over the government announcement. "Claims that an epidemic is under control must be supported by objective indicators. If the indicators show that the epidemic is indeed under control, let's make them public. Transparency in the data will strengthen public confidence," he said - a polite parliamentary way of saying "show your work."
He warned that some indicators that showed an epidemic was under control seemed to have been omitted by the DRC authorities, such as a sustained decline in new cases (over seven to 21 days), a decrease in deaths, a reduction in areas with active transmission, the majority of new cases originating from contacts already identified, and a high rate of contact tracing, as well as dignified and safe burials.
Early last month, Jean Kaseya, the director general of the African Centres for Disease Control and Prevention, visited Bunia - capital of Ituri and a centre of the current Ebola outbreak - and said then that there was no way of knowing when the peak might be reached but that containment and contact tracing were still not effective enough. Kaseya said: "A large portion of the mortality - 60 to 70% of deaths - comes from the community. The list of contacts we have just keeps growing. Epidemiologists say we've reached the peak when all cases come from the list of contacts." In other words, the peak is not when the numbers look better; it's when the disease runs out of strangers to infect.
In Rwampara, a town in Ituri, people are exhausted from the past few months of living with the dread of the disease. Léa Munyere, 36, a mother of four, said she was relieved that the health authorities had announced that Ebola was under control. Two of her close friends had died and she was still struggling to come to terms with the loss, she said. "We hope the disease will soon be declared over. It has robbed us of the people we cherish so much since it was first reported," she said. "We just want to get back to our normal lives." A modest wish, and one that - unlike the outbreak - genuinely deserves to be declared over.
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