The Ebola epidemic now sweeping West Africa is a public health catastrophe, yet the world’s response has been to treat it like a faraway monsoon or volcano, perhaps frightening but not something that much can be done about. This complacency is wrong-headed and dangerous. The catastrophe is worsening by the day because of the actions and inactions of people, those on the ground and those far away.
The Ebola epidemic now sweeping West Africa is a public health catastrophe, yet the world’s response has been to treat it like a faraway monsoon or volcano, perhaps frightening but not something that much can be done about. This complacency is wrong-headed and dangerous. The catastrophe is worsening by the day because of the actions and inactions of people, those on the ground and those far away.
On Monday, the World Health Organization published a grim and shocking assessment of the outbreak in Liberia, the hardest-hit of the four countries where the virus has exploded. Liberia has more than 2,000 cases of infection and has suffered about 1,000 deaths. According to the WHO, Liberia “is experiencing a phenomenon never before seen in any previous Ebola outbreak.” As soon as a new treatment facility opens, it immediately fills to overflowing, “pointing to a large but previously invisible caseload.” The number of new cases is increasing “exponentially,” the WHO warned. “The number of new cases is moving far faster than the capacity to manage them in Ebola-specific treatment centers.”
This is very bad news. With no vaccine or antiviral available, the means to control Ebola, known from past outbreaks, is to cordon off the infected and prevent transmission of bodily fluids by which the disease spreads. This is doable in small villages and isolated locations. But this outbreak has detonated in big cities, and because of inaction and fumbling by governments, as well as fear, suspicion and panic among residents, control efforts are a shambles. In Liberia alone, there will be thousands of new cases of infection in the next few weeks, rippling to tens of thousands. About half of them will die, judging by what’s happened so far.
The WHO team in Monrovia estimated that the county around the capital urgently needs 1,000 treatment beds. It has some 240 available with another 200 on the way. President Barack Obama has pledged support and asked Congress for more money; on Monday the Defense Department announced it would deploy a 25-bed field hospital to Liberia at a cost of $22 million. The U.S. military will deliver it, set it up and go home. The British are sending a 62-bed facility, which will be operational in eight weeks. Every little bit helps, but these responses are meager in face of the need. Hundreds of health care workers are also required. The WHO reiterated what Doctors Without Borders and others at the front lines have been shouting from the rooftops: The current effort needs to be scaled up three- or four-fold. The states of West Africa cannot do it alone.
Reports from the epicenter of the disaster are ominous. Taxis in Monrovia are filled with entire families, some of them infected, crisscrossing the city looking for treatment beds that don’t exist. No free beds exist anywhere in the country. The taxis are now becoming a hot source of potential Ebola transmission, too. When patients are turned away from full treatment centers, they go home to infect others.
This is a dire emergency. The paltry response is unacceptable.