Friday, November 30, 2018

Ebola's still getting worse, and I'm getting worried

The most recent Ebola outbreak, about which we've written before in these pages, is steadily getting worse.

The Ebola outbreak in eastern Congo is now the second biggest in history, with 426 confirmed and probable cases, the health ministry said late on Thursday.

The epidemic in a volatile part of Democratic Republic of Congo is now only surpassed by the 2013-2016 outbreak in West Africa, where more than 28,000 cases where confirmed, and is bigger than an outbreak in 2000 in Uganda involving 425 cases.

Ebola is believed to have killed 245 people in North Kivu and Ituri provinces where attacks by armed groups and community resistance to health officials have hampered the response.

There's more at the link.

The worst part of it is, those 426 "confirmed cases" are most likely the tip of the iceberg.  There are probably anywhere from two to five times as many, but they're not being officially reported or counted.  The reasons are numerous:
  1. That part of the world includes many isolated communities reached only by bush paths.  Officials using vehicles seldom, if ever, reach them, and so won't be aware of cases of Ebola in those communities.  There's also the very difficult mountainous and jungle terrain, which is a major factor in itself.  I know that part of the world.  I've been there.  One can pass a stone's throw from a thousand people in the thick bush, and never realize it.
  2. The stigma attached to Ebola is enormous.  Those suffering from it are regarded with superstitious fear, as if they'd been cursed by the gods, and their families are treated likewise.  There's huge social pressure to be sick with almost anything except Ebola, so many sufferers will insist they've got flu, or a cold, or something like that.  Even when they collapse and are near death, their families will carry on the pretense, because they don't want to be shunned by their communities or forcibly quarantined by the authorities.
  3. Because of the stigma, many who die of Ebola will be quickly buried by their families, and their deaths will not be officially reported for some time, for fear that the body will be exhumed and tested.  If a bureaucrat is told that so-and-so died of "a fever" six weeks ago, he'll have no official reason to record it as an Ebola fatality.  Indeed, the authorities would probably prefer that he didn't, to minimize the numbers and make them look better.
  4. As I've noted before, the entire Kivu province, and thousands of square miles surrounding it, is in a state of anarchy.  There are dozens, perhaps scores or even hundreds of armed groups, all preying on the local populace for whatever they can glean at gunpoint.  That makes it extraordinarily difficult and dangerous for health care professionals to move around, educating the people about Ebola, assessing the situation, and making an accurate count of the sick and the dead.

The risk to health care workers and international aid agencies is very real.

When medics tried to reach Ebola patients in a village in eastern Democratic Republic of Congo during a recent surge in violence, they were blocked by men wielding machetes and axes.

Worried about being kidnapped, they turned back, the latest in a series of setbacks in their attempts to contain the central African country's worst outbreak of the deadly virus.

As fighting has worsened between rival militia seeking control of land and natural resources, vaccinations and vital treatments have increasingly been delayed and Ebola has spread.

The situation has become so dangerous in eastern Congo that humanitarian workers were temporarily evacuated last month from their base in the town of Beni in the North Kivu region close to Rwanda and Uganda.

. . .

"Sometimes in the field we hear bullets flying left to right and we tell ourselves maybe it is going to hit one of us," said Mimi Kambere, emergency response coordinator for nonprofit group Oxfam, whose team was confronted by the men with machetes.

"Sometimes the insecurity pushes us not to respond to calls, and not to go into certain areas for days," she told Reuters in Goma, the town on the northern shores of Lake Kivu to which she and other health workers were evacuated on Nov. 17.

Again, more at the link.

Keep a very watchful eye on this Ebola outbreak.  So far, it's relatively well contained to certain areas of the Congo.  If it breaks out into the neighboring states of Burundi, Rwanda and Uganda, it'll create mass panic, with tens of thousands of people trying to flee to safer areas - and taking the infection with them.  It's flatly impossible to quarantine that entire area;  it's tens of thousands of square miles, in terrain so rugged that one can't even begin to identify (let alone secure) all the ingress and egress routes on the ground.  It'd take aerial sensors and interdiction to do it, with bombs and rockets, and that simply isn't going to happen.

Once the disease reaches more major cities, richer people will try to get out by rail, road or aircraft, or by taking ferries across the African great lakes in the area.  That'll speed up the spread of Ebola by an exponential factor . . . and then the whole of central Africa, from the Atlantic to the Indian Oceans, will be neck-deep in the dwang.  It won't take much more to spread the disease from there to every country having airline service to that part of the world.  That's not a happy thought.

I hope and pray that those fighting this disease on the ground can get a handle on the situation before things spiral out of control.  Let's all hope and pray so, for all our sakes.



Aesop said...

I checked up the other day, and I'll write it up this weekend for an update, but essentially, nothing's changed except it continues to grow...slowly.

It hasn't metastasized, jumped the border, nor hit a major city (yet).

Every day, it threatens to do any or all of the preceding, and each sunrise is another chance to roll the dice, and hope it isn't snake eyes.

That's about all that's keeping it from exploding in wide release.

At that point, the only successful strategy would be to quarantine Africa.

Not just DRC, but rather the whole flipping continent.

I'm hoping we don't find out if POTUS has the sense this time around to do that, because right now, hope is all there is.

This outbreak isn't burning out, and in fact, as its continual spread shows, it's still just getting warmed up.

riverrider said...

I fail to see the problem. surround the place and either let them kill each other off or nuke it. ebola gone/shithole sterilized. win/win. we're keeping three times the people alive than the land can support. nature is desperately trying to return to center. let it.

Jess said...

Most terribly infectious diseases are never contained, which makes me wonder about filoviruses. If I was one to embrace conspiracy theories, Africa would make a wonderful experiment for anyone that has no value for human life. Eliminate enough of the population, with a disease that has a cure for select people, and the vast resources become ready for the taking.

IamLegion said...

Lived in North Africa, visited a bunch more of it. You are dead on. This whole continent produces very little. Gold, diamonds, diseases and and ignorant muslim refugees. Ask a German...or any European how they feel about it.

Aesop said...

It's all fun and games cheering while your idiot neighbor's house made of straw burns down, until you realize you're downwind, and your house is made of wooden sticks.

Beans said...

With the advent of air travel AND stupid humanitarian Non-Government Organizations, the ability to effectively quarantine, say, New Zealand, let alone some or all of Africa is, quite frankly, impossible.

As long as you have airports/airlines that openly let sick passengers fly, you don't quarantine or control your airports and you don't immediately have a plane or ship with suspected illness in it land at a secured airport somewhere far away from habitation.

Seriously, as a culture, we don't have it in us to be effectively mean enough. Think I'm kidding? If you work for any reasonably large entity, there will be an 'Employee's Code of Conduct' which will list all the things they will say you've done when they fire you. One of those is probably phrased as "Knowingly harboring an infectious disease" or something like that. When was the last time you ever heard anyone getting written up or fired for being infectiously sick at work? Heck, you're supposed to come in with Leprosy until your fingers and other body parts fall off. Let alone having the Flu and hocking up your lung all over the work environment.

If you can't control infectious illness at your work, sure can't control plague on a whole continent.

jen said...

More arabic?

Sam L. said...

Sometimes all you can do is wait for the ignorant people to die off.

Beans said...

But in this case the ignorant people can also take out the non-ignorant. That's the fun thing about killer viruses when they go all plague-y.

MadMcAl said...

The only way to quarantine Africa would be to be as ruthless as possible and shoot down any aircraft not turning back and sink any ship that refuses to return. Even then, there is a land bridge.
Close the Sinai, position an army there that keeps anybody from moving through it.

Of course politicians will do nothing of the sort (well maybe Putin would). So we only can hope that they wise up and use the vaccine in the civilized nations freely and widely and of course that it works as advertised.

HMS Defiant said...

At last, thank God, this President didn't decide to send the U.S. Army to "help" the disease spread.