Tech + Health

08.07.14

Ebola Experts Warn of an African ‘Apocalypse’

At an emergency hearing Thursday, leaders of the fight against Ebola gave updates on the situation in Africa and the future of the deadly disease’s possible spread.

At an emergency hearing in Washington on Thursday afternoon, major players in the fight against Ebola in West Africa addressed the outbreak that has stolen the lives of more than 900. Leaders from health agencies and humanitarian efforts addressed the need for increased support, as one called the current state of affairs in West Africa “apocalyptic.”

Rep. Christopher Smith, the chairman of the House Foreign Affairs Subcommittee on Africa and Global Health, opened the hearing by urging the speakers to clear the air on a “grave issue” that has “gripped” the mass media for weeks. “We hope to gain a realistic understanding of what we’re up against while avoiding sensationalism,” he told the floor. Here are the takeaways:

The outbreak is getting worse.

It’s already an unprecedented outbreak, CDC Director Dr. Tom Frieden says, and the number of infected and killed by Ebola will likely soon outnumber all other Ebola outbreaks in the past 32 years combined. According to the CDC, there have already been more than 1,700 suspected and confirmed cases of Ebola in West Africa, and more than 900 deaths—numbers that Frieden later called “too foggy” to be definitive. Ken Isaacs, the vice president of Program and Government Relations for Samaritan’s Purse, painted an even bleaker picture. According to the World Health Organization, West Africa has counted 1,711 diagnoses and 932 deaths, already, which could represent only a small fraction of the true number. “We believe that these numbers represent just 25 to 50 percent of what is happening,” said Isaacs.

The atmosphere in West Africa is “apocalyptic.”

In a six-hour meeting with the president of Liberia last week, Isaacs said workers from Samaritan’s Purse and SIM watched as the “somber” officials explained the gravity of the situation in their countries, where hundreds lie dead in the streets. “It has an atmosphere of apocalypse,” Isaacs said of the Liberia Ministry of Health’s status updates. “Bodies lying in the street…gangs threatening to burn down hospitals. I believe this disease has the potential to be a national security risk for many nations. Our response has been a failure.” Isaacs says that the epidemic is inciting panic worldwide that, in his opinion, may soon be warranted. “We have to fight it now here or we’re going to have to fight it somewhere else.”

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U.S. Centers for Disease Control and Prevention (CDC) Director Tom Frieden shows an awareness poster as he testifies before an Africa, Global Health, Global Human Rights and International Organizations Subcommittee hearing on “Combating the Ebola Threat” at the Rayburn House Office Building in Washington, D.C., on August 7, 2014. (AFP/Getty)

It’s unclear how many “serums” are available in the U.S.

Frieden explained that the government is looking carefully into any possible treatment for the infection but stressed that because of “rapidly evolving” information, it is unclear how many of the potentially life-saving Ebola “serums” are available. “I can’t tell you definitively how many courses there are,” said Frieden. “I heard there are a handful—fewer than the fingers of one hand. Some manufacturers have reportedly said they can make some, but some companies are saying it could take months. I don’t have definitive information.” Frieden further reiterated that Dr. Kent Brantly and Nancy Writebol are the first two humans to be given the treatment, suggesting that even if additional treatments were available, using them may not be ethical. “Whatever happens with these individuals…we still do not know from their experience whether these drugs work. Antibodies are only one part of our response to an illness—in other conditions antibodies can make a disease worse. It’s too soon to know.”

The international response has been disastrous.

Isaacs, head of the humanitarian agency for which Brantly worked, vehemently condemned the international community for a response that he considers both delayed and insufficient. “The disease is uncontained and out of control. The international response has been a failure,” he said. With three of the poorest nations in the world affected, West Africa is extremely ill-prepared for the disaster—a fact, Isaacs argued, that necessitates a stronger response. “The ministries of health in these countries do not have the capacity to handle this. If a mechanism is not found, the world will be effectively relegating the containment of this disease to three of the poorest nations in the world,” he said, adding later: “Is the world willing to let the public health of the world be in their hands?”

Writebol and Dr. Brantly are “getting better.”

When asked for an update on the current status of the two American workers being treated at Emory University in Atlanta after contracting the disease in Liberia, Isaacs said they were “getting better every day.” He was not able to confirm whether either can be classified as stable. “I don’t think [their recovery] will be fast,” he said. “I will say that they seem to have gotten better. We appreciate that they are getting good treatment—we pray that they will survive.”

But their introduction back to the U.S. will be painful.

In the days since the two American workers have returned to America, Samaritan’s Purse has heard widespread concern about their reintegration. “People are afraid to get around them—husbands, wives, no one knows if it’s safe,” he said. “We are doing everything we can to give them a safe place to be, but imagine how difficult it is for American citizens—and all citizens—to suffer from this,” he said. Some from the communities where the two Americans came from reportedly have expressed concern about them infecting other residents. “This is a nasty, bloody disease; I could give you descriptions of people dying that you cannot even believe.”

Doctors in the Ebola-infected countries are in desperate need of supplies.

Dr. Frank Glover, a missionary with SIM who also testified at the hearing, expressed frustration at the affected countries’ lack of personal protective gear (PPG), which he says is increasing the spread of infections significantly. Glover says the doctors and nurses in these areas, particularly Liberia, are “terrified” to enter the hospitals because of a lack of proper gloves, goggles, and gowns that are needed to protect them. “The No. 1 cause of infections in Liberia is lack of protective gear. It’s unconscionable that we’re asking them to take care of people without gloves. If we’re putting people on the line, we owe it to them to give them a fighting chance.”

The quarantined towns are in desperate need of other vital support systems.

Rep. Karen Bass, a standing member on Smith’s subcommittee who spoke with Liberian President Ellen Johnson Sirleaf, says the quarantined areas in West Africa are in desperate need of basic supplies like food and water. “Health care is a human right. We must ensure these countries have what they need to fight for it,” she said. Both Isaacs and Glover also expressed concern over the lack of education in West Africa about both the symptoms and proper response that should be taken in the wake of an infection. “A poster on the wall saying ‘Ebola kills’ isn’t going to do it,” said Isaacs. “They need education.” Grover cited the 14-year civil war in Liberia, which left millions illiterate, as one of the main roadblocks in educating the country.

The U.S. may not be prepared to treat American relief workers should they get infected.

According to Isaacs, of the Samaritan’s Purse, the plane that flew Writebol and Brantly to safety in Atlanta is the sole vehicle of that kind in existence. “There is only one airplane in the world with one chamber to carry a Level 4 pathogenic victim. One—and it’s in the U.S,” said Isaacs. “There is no other aircraft in the world.” Isaacs says that unless the Department of Defense is secretly in possession of another aircraft, then the U.S. will not have the power to evacuate more than one American relief worker at a time, should they get infected. “If the U.S. is going to expect CDC people [to be in these nations], there has to be assurance that we can care for them when they are sick.”

The disease could spread to other countries.

Isaacs, whose warnings to Congress about the urgency for a better response prompted Thursday’s meeting, says he is gravely concerned about the future. After first observing the outbreak in April, he’s watched the disease spread furiously across West Africa with little to no effective international support. “I think we are going to see death tolls in numbers that we can’t imagine,” said Isaacs. “If we do not fight and contain this disease, we will be fighting this and containing this in multiple countries across the world. The cat is, most likely, already out of the bag.”