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Could Ebola Be Slowing Down In Liberia?

A nurse walks through a newly completed Ebola treatment unit near the Tubmanburg hospital in Liberia. It has three separate areas for suspected, probable and confirmed cases of Ebola.
John W. Poole
A nurse walks through a newly completed Ebola treatment unit near the Tubmanburg hospital in Liberia. It has three separate areas for suspected, probable and confirmed cases of Ebola.

A few weeks ago, scientists issued a dire warning about the Ebola epidemic in West Africa: If nothing changes, the world could have tens of thousands of cases in the coming months.

So how can we tell if things have started to change — if international aid is starting to work?

One way is to follow a chart published every few days by the World Health Organization. It shows the number of new cases detected in West Africa. And on Wednesday, the chart showed something we hadn't seen in months: a decline in cases reported in Liberia.

Starting at the end of September the line goes down by about 160 cases each week. Could this mean the situation is improving in Liberia?

"You look at that, and it looks great. It's encouraging," says Columbia University's Jeffrey Shaman, who uses computer models to forecast the epidemic's future. "Maybe there's a slowing, which would be a very, very good thing."

And Shaman says his models also show a similar trend. For about five or six weeks now, the epidemic in Liberia has been growing more slowly than his models predicted.

But Shaman is cautious.

"I wouldn't be jumping for joy though, OK," Shaman says. "And the reason is that there are delays in the reporting, and not all the cases are actually found."

In fact, the big dip in cases could actually be a bad sign, Shaman says. It could mean more people might be hiding sick family members or not getting help for them because they're afraid.

For instance, treatment centers in Monrovia have started reporting they have some empty beds, which is surprising. Usually they have to turn away patients.

Those empty beds could be a good sign — it could mean there are fewer cases. But it might mean, instead, that people are staying away from treatment centers.

Health officials have been tricked before by what looks like a big drop in cases. Earlier in the outbreak, reported cases plummeted to zero in Guinea for almost a month. And health officials thought the outbreak might be over. They started relaxing.

"The key issue that made us fail in the early stages [of this outbreak], and why we didn't stop this back in March, is we thought we were on top of this," says WHO's Ian Norton, who is in charge of getting medical aid to West Africa.

But this time there's reason to be a bit more optimistic: Some help has arrived in Liberia.

More sick people in Monrovia now have a place to go for treatment, Norton says. That means they have a better chance of surviving and also are less likely to spread the virus to family and friends.

"We just opened the first of the new WHO-built facilities in Monrovia," he says. "And we're about to, in two weeks or so, open [an additional] 400 beds in two sites.

"The local contractors who have been working with us there have been working three back-to-back shifts a day so they're working 24 per day on sites," Norton adds. "It's incredible."

The international effort is about 20 percent along the way of building all the new treatment centers across Liberia, he says. And simply building the clinics isn't enough — a massive number of people still need to be trained to work in them.

"When you do the math," Norton says, "we quickly get up into the 6,000 to 7,000 staff needed in Liberia alone."

So there's still a long way to go to get this epidemic under control. But at least at this moment, he says, there's a bit of hope.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Michaeleen Doucleff, PhD, is a correspondent for NPR's Science Desk. For nearly a decade, she has been reporting for the radio and the web for NPR's global health outlet, Goats and Soda. Doucleff focuses on disease outbreaks, cross-cultural parenting, and women and children's health.
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