New Ebola Outbreak: A terrifying new development in the Congo, a country on the brink

New Ebola Outbreak: A terrifying new development in the Congo, a country on the brink

The Democratic Republic of Congo (DRC) has a new Ebola disease outbreak. This week, there have been 9 reported cases in Mbandaka, a large city in the western part of the country.

This outbreak is separate from the country’s ongoing Ebola epidemic (750 miles away on the eastern side of the country) that has been claimed of 2200 lives since starting in 2018. The eastern DRC epidemic was days away from being declared over…until a single new case was identified.

This outbreak is separate from the country’s ongoing Measles outbreak that has claimed more than 6000 lives since starting in 2019.

This outbreak is separate from the country’s coronavirus outbreak. COVID reporting has been sparse in the DRC thus far but it is already widely circulating with more than 70 reported deaths.

It is hard for many of us to grasp the emergence of a poorly understood, seemingly exotic, disease on the other side of the globe. The chart below summarizes mortality (case fatality rate) and contagiousness (R0) for several infectious diseases in a well-resourced, developed world. Because COVID-19 is on everyone’s mind, it’s a suitable paradigm. Measles is slightly less deadly than COVID…but 15x more contagious. Ebola is slightly more contagious than COVID and at least 10x deadlier. AND these numbers are certainty underestimates because the DRC is one the worst performing medical systems in the world that has been further strained by the aforementioned outbreaks. On the contrary, measles and Ebola both have effective vaccines which will be crucial

Image adapted from David McCandless @ Information is Beautiful. V1/04/Oct 2014

Sources: Centers for Disease Control, World Health Organization, CIDRAP, Public Health Agency of Canada, Center for Evidence-Based Medicine..

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For as much scientific and media attention and Ebola virus disease (EVD) has gotten in the past few years, there are burning questions that remain unanswered. It is unclear what the animal reservoir is. The viruses have been found in several fruit bats but the evidence is not definitive. It is also unclear what happens in between outbreaks. COVID, for example, infected a single person and then spread around the globe. But Ebola outbreaks are general isolated from one another. One outbreak can quickly spread out until it is contained or, more frequently, it runs out of people to infect, and then the virus disappears. It is unclear where the virus lives between outbreaks. And this emerging outbreak in western DRC is a new outbreak.

There are countless lessons to be learned from COVID-19. An overarching lesson is that viruses do not respect geopolitical borders. Every country has a vested interest in helping out their neighbors in the face of a pandemic. Hopefully, the international community will rise to the challenge of helping the DRC.

A lesson that 2020 has unfortunately already taught us several times, public health emergencies are not mutually exclusive. The danger to the public increases exponentially when several health crises coexist and the developing imperilment in the DRC cannot be overstated.