New figures published Monday by the World Health Organization reveal a far worse outlook than it had previously anticipated for the Ebola epidemic in West Africa.
In addition to predicting many more cases and deaths, the new report for the first time raises the possibility that the epidemic will not be brought under control and that the disease will become endemic in West Africa, meaning that it could reach a steady state and become a constant presence there.
“The epidemiologic outlook is bleak,” the report said.
If control does not improve now, there will be more than 20,000 cases by Nov. 2, and the numbers of cases and deaths will continue increasing from hundreds to thousands per week for months to come, according to the report. The death rate is about 70 percent in each of the heavily affected countries, Guinea, Liberia and Sierra Leone.
An editorial in the same journal called the epidemic “an avoidable crisis,” and faulted a “highly inadequate and late global response” for letting it surge out of control. It was written by Dr. Jeremy J. Farrar of the Wellcome Trust, and Dr. Peter Piot of the London School of Hygiene and Tropical Medicine. Dr. Piot helped discover the Ebola virus in 1976.
The editorial also warns that it will be impossible to control the epidemic “without a massive increase in the response, way beyond what is being planned,” and says that drugs and vaccines are urgently needed. The epidemic is growing so large, they write, that standard containment measures — isolating the sick and monitoring their contacts for signs of illness every day for 21 days — may not be feasible. One patient can easily have 10 contacts, so the number to be traced has already reached into the tens of thousands. No organization now has the staffing to follow that many people.
If Ebola becomes endemic in West Africa, Dr. Piot and Dr. Farrar say, the region could become a reservoir of the virus and pose a constant threat to the rest of Africa and other parts of the world.