An American charity used to staff its Ebola wards in Congo mostly with Americans. Now it's about one in five. And Reuters says Washington's own rules are a big part of why. For anyone catching up: Congo declared this outbreak on May 15. It's Bundibugyo virus, an Ebola species with no licensed vaccine or treatment. Ituri province has carried most of the cases, North Kivu is where it's growing, and seven provinces are affected. You're listening to Ebola Watch, it's Tuesday, October 6. Coming up: what America First has meant for the response, a fresh national count that tests the minister's peak claim, North Kivu running out of beds, and new testing machines bound for Bunia. Follow the show and the next briefing lands in your feed on its own.
From a Reuters investigation published Tuesday:
The threat of offshore treatment for exposed citizens and the 21-day policy have dramatically slowed the flow of American medical volunteers, increasing the strain on local doctors and weakening the overall response, 19 of the people said.
Walk me through those two policies, because I think most people have never heard of either. Reuters spoke to more than 50 people. According to a senior administration official, once the White House heard Americans had been exposed in Congo in May, the directive was that none would come home for treatment. The administration built a 50-bed quarantine camp on an air force base in Kenya, and in July issued a do-not-board order for citizens who'd been anywhere in Congo in the past 21 days. One exposed doctor went to Prague. His infected colleague was treated in Berlin and recovered. And the effect on the ground? Franklin Graham of Samaritan's Purse told Reuters Americans were once 80 percent of staff at the charity's Ebola centers in Congo, and now it's about 20, and deployment costs have more than doubled. A hospital director in Bunia says six U.S. doctors worked in Bunia and Nyankunde before the policy. Now there's one. The Kenyan camp, built for an estimated 70 million dollars, has housed seven people. What does the administration say? HHS spokeswoman Emily Hilliard said the characterization overlooks extensive work by HHS and CDC at home and in Africa. CDC says it has more than 120 people in Congo and Uganda. And one number to flag: the State Department told Reuters it has allocated 780 million dollars, while Africa CDC's tally last month credited the U.S. with 886 million. The reporting doesn't reconcile the two, so I won't either. And for the traveler listening, the entry ban on recent travelers from Congo, Uganda and South Sudan still runs through Sunday, October 11, unless it's amended. Right. WHO's Marie Roseline Belizaire didn't judge the U.S. policy directly, but said any measure that makes it harder to deploy responders risks slowing the response.
Emmanuel Mujyakera, writing in the Kivu Post:
Eighteen people who died from Ebola were buried within 24 hours in Biakato, Ituri Province, as the Democratic Republic of Congo’s outbreak continues to place severe pressure on communities and health services across the east of the country.
Eighteen burials in one town in one day. Yesterday we heard the minister say the peak was behind us. Where do the numbers actually stand? The government's update for Saturday, October 3, counts 8,544 confirmed cases and 4,114 deaths, with 2,230 recoveries and 824 people in isolation or hospital. That's a case fatality ratio of 48.2 percent among confirmed cases. Yesterday's figure was 8,376 confirmed, so read the climb against slightly different cutoff dates. Do the sources agree with each other? Close, not identical. For Friday, October 2, Congo's National Institute of Public Health reported 8,442 confirmed cases and 4,080 deaths, while AFP cites WHO at 8,463 cases and 4,082 deaths. Same picture, small gaps, and I'd rather you hear both. That same national report logged 66 new confirmed cases in 24 hours and 22 deaths in the community, meaning outside treatment centers. And contact tracing? 73.8 percent of identified contacts followed up, against a target of 95. Back in Biakato's area, WHO sent a rapid response team to Mambasa and Mandima, but the Kivu Post reports fuel shortages for response vehicles and an ambulance. So maybe a national peak. Not one you can feel in Biakato. One bright spot from Mambasa: three patients were recently discharged as cured, and the chief medical officer is urging people to come in early.
UrduPoint, carrying the Emirates News Agency wire on a Doctors Without Borders warning issued Monday:
With new hotspots emerging every week, treatment capacity remains largely insufficient to meet needs, putting both patients and entire communities at greater risk, the organisation said, warning that Ebola treatment facilities in North Kivu are operating at full capacity.
We mentioned North Kivu's share of cases yesterday. What's actually new here? The full statement. MSF says that as of September 28, 34 percent of confirmed patients were still being treated in non-specialised facilities, because of limited beds and slow diagnosis. And the Butembo coordinator, Stéphanie Hoffmann, says that without enough beds they're sometimes forced to refer confirmed patients elsewhere, despite the risk to the wider community. So a third of confirmed patients are in places not built for Ebola. Per MSF, yes. Her description is 'like fighting a megafire,' with multiple outbreaks at once. Butembo has seen a slight decline in recent days, but neighbouring Beni is rising. Butembo, home to an estimated two million people, recently went from two treatment centres to four, and MSF says substantial investment is still needed. Beds alone won't fix it, though, right? She says as much. More than 60 percent of Ebola-related deaths still happen in the community, so trust matters as much as capacity. MSF is calling on all stakeholders to increase treatment capacity in Butembo and across North Kivu immediately.
Streamline Feed, reporting on a Roche Diagnostics release dated Monday:
Roche Diagnostics says it has provided two molecular-testing instruments to the Democratic Republic of the Congo’s Institut National de Santé Publique, or INSP, as health authorities respond to an outbreak of Bundibugyo virus disease.
Testing machines. Does that mean faster diagnosis next week? Not that fast. Roche says it will configure the equipment, train lab technicians, and send the instruments to Bunia for local validation. The Bundibugyo assay from its subsidiary TIB MOLBIOL is classified research use only, and the release doesn't say validation is done or that it's cleared for clinical diagnosis. So, promising, with an asterisk. A real asterisk. But it connects to MSF's point: delays in diagnosis are one reason patients end up in the wrong facilities. WHO's temporary recommendations call for decentralized RT-PCR testing and lab staff training, so local capacity in Bunia is the right target. And Streamline flagged the numbers in the release, too. It did. It couldn't verify Roche's outbreak totals against WHO, and said so. Exactly the habit we try to keep here.
If there's a number you want us to track, or something we got wrong, write to ebolawatch at lantern podcasts dot com. We read every note.
Tomorrow, Wednesday, we'll look for WHO's next figures to set against Congo's, any response from Washington to the Reuters findings, and whether the U.S. entry ban gets extended before Sunday. The full stories are in the show notes. Thanks for listening to Ebola Watch, a Lantern Podcast. We'll talk tomorrow.