Sustained effort needed against Ebola

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The specter of Ebola virus spreading across Africa and the rest of the world is so frightening, even a hint that the tide is receding seems like welcome news. The Post’s Lenny Bernstein reported Tuesday from Monrovia that Ebola treatment beds, in dire shortage during the early months of the outbreak, are now lying vacant. Bernstein also reported that plans by the United States to build 17 treatment centers with 100 beds each in Liberia are being reevaluated, and some may be constructed with as few as 10 beds.

The specter of Ebola virus spreading across Africa and the rest of the world is so frightening, even a hint that the tide is receding seems like welcome news. The Post’s Lenny Bernstein reported Tuesday from Monrovia that Ebola treatment beds, in dire shortage during the early months of the outbreak, are now lying vacant. Bernstein also reported that plans by the United States to build 17 treatment centers with 100 beds each in Liberia are being reevaluated, and some may be constructed with as few as 10 beds.

Bernstein’s reporting is encouraging, but policymakers should not declare victory in the war on Ebola. The virus, for which there is no available therapeutic or vaccine, is a wily adversary.

Clearly, there has been a shift in the dynamic of the epidemic in Liberia, seen most dramatically in Foya, a city in the north, where the outbreak took off this year and infections have now declined. On October 23, Jina Moore of Buzzfeed reported that only four patients were in a facility there designed to hold 157. On Tuesday, The Post reported that the same treatment center is now empty. At the same time, in Conakry, Guinea, where the virus appeared to be receding in July, Doctors Without Borders reported a massive spike in cases, with treatment facilities “stretched to the limit.” Another spike has been reported in a remote district of Sierra Leone that had been largely free of the virus.

Several factors may be at work, and all of them suggest caution and vigilance. First, the totals are likely an undercount. Public health workers simply can’t be everywhere. Infections and deaths happen far from where they can be tallied. If patients in remote areas are not isolated and treated, then further transmission of the virus by bodily fluids may also be unfolding beyond the line of sight.

Second, the decline in Liberia is due in part to effective use of special burial teams, which make sure that the dead are safely interred without infecting relatives who, by custom, often touch the deceased. It is quite possible that traditional burials in remote areas are still spreading the virus beyond the reach of the special teams.

A third and important factor is that, in this outbreak, Ebola has surged and then seemed to fade, only to come back again. This oscillation may be due to natural causes, medical interventions in the chain of transmission or both. When the outbreak was more limited this spring, West African authorities spotted a decline in cases and assumed they had defeated the virus. Instead, it took off. The longer trend, not the short-term fluctuations, is important, which remains worrisome. The Ebola virus epidemic demands a relentless, sustained response from the entire world until the fire is extinguished and the embers are cold. Right now, the fire is still burning.

— From the Washington Post