Guest essay by Eric Worrall
Given documented cases of Ebola survivors becoming long term symptomless carriers, this outbreak should worry everyone, though for now the WHO claims the risk of the Ebola outbreak spreading outside the afflicted region is not high.
Ebola outbreak in the Democratic Republic of the Congo declared a Public Health Emergency of International Concern
17 July 2019 News release
WHO Director-General Dr. Tedros Adhanom Ghebreyesus today declared the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) a Public Health Emergency of International Concern (PHEIC).
“It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system,” said Dr. Tedros. “Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders — coming from not just WHO but also government, partners and communities — to shoulder more of the burden.”
The declaration followed a meeting of the International Health Regulations Emergency Committee for EVD in the DRC. The Committee cited recent developments in the outbreak in making its recommendation, including the first confirmed case in Goma, a city of almost two million people on the border with Rwanda, and the gateway to the rest of DRC and the world.
This was the fourth meeting of the Emergency Committee since the outbreak was declared on 1 August 2018.
The Committee expressed disappointment about delays in funding which have constrained the response. They also reinforced the need to protect livelihoods of the people most affected by the outbreak by keeping transport routes and borders open. It is essential to avoid the punitive economic consequences of travel and trade restrictions on affected communities.
“It is important that the world follows these recommendations. It is also crucial that states do not use the PHEIC as an excuse to impose trade or travel restrictions, which would have a negative impact on the response and on the lives and livelihoods of people in the region,” said Professor Robert Steffen, chair of the Emergency Committee.
Since it was declared almost a year ago the outbreak has been classified as a level 3 emergency – the most serious – by WHO, triggering the highest level of mobilization from WHO. The UN has also recognized the seriousness of the emergency by activating the Humanitarian System-wide Scale-Up to support the Ebola response.
In recommending a PHEIC the committee made specific recommendations related to this outbreak.
“This is about mothers, fathers and children – too often entire families are stricken. At the heart of this are communities and individual tragedies,” said Dr. Tedros. “The PHEIC should not be used to stigmatize or penalize the very people who are most in need of our help.”Source: https://www.who.int/news-room/detail/17-07-2019-ebola-outbreak-in-the-democratic-republic-of-the-congo-declared-a-public-health-emergency-of-international-concern
Although Ebola is not an airborne disease in humans, at least one study has suggested pigs infected with Ebola can infect other animals via airborne transmission. Given evidence of airborne transmission in other species, the virus seems physically robust enough to survive airborne transmission; we may only be a few unlucky mutations away from an airborne human strain of Ebola.
The appearance of Ebola in Goma, a city of international business and fly-in mining consultants, is a serious concern, both for the people of Goma and for everyone else. The documented potential for Ebola survivors to become long term symptomless carriers, capable of passing on the disease through sexual or casual contact, in my opinion undermines the WHO’s dismissal of the risk of Ebola spreading. While I appreciate the WHO’s obvious desire not to impose additional burdens on the people they are helping by declaring a quarantine, the safety of my family is a higher priority to me than the economic wellbeing of poor people in the DRC.
Having said that, the vaccine is claimed to be very effective; even if an outbreak occurs in a vulnerable Western population such as the large groups of homeless people living in California, it should be possible to rapidly contain the threat, providing there is sufficient vaccine available.