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| CDC: Ebola could infect 1.4 million in West Africa by end of January if trends continue | CDC: Ebola could infect 1.4 million in West Africa by end of January if trends continue |
| (35 minutes later) | |
| The number of Ebola cases in West Africa could reach 1.4 million by the end of January if trends continue without an immediate and massive scale-up in response, according to a new estimate by the Centers for Disease Control and Prevention. | The number of Ebola cases in West Africa could reach 1.4 million by the end of January if trends continue without an immediate and massive scale-up in response, according to a new estimate by the Centers for Disease Control and Prevention. |
| The report released Tuesday is a tool the agency has developed to help with efforts to slow transmission of the epidemic and estimate the potential number of future cases. Researchers say the total number of cases is vastly underreported by a factor of 2.5 in Sierra Leone and Liberia, two of the three hardest-hit countries. Using this correction factor, researchers estimate that approximately 21,000 total cases will have occurred in Liberia and Sierra Leone by Sept. 30. Reported cases in those two countries are doubling approximately every 20 days, researchers said. | The report released Tuesday is a tool the agency has developed to help with efforts to slow transmission of the epidemic and estimate the potential number of future cases. Researchers say the total number of cases is vastly underreported by a factor of 2.5 in Sierra Leone and Liberia, two of the three hardest-hit countries. Using this correction factor, researchers estimate that approximately 21,000 total cases will have occurred in Liberia and Sierra Leone by Sept. 30. Reported cases in those two countries are doubling approximately every 20 days, researchers said. |
| “Extrapolating trends to January 20, 2015, without additional interventions or changes in community behavior,” such as much-improved safe burial practices, the researchers estimate that the number of Ebola cases in Liberia and Sierra Leone could be between approximately 550,000 to 1.4 million. | “Extrapolating trends to January 20, 2015, without additional interventions or changes in community behavior,” such as much-improved safe burial practices, the researchers estimate that the number of Ebola cases in Liberia and Sierra Leone could be between approximately 550,000 to 1.4 million. |
| “The findings in this report underscore the substantial public health challenges posed by the predicted number of future Ebola cases,” the researchers wrote. “If conditions continue without scale-up of interventions, cases will continue to double approximately every 20 days, and the number of cases in West Africa will rapidly reach extraordinary levels.” | “The findings in this report underscore the substantial public health challenges posed by the predicted number of future Ebola cases,” the researchers wrote. “If conditions continue without scale-up of interventions, cases will continue to double approximately every 20 days, and the number of cases in West Africa will rapidly reach extraordinary levels.” |
| They also said their assumptions may not fully account for sick patients who are turned away from treatment centers that don’t have any spare beds. That suggests the number of underreported cases could be even higher. | They also said their assumptions may not fully account for sick patients who are turned away from treatment centers that don’t have any spare beds. That suggests the number of underreported cases could be even higher. |
| CDC Director Tom Frieden cautioned that the estimates in the report don’t take into account actions taken or planned since August by the United States and the international community. In a telephone briefing with reporters, he said he did not believe the worst-case scenario “would come to pass.” | |
| He added: “A surge now can break the back of the epidemic, but delay is extremely costly.” | |
| He said the actions by the United States and other countries and organizations will slow the spread of the epidemic. The estimates in the report are based on data from August and don’t reflect the considerable increases in efforts to improve treatment and isolation. | |
| He said the tool developed by the CDC to make these projections provides the ability to help Ebola response planners make more informed decisions on the emergency response to help bring the outbreak under control – and what can happen if these resources are not brought to bear quickly. | He said the tool developed by the CDC to make these projections provides the ability to help Ebola response planners make more informed decisions on the emergency response to help bring the outbreak under control – and what can happen if these resources are not brought to bear quickly. |
| “It is still possible to reverse the epidemic, and we believe this can be done if a sufficient number of all patients are effectively isolated, either in Ebola Treatment Units or in other settings, such as community-based or home care,” he said. “Once a sufficient number of Ebola patients are isolated, cases will decline very rapidly – almost as rapidly as they rose.” | “It is still possible to reverse the epidemic, and we believe this can be done if a sufficient number of all patients are effectively isolated, either in Ebola Treatment Units or in other settings, such as community-based or home care,” he said. “Once a sufficient number of Ebola patients are isolated, cases will decline very rapidly – almost as rapidly as they rose.” |
| The latest findings come as the World Health Organization’s official count for the outbreak has surged past 5,800 people infected and 2,800 deaths. New projections by the WHO published by the New England Journal of Medicine on Tuesday, also acknowledge that “the true numbers of cases and deaths are certainly higher.” The WHO says the number of cases could quadruple to more than 20,000 by early November. | The latest findings come as the World Health Organization’s official count for the outbreak has surged past 5,800 people infected and 2,800 deaths. New projections by the WHO published by the New England Journal of Medicine on Tuesday, also acknowledge that “the true numbers of cases and deaths are certainly higher.” The WHO says the number of cases could quadruple to more than 20,000 by early November. |
| The key to slowing or stopping spread of the deadly virus is getting sick patients into medical facilities or Ebola treatment units or in other settings where there is reduced risk of transmission. But many hospitals are closed, and treatment centers are so stretched that they must turn patients away. | The key to slowing or stopping spread of the deadly virus is getting sick patients into medical facilities or Ebola treatment units or in other settings where there is reduced risk of transmission. But many hospitals are closed, and treatment centers are so stretched that they must turn patients away. |
| Projections for new Ebola cases: Read the CDC report | Projections for new Ebola cases: Read the CDC report |
| The CDC report offered a hypothetical scenario for slowing and eventually stopping the epidemic. In order for that to happen, about 70 percent of infected patients would need to be properly isolated and treated. Health officials and aid workers say only a tiny fraction of sick people are receiving the proper medical care. | |
| The report also attached specific numbers showing the high cost of delay. Every month-long delay in increasing the percentage of patients in treatment to 70 percent results in a tripling of the number of daily cases. | The report also attached specific numbers showing the high cost of delay. Every month-long delay in increasing the percentage of patients in treatment to 70 percent results in a tripling of the number of daily cases. |
| The United States recently launched a $750 million effort to establish treatment facilities in Liberia, and the United Nations Security Council voted unanimously last week to create an emergency medical mission to respond to the outbreak. In addition, the WHO is launching an effort to move infected people out of their homes and into small centers that would provide at least rudimentary levels of care, in hopes of increasing survival rates and slowing the transmission of the disease. | The United States recently launched a $750 million effort to establish treatment facilities in Liberia, and the United Nations Security Council voted unanimously last week to create an emergency medical mission to respond to the outbreak. In addition, the WHO is launching an effort to move infected people out of their homes and into small centers that would provide at least rudimentary levels of care, in hopes of increasing survival rates and slowing the transmission of the disease. |
| Global health officials say the priority is Ebola treatment units, and those facilities are not arriving fast enough. It could be weeks, even months, before the 1,700 new treatment beds promised by Washington are operational. | Global health officials say the priority is Ebola treatment units, and those facilities are not arriving fast enough. It could be weeks, even months, before the 1,700 new treatment beds promised by Washington are operational. |
| Gayle Smith, Special Assistant to the President and Senior Director for Development and Democracy, who was also on the call, said she could not provide more specifics on when those new treatment beds are likely to be operational.. | |
| “I cannot give you an exact date,” she said. “What I will say is that DoD [Department of Defense] along with civilian agencies are working extremely hard on a fast basis to identify sites and getting construction up and running.” The new regional U.S. command based in Monrovia has been on the ground for a week, and officials are “very satisfied” with how fast they have been moving, she said. | |
| The report did not include any modeling for Guinea because of the way that country has experienced the outbreak so far, Frieden said. The disease has struck “in three separate waves,” he said, making it difficult to come up with a valid model to predict what can happen next. “The situation in Guinea is very much in the balance, and they do have the potential to control it — they’ve done it three times already.” The biggest area of uncertainty centers on a heavily forested region where Guinea, Sierra Leone and Liberia intersect, which has been the epicenter of the outbreak. | |
| CDC researchers said findings in the report do not take into account several factors that could affect the forecast. Substantial changes in movement of people within countries or across borders could affect the arc of the epidemic. Researchers are also assuming the current epidemic has incubation periods and other characteristics similar to previous outbreaks. The correction factor — needed to adjust for underreporting of cases — could “change substantially over time,” the report said. Regional differences in underreporting of cases “might mean that using one correction factor across an entire country is inappropriate.” | CDC researchers said findings in the report do not take into account several factors that could affect the forecast. Substantial changes in movement of people within countries or across borders could affect the arc of the epidemic. Researchers are also assuming the current epidemic has incubation periods and other characteristics similar to previous outbreaks. The correction factor — needed to adjust for underreporting of cases — could “change substantially over time,” the report said. Regional differences in underreporting of cases “might mean that using one correction factor across an entire country is inappropriate.” |
| Read more: | Read more: |
| A look at an Ebola treatment center | A look at an Ebola treatment center |
| New Liberian plan would move sick out of their homes | New Liberian plan would move sick out of their homes |
| Health officials will begin first Ebola treatment trials in West Africa | Health officials will begin first Ebola treatment trials in West Africa |