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Ebola: Are cases levelling off? | Ebola: Are cases levelling off? |
(about 1 hour later) | |
We may be entering a new phase of the Ebola epidemic in West Africa. | We may be entering a new phase of the Ebola epidemic in West Africa. |
There is growing - but certainly guarded - talk within the World Health Organization that the overall number of new cases is levelling off. | There is growing - but certainly guarded - talk within the World Health Organization that the overall number of new cases is levelling off. |
Officials have told me they now expect the figure to stick at around 1,000 fresh cases each week. | Officials have told me they now expect the figure to stick at around 1,000 fresh cases each week. |
It is in sharp contrast to the early phase of the outbreak when the number was doubling every three to four weeks. | It is in sharp contrast to the early phase of the outbreak when the number was doubling every three to four weeks. |
Back in September, a major report by a team at the WHO and Imperial College London was estimating 20,000 cases by today (November 2). | Back in September, a major report by a team at the WHO and Imperial College London was estimating 20,000 cases by today (November 2). |
Instead the number of confirmed, probable and suspected cases stands at 13,567. | Instead the number of confirmed, probable and suspected cases stands at 13,567. |
Those early predictions, based on mathematical modelling, were hugely important for making the world pay attention to the severity of the outbreak. | Those early predictions, based on mathematical modelling, were hugely important for making the world pay attention to the severity of the outbreak. |
They were based on the "exponential growth phase" of the epidemic, in which the rate of new infections soar. | They were based on the "exponential growth phase" of the epidemic, in which the rate of new infections soar. |
But now that exponential phase may be over. | But now that exponential phase may be over. |
Levelling off? | Levelling off? |
Dr Christopher Dye, the director of strategy in the office of the director general at the World Health Organization, has the challenge of predicting the spread of Ebola. | Dr Christopher Dye, the director of strategy in the office of the director general at the World Health Organization, has the challenge of predicting the spread of Ebola. |
"Things clearly have changed with respect to the trajectory of the epidemic," he told the BBC News website. | "Things clearly have changed with respect to the trajectory of the epidemic," he told the BBC News website. |
"What we've seen is, very clearly, a slowing down in the some of the affected areas in the three countries." | "What we've seen is, very clearly, a slowing down in the some of the affected areas in the three countries." |
Lofa county in Liberia as well as Kenema and Kailahun district in Sierra Leone are held up as areas making strong progress. | Lofa county in Liberia as well as Kenema and Kailahun district in Sierra Leone are held up as areas making strong progress. |
Dr Dye added: "When we look at the total epidemic now, with the best information we have got available I would guardedly say that the case incidence per week is not going to get larger than it is at the moment, so around 1,000 cases per week. | Dr Dye added: "When we look at the total epidemic now, with the best information we have got available I would guardedly say that the case incidence per week is not going to get larger than it is at the moment, so around 1,000 cases per week. |
"In terms of the trend of the epidemic, it is possible it has flattened out. | "In terms of the trend of the epidemic, it is possible it has flattened out. |
"We know there's under-reporting so we have to emphasise caution, but broadly we're out of this big epidemic growth phase seen in August and September." | "We know there's under-reporting so we have to emphasise caution, but broadly we're out of this big epidemic growth phase seen in August and September." |
Tiger waiting to pounce | Tiger waiting to pounce |
Even if it is confirmed, 1,000 cases per week is still no cause for celebration. | Even if it is confirmed, 1,000 cases per week is still no cause for celebration. |
That would be the equivalent of every other Ebola outbreak in history happening every fortnight. | That would be the equivalent of every other Ebola outbreak in history happening every fortnight. |
And any attempt to claim Ebola is being contained is "like saying your pet tiger is under control", as the WHO's Dr Bruce Aylward put it last week. | |
There is still clearly a huge amount of work ahead. | There is still clearly a huge amount of work ahead. |
However, Dr Nick Golding from the University of Oxford shares the broad view that the dynamics of the outbreak are shifting. | However, Dr Nick Golding from the University of Oxford shares the broad view that the dynamics of the outbreak are shifting. |
He said: "That's probably right when you look at the whole outbreak, but in specific areas it's still growing exponentially. | He said: "That's probably right when you look at the whole outbreak, but in specific areas it's still growing exponentially. |
"It certainly looks like that for Liberia and the capital Monrovia; it appears to have plateaued in the past two months of data and there's a similar sort of thing in Guinea, but I'm not sure we can say that for Sierra Leone." | "It certainly looks like that for Liberia and the capital Monrovia; it appears to have plateaued in the past two months of data and there's a similar sort of thing in Guinea, but I'm not sure we can say that for Sierra Leone." |
Bad stats | Bad stats |
However, the data remains extremely poor. | However, the data remains extremely poor. |
This is particularly pertinent in Liberia - where new cases are supposedly falling - as only 38% of the reported cases are actually laboratory confirmed, compared with 85% in Guinea. | This is particularly pertinent in Liberia - where new cases are supposedly falling - as only 38% of the reported cases are actually laboratory confirmed, compared with 85% in Guinea. |
There is also the overhanging spectre of vast numbers of unreported cases - the best guess is there are around twice as many cases out there as have been reported. | There is also the overhanging spectre of vast numbers of unreported cases - the best guess is there are around twice as many cases out there as have been reported. |
New predictions on the future of the outbreak are expected soon as scientists get to grips with the changing shape of the epidemic. | New predictions on the future of the outbreak are expected soon as scientists get to grips with the changing shape of the epidemic. |
It seems certain that the early prediction by the US Centres of Disease Control of 1.4 million cases by January is way too high. | It seems certain that the early prediction by the US Centres of Disease Control of 1.4 million cases by January is way too high. |
But Dr Dye concluded: "Even if we are able to say the exponential phase is over, our goal is complete elimination in the human population and we clearly have a long way to go on that. | But Dr Dye concluded: "Even if we are able to say the exponential phase is over, our goal is complete elimination in the human population and we clearly have a long way to go on that. |
"If we could show cases falling in every area - and we can't - we would still have a major job on our hands." | "If we could show cases falling in every area - and we can't - we would still have a major job on our hands." |
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