Ebola Is Spreading Faster Than Congo Can Vaccinate

The speed is the story

Congo's health minister calls this the fastest Ebola outbreak in history, and the data backs him up. By the 13th week after the outbreak was declared, it had recorded ten times more cases and seven times more deaths than the 2014-16 West Africa epidemic had at the same point, according to Africa CDC data. Measured against Congo's own worst previous outbreak — 3,400 cases and more than 2,200 deaths in 2018-20 — this one is moving 18 times faster on confirmed cases and 13 times faster on deaths.

Congo's government put the toll at 2,516 deaths out of 5,290 confirmed cases as of Friday. That makes it the second-deadliest Ebola outbreak ever recorded, behind only the West Africa epidemic that killed more than 11,000 people. The World Health Organization says it is on track to pass it.

The doses landed Friday night

16,250 doses of the Ervebo vaccine arrived at N'djili International Airport in Kinshasa late Friday, the health minister said. They are the first tranche of 70,000 doses the WHO and partners announced Thursday, released from the global Ebola vaccine stockpile at Congo's request. More are expected early next week.

The catch: Ervebo is not licensed against the virus doing the killing. This outbreak is caused by the rare Bundibugyo species, which has no approved vaccine and no approved treatment. The WHO says early laboratory and animal data suggest Ervebo may provide some protection. Of the 70,000 doses, 50,000 are for frontline and health workers as recommended by WHO experts; 20,000 are reserved for a Phase 3 clinical trial to establish whether the vaccine works against Bundibugyo at all.

Responders cannot find the people they need to find

Fewer than 10% of cases are currently coming from known contacts, against the 90-95% rate that signals an outbreak under control, according to Yap Boum, head of emergency preparedness and response at the Africa CDC. Over three recent weeks the agency logged 19,630 contacts — but with an average of 60 contacts per confirmed case, it expected close to 99,780. The actual contact tracing rate, the agency said, is 16% of what it should be.

Boum told reporters Thursday that current estimates suggest only 30% to 40% of cases are being detected, meaning the real outbreak could be three times its known size. It has not peaked.

Most of the dying is happening out of sight. Africa CDC data shows 97% of the deaths reported on August 17 occurred in the community, outside Ebola treatment centers, while only 20% of health alerts originate from communities. The overall case fatality rate is 46.7%, rising to 68.2% in North Kivu.

Short of money, short of paid staff

Julien Harneis, the UN's senior Ebola coordinator, told reporters Friday from Bunia that the outbreak is "growing exponentially" across an area larger than France, and that the existing pool of funds will run out within weeks. "The outbreak is growing faster and wider than the Ebola response," he said, "and all of this is happening in an area which has had three decades of conflict and is generating huge humanitarian needs." He said 160 health workers have fallen ill with Ebola and 43 have died.

The six-month WHO and Africa CDC response plan launched in June carries a $518 million price tag. Of that, $264 million has been disbursed — roughly half.