Ebola crisis: ‘five new cases an hour in Sierra Leone’

The number of people being infected by Ebola in West Africa is doubling every couple of weeks now. The disease – for which there is no established cure, and which is killing more than half of those it infects – is spreading like wildfire.

The international response, which was condemned as “lethally inadequate” by the director of Medicins Sans Frontiers (MSF) Joanne Liu at the UN Security Council exactly one month ago, is now belatedly gearing up.

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The big question hanging over the Lancaster House Defeating Ebola pledging conference – hurriedly arranged by the Foreign Office and Department for International Development over the past week – is whether what’s now being promised will be delivered fast enough to stop the apocalyptic projections from becoming reality.

If we don’t start to increase the number of treatment beds and isolation facilities that are available now, then absolutely, many, many more thousands of people are going to become infected and will die MSF’s UK Director Vicky Hawkins

“We’re in a race against time,” says Justin Forsyth from Save the Children. “It’s spreading at a terrifying rate: five new cases every hour in Sierra Leone today and at the current rate it will be ten people an hour by the end of this month.”

Save the Children has today launched a $70m appeal for emergency funds.

MSF, which has been the lead agency in Sierra Leone, Libera and Guinea – the three countries worst affected – is reluctant to criticise the newly scaled-up response, but, as she entered the conference, MSF’s UK Director Vicky Hawkins told me it was frightening how much was needed, at incredible speed, in order to turn the tide.

“We do know that if we don’t start to increase the number of treatment beds and isolation facilities that are available now, then absolutely, many, many more thousands of people are going to become infected and will die,” she said. “These commitments now need to be delivered – and really fast.”

Vicky Hawkins, Executive Director MSF UK

In addition to US pledges to provide 1,700 beds in 10 different isolation units across Liberia, the UK is today announcing a £20m package to improve public health services in Sierra Leone. This is on top of its £100m action plan to deliver a command and control hub and construct and operate 700 beds in the country.

These 700 beds, DfID says, will allow for the specialised treatment of 8,800 patients over the next six months. This will treble the country’s capacity. The British government is also paying for international and national medics to staff the unit.

The Sierra Leonian President, Ernest Bai Koromo, was to have attended the London conference, but technical difficulties with his aircraft reportedly prevented his flying to London.

DfID has meanwhile found itself on the back foot today, following the publication today of an international development select committee report which links the rapid spread of the epidemic to cuts in British aid to Sierra Leone – including to the health sector.

“The planned termination of futher UK funding to the Liberian health sector is especially unwise,” the report says.

DfID dismisses the report as “out of date” and says the UK remains the largest bilateral donor to Sierra Leone and is leading the international response to what it calls “this unprecedented outbreak.”

Although governments and aid agencies concede that statistics must have a large margin of error built in, there are real fears that the scale of infection is being massively under-reported. The present extreme lack of bed capacity has left Ebola victims dying ignominiously at the gates of medical factilities that are full to capacity.

“The demand for treatment beds and nurses to halt the rapid spread of Ebola across Sierra Leone is far outstripping supply,” Save the Children says, adding that 765 new cases were reported last week, while there are only 327 beds in the country. “The critical shortage comes as untold numbers of children are dying anonymously at home or in the streets.”

A month ago, MSF listed a large number of things that had to happen with immediate effect if the crisis was to be contained. These included air bridges to, from and within, the affected region, to enable equipment and personnel to be moved around.

This is now happening, and is being coordinated by the UN’s World Health Organisation through a newly established Command and Control Centre based in Accra in Ghana.

The WHO has come in for severe criticism for its failure to move fast enough, despite repeated warnings over recent months by MSF. Its response has now been ramped up too, under the aegis of David Nabarro, appointed the UN’s Ebola respose chief by the Secretary General. Mr Nabarro flew into London from Liberia last night to attend the London conference.

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One crucial thing that has not been resolved is the evacuation of international medical staff who become infected. This issue is currently being hammered out. But failure to work out a plan led Australia to turn down requests to send medics to the Ebola region.

One of the greatest fears associated with the rapid spread of the epidemic is the potential for social unrest in extremely poor countries recoving from years of civil war. “The Ebola health crisis threatens to become a political crisis that could unravel years of effort to stabilise West Africa,” says the International Crisis Group.

“The hardest-hit countries now face widespread chaos and, potentially, collapse,” the ICG says in a statement. “Eight people, includig three journalists, were killed in Guinea .. by villagers fearing they were actually bringing the virus. This type of event could easily reignite violence in this region” it says.