The U.S. Centre for Disease Control and Prevention, CDC, has predicted Liberia and Sierra Leone could have 1.4 million ebola cases by January 20, 2015 if the spread of the disease keeps soaring without effective containment.
In a report released Tuesday, the CDC gave the worst- and best-case estimates for Liberia and Sierra Leone based on computer modeling.
According to the CDC, the two countries could have 21,000 cases of Ebola in seven days time- September 30.
These figures, according to the report, take into account the fact that many cases go undetected, and estimate that there are actually 2.5 times as many as reported.
The report, however, does not include figures for Guinea because case counts there have gone up and down in ways that cannot be reliably modeled.
In the best-case model — which assumes that the dead are buried safely and that 70 percent of patients are treated in settings that reduce the risk of transmission — the epidemic in both countries would be “almost ended” by January 20, the report said. It showed the proportion of patients now in such settings as about 18 percent in
Liberia and 40 percent in Sierra Leone.
“My gut feeling is, the actions we’re taking now are going to make that worst-case scenario not come to pass,” Thomas Frieden, the CDC director, said in a telephone interview with New York times.
“But it’s important to understand that it could happen,” Mr. Frieden added.
According to the current official case count, there have been 5,843 Ebola cases in Africa including 2,803 deaths.
The WHO, Monday, predicted over 20,000 cases by November 2 if control remains ineffective.
The WHO report, however, noted that many cases were unreported and said that without effective help, the three most affected countries would soon be reporting thousands of cases and deaths per week. It said its projections were similar to those from the CDC.
The WHO report, for the first time, raised the possibility that the disease would not be stopped but would become endemic in West Africa, meaning that it could become a constant presence there. The report from the CDC did not discuss that possibility, but it is something that health officials have feared all along, and the reason they say
help is needed so quickly.
The WHO reported on Wednesday that a new treatment centre had just open in Monrovia, the Liberian capital, with 120 beds for treatment and 30 for triage. Patients were already lined up at the door.
The CDC unfortunately reports that case counts were rising faster than hospital beds could be provided. It said that in the meantime, different types of treatment would be used, based in homes or community centres, with relatives and others being given protective gear to help keep the disease from spreading.
As a way out, the United States government is sending 400,000 kits containing gloves and disinfectant to Liberia to help families take care of patients at home. The kits reflect the recognition that even the most ambitious new program will not be able to add hospital beds fast enough to keep up with the disease.
At least one aid group working in Liberia is already shifting its focus to teaching people about home care and providing materials to help.
Ken Isaacs, a vice president of the aid group Samaritan’s Purse, told New York times: “I believe inevitably this is going to move into people’s houses, and the notion of home-based care has to play a more prominent role.”
He said there could be 100,000 or more cases by the end of 2014.
“Where are they going to go?” Mr. Isaacs asked. “It’s too late. Nobody’s going to build 100,000 beds.”
Though providing home-care kits may seem like a pragmatic approach, some public health authorities said they were no substitute for beds in isolation or containment wards.
But Mr. Frieden said that home care had been used to help stamp out smallpox in Africa during the 1960s. The caregivers were often people who had survived smallpox themselves and were immune to it.
Some experts consequently have suggested that Ebola survivors might also be employed to care for the sick.
Meanwhile, United States President Barrack Obama’s last week promised to send 3,000 military personnel to Liberia and to build 17 hospitals there, each with 100 beds.
The Defence Department had already delivered parts of a 25-bed unit that will soon be set up to treat health workers who become infected, a safety measure said to be important to help encourage health professionals to volunteer.
Aid groups are also flooding into the region and setting up treatment centres.