Q: Is the Ebola epidemic ending in Africa?
A: No one knows exactly what is going on in West Africa. Several medical groups, like Doctors Without Borders, are reporting that they suddenly have far more beds than patients. In some cases, there are empty beds at centers where, just a few weeks ago, people were dying on the streets outside because there was no room.
The trend is especially noted in Liberia, the hardest-hit country. Laboratories are getting fewer samples to test. Ambulance crews are picking up fewer bodies. The World Health Organization confirmed that new cases were dropping.
But health authorities are warning that it is too early to celebrate.
It is important to remember that this happened once before, on a smaller scale. In March, after alarming reports from Guinea that a rural outbreak had reached the capital, the W.H.O. and the Centers for Disease Control and Prevention sent experts in to help. The epidemic spread to Sierra Leone, and then to Liberia. But cases grew only slowly, and by May, most of the experts were withdrawn. At the time, there was more worry about MERS in Saudi Arabia.
In early August, the chief scientist for Britain’s foreign aid agency said the “end of the epidemic was in sight.” He was wrong. About 800 people were known to be dead then. Cases had actually begun to explode in July, and now about 5,000 are dead.
There are some theories as to why the numbers seem to be going down. The leading one is that more West Africans now believe that Ebola exists, are afraid of it, and are touching each other less.
In that way, it is like lung cancer, only on a speeded-up time scale. It took 30 years for Americans to fully accept that smoking caused lung cancer. Once they believed, fewer started smoking. Deaths from lung cancer are now much lower than they used to be because many Americans in their 50’s and 60’s didn’t start as teenagers, or quit. But you wouldn’t say that the lung cancer epidemic is over.
Because poor West Africans often have many people sleeping in one room, Ebola spreads in households. Because the incubation period is up to 21 days, it often kills the family slowly, one by one. But for each other family that keeps the virus from entering its household, that can mean five or six fewer deaths.
Other theories are that tens of thousands of home-care kits have been handed out. They contain gloves, bleach, a bucket, plastic bags and a bleach sprayer. Using them around the sick, and especially during burials, may have helped.
Alternatively, hospitals may be empty because more people are dying at home. In Liberia, it has been reported that families are refusing to bring in their relatives because, if they die, they will be cremated.
Another report is that taxi and minibus drivers are refusing to take passengers who are bleeding or vomiting to hospitals. That forces them to die at home – which is cruel, but could slow the spread of disease to other passengers.
It is also important to remember that epidemics typically come in waves. The reasons for some are obvious, like the weather: flu cases rise in winter, polio cases rise in summer. Pox diseases like smallpox, measles and chickenpox used to surge every few years after a new set of young children was born. For other diseases, the reasons are not clear. Ebola may simply be having a moment between waves.