Posted by: Chris Maloney | November 3, 2014

Do We Really Know What’s Happening With Ebola In Africa?

I’m interested in the progression of Ebola in Africa. And I’d like to have some facts about what is happening there. When I read the newspaper or listen on the radio, what I hear are the official statistics. Where do these statistics come from?

The NIH has created a whole new page for Ebola, listing all sorts of information about what’s happening with Ebola. Surely there is more information here than I might need. But the information is disturbing.

Take the overall numbers of Ebola cases and Ebola deaths. The World Health Organization’s Roadmap of Ebola as of October 31 lists: 13,567 cases, with 4,951 deaths. At the end the WHO says they discarded the suspected cases in Guinea to make the numbers drop. That gives a strange, much more deadly picture of the disease in Guinea.

In Guinea, with only 1667 cases and 1018 deaths, Ebola has a fatality rate of 61%. It makes more sense, from a “let’s not panic people” point of view, to keep the suspected cases and lower the death rate from the disease. In comparison, Liberia has 6535 cases and 2413 deaths, a 37% fatality rate. Sierra Leone has 5338 cases and only 1510 deaths, giving them a 28% fatality rate.

Now, I’m not sure what they’re doing right in Sierra Leone, but these numbers don’t maintain an expected mortality rate across country borders. If Sierra Leone is doing so much better than Liberia, the best thing we could do is get the two country’s doctors to talk to each other. But my suspicion is that Sierra Leone is poorer at collecting cases than Liberia, not better at treating the disease.

If we add together the idea that the WHO just “discarded” the suspected cases in Guinea and the idea that the mortality rates don’t match up in Liberia and Sierra Leone, I’m wondering how much stock we should put in the “13,567 cases” number. It may be correct in terms of magnitude, (ten thousand cases vs. a hundred thousand) but I don’t think it has the same sort of stringent analysis as say, the batting average of a Major League Baseball player. It feels more like the size of the fish that got away. In other words, I think we’re making it up as we go along.

In hopeful news, both Nigeria and Senegal have been declared Ebola free. But the most recent case in Mali shows just how fragile the line can be.

In terms of treatment, we don’t have anything that works. At this point we should have preliminary data on blood transfusions from previously infected patients, but I haven’t seen anything. It’s been a priority treatment for the past month:

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