Ebola outbreaks past and present

0:01On Consider This, NPR's afternoon news podcast, we cover everything from politics to the economy to the world. But every story starts with a question. At NPR, we stand for your right to be curious, to make sense of the biggest story of the day and what it means for you. Follow Consider This wherever you get your podcasts. Today on State of the World, Ebola outbreaks past and present.

0:33You're listening to State of the World from NPR. We bring you the day's most vital international stories, up close, where they're happening. It's Wednesday, May 20th. I'm Greg Dixon. The World Health Organization has declared an international public health emergency. An outbreak of Ebola, centered in the Democratic Republic of Congo, has so far likely killed over 130 people, with more than 600 people believed to have gotten sick from the virus. The size of the new outbreak raises questions about whether there were delays in detection. In a few minutes, we'll hear about the U.S. role in containing the last major outbreak of Ebola in 2014.

1:13First, to understand what's happening now, we're going to hear from NPR Global Health correspondent Jonathan Lambert. He spoke to Juana Summers. So just bring us up to speed if you can. Why is the WHO concerned about this outbreak? For a number of reasons. For one, Ebola is a really serious disease. The virus kills about half the people it infects, so health officials are generally really on the lookout for it. And usually when an outbreak gets announced, it's just a handful of cases. Like last year, the DRC had an outbreak that was declared after just 28 cases. Eventually, 45 people died during that outbreak.

1:49This one is already much bigger. I asked Jeremy Conundike about this. He was involved in Ebola response when he worked at the United States Agency for International Development during the Obama administration. I'm very, very worried. If I compare this to past outbreaks, this one has more momentum at time of detection than the huge West Africa outbreak in 2014 did. And more than 11 ,000 people died during that outbreak. I mean, there have been so many cases. Why are we just finding out about this outbreak now? There are a few reasons. One may be the kind of Ebola that's spreading. It's a rare strain called bundabuyo, and standard field tests often miss it.

2:28Samples had to be sent to larger labs, and in a big country like DRC, that can take time. Now, historically, the U.S. has played a pretty significant role in supporting this kind of surveillance. That's especially true in DRC because it's kind of a hotspot for infectious disease outbreaks. What did that support look like during past outbreaks? It took a lot of different forms. Some of them were formal. For instance, USAID staff placed across the country played a key role in flagging outbreaks of unidentified diseases, and CDC staff in DRC and in the U.S. lended their expertise, things like transporting samples to labs and testing them.

3:05But the Trump administration dismantled USAID last year, and CDC has experienced ongoing challenges from funding cuts. Conundike says that could have hampered this response and allowed the virus to spread. You know, we are just in a much, much weaker position now to respond to a challenging Ebola outbreak like this one than we would have been even 18 to 24 months ago. What does the Trump administration have to say about that? In a statement, the State Department said that it was false to claim that USAID reform has negatively affected their ability to respond to Ebola. And on a press call Sunday, I asked CDC about this.

3:40Satish Pillai, the Ebola response manager, didn't answer my question. He did say, though, that CDC was only notified of the first case the day before the outbreak was announced. Usually they'd get more of a heads up, but he claimed difficult conditions on the ground delayed the process. Okay, so what are the conditions that might have delayed detection of the outbreak? The cases are in a remote mining area where there's a lot of ongoing conflict. But aid cuts may play into this too. In these conflict areas, humanitarian aid workers are kind of an informal surveillance network. They can often get where government workers can't, and they might hear about some strange outbreak and flag it to officials.

4:17In DRC, U.S. funding for that kind of humanitarian aid has dropped by nearly 80 percent during the Trump administration, and that could have made detection harder. So the delayed detection may be because of the rare strain or maybe because of funding cuts. But now that this outbreak is here, how bad could things get? For the region, it could get pretty bad because this is such a rare strain. There aren't approved vaccines or treatments. But the risk outside the region to the U.S., for instance, is low. Ebola doesn't spread like an airborne disease like COVID. So it's likely not a pandemic risk.

4:51Good to know. NPR's Jonathan Lambert. Thanks so much. Thank you. As we just heard, the U.S. played an important role in containing the last major outbreak of Ebola in 2014, sending thousands of people to West Africa to help stop the transmission. NPR's Ping Huang looks back at that effort 12 years ago. Dr. Tom Frieden was director of the U.S. Centers for Disease Control and Prevention in 2014. This was the world's first Ebola epidemic. There was no playbook for this. And there is often, in the early stages of an epidemic, a kind of fog of war reality. Cases were rising. People were dying. Ebola was devastating to Liberia, Sierra Leone, and Guinea, and had potential consequences beyond.

5:36We could see a future in which Ebola spread for months or years throughout much of Africa and endangered travel, tourism, the economy for much of the world. So the U.S. government took on a leading role. They established a White House Ebola czar and sent more than 3 ,000 U.S. personnel to West Africa from the military, CDC, and USAID. They helped treat the ill, bury the dead, and keep close track of who had been exposed to sick patients. Neil Vora deployed with the CDC to help with infection control. He went to Bomi County in Liberia, where resources were scarce. For example, the Ebola Care Center one night when I was there ran out of gloves.

6:19How can you take care of patients with Ebola without gloves? Vora also helped keep track of patients and the people they'd been close to. When he returned, he ran an Ebola monitoring program in New York City. He managed a team that tracked more than 5 ,000 people coming from West Africa, checking in with them every day for 21 days in case they developed symptoms. We even had the UN General Assembly happen in September of 2015. So we ended up monitoring major political dignitaries, former heads of state, people in very prominent positions, but they would comply with this operation as well. These efforts happened all over the U.S.

6:56and succeeded in keeping the risk to the U.S. public low. The 2014 epidemic killed more than 11 ,000 people over two years. It led to new capacity in the region, laboratories and surveillance systems built with money and help from the United States. But Frieden, the former CDC director, says times have changed. Ebola is back, and the U.S. government spent the past year weakening our defenses. We are way less prepared than we were a year and a half ago. The CDC has lost thousands of employees. The U.S. has left the World Health Organization and dismantled USAID. The CDC said that they're working around the clock and with partners in Africa to get them assistance, and they're restricting some incoming travelers from certain countries.

7:43Ping Quang, NPR News.

7:50That's the State of the World from NPR. Thanks for listening.