00:00Medical facilities in the Democratic Republic of Congo are feeling the strain as Ebola makes its way through parts of
00:05the country.
00:06At a hospital in the northeastern part there, doctors describe a sense of dread spreading almost as quickly as Ebola
00:12itself.
00:13In the mining town at the center of this epidemic, Bloomberg reports bats the size of chickens swarm abandoned tunnels
00:19and may be spreading the virus.
00:21Janice Q is one of our colleagues covering the outbreak and she joins us now from Johannesburg.
00:24Janice, great to have you with us and I wonder if you could just get us up to speed first.
00:27We had a couple of conversations yesterday with Jason Gale and Jeremy Conondyke, former U.S. official who handled the
00:33Ebola outbreak in 2014 for the U.S.
00:36Just about the prospect of there being a massive undercount here and the difficulty of piecing together sort of how
00:40widespread this outbreak is thus far.
00:42What does your latest reporting tell you just about how widely this has spread to the DRC and neighboring countries?
00:50We've certainly seen quite a lot of spread within the Congo itself.
00:53The probable cases at this stage are sitting at about 867 with just over 200 deaths.
01:01But that is undoubtedly an undercount.
01:04It is very difficult for health workers on the ground to really do contact tracing.
01:10The estimate at this stage is that it's about a fifth of contacts that are being traced.
01:15And already Africa CDC's Director General, Kasia, yesterday was saying that on a like-for-like basis, this particular outbreak
01:25is already the second largest after the 2014 to 2016 epidemic in West Africa.
01:31And that epidemic was, it was large.
01:35It was a lot of people.
01:35There were more than 28,000 people infected in that epidemic.
01:39You asked in your piece, you say you've reported the WHO believes this outbreak likely started months ago.
01:44Why didn't they catch it sooner and are they trying to recover from that effort?
01:48Is there anything that health officials can do to try to catch these things earlier?
01:54There are a lot of factors in a region like this.
01:56The Congo is a really large country in the middle of Africa.
01:59The geography is difficult.
02:02And then there are also armed forces, specifically in the east, where the epicenter of this has been.
02:09There's also been all the funding cuts that we've spoken about before and we know well of, particularly USAID, which
02:17has weakened surveillance in that area.
02:19And then there's also the fact that this is a very rare strain.
02:22The Bundibugio strain is not the strain that was in that West Africa epidemic.
02:28It's not the one that's been studied and it's also not the one that has any vaccines or therapeutics approved.
02:34And so even on the diagnostics, on the testing, the original tests were really showing negative because it was testing
02:42for the Zaire strain instead of this Bundibugio strain.
02:45Janice, talk a bit about funding and the funding needs as this outbreak widens.
02:49You and Jason Gale, with whom we spoke yesterday, write about a request for $319 million.
02:54And I wonder if you can put that in a wider context.
02:56Bloomberg had reporting earlier last week just about how small the U.S. investment is in Ebola surveillance and mitigation
03:03since the cuts that we've seen to USAID here.
03:06So put that $319 million figure in context, if you would.
03:10Is it likely to be sufficient?
03:12Is it likely to come through?
03:15There is quite a lot being promised, but whether it really comes through is yet to be seen.
03:21The Africa CDC had a briefing yesterday evening and they were saying that they really are trying to work as
03:29one voice.
03:29They had the health ministers from three different countries there.
03:32So it was Congo, let me just check this, South Sudan and Uganda.
03:37Those health ministers were all there.
03:39And they also had the WHO and Africa CDC.
03:42And they are definitely focusing on coordinating a cross-border response.
03:48Of that amount that you mentioned, the $319 million, about 84% is set aside for Congo and Uganda.
03:56And then the rest for high-risk neighboring countries.
04:00It is to deal with some of the immediate needs, which range to things as basic as personal protective equipment
04:09for health workers, etc., on the ground.
04:12But also for building longer-term facilities that can be used during outbreaks like this.
04:21I also want to ask what mitigation matters are being done.
04:26I was reading this morning that for the first time, DRC itself has suspended flights from the eastern part of
04:31the country.
04:31Usually that's something airlines do on their own or other governments.
04:34They're taking that precautionary step.
04:36What are they trying to do to stop this outbreak?
04:39Because I know resources are tight.
04:40In your piece, you say hospitals in northeast Congo don't have proper isolation rooms.
04:44One is running low on supplies and staff as the staff members are now falling ill.
04:49This isn't the first time this country has dealt with an Ebola outbreak.
04:52So why are they struggling to keep up with this one?
04:57I think the funding cuts, again, have definitely paid a part.
05:01And then, as I said, they didn't detect which strain it was very early.
05:08And so it probably was going undetected for a long period of time.
05:12Then on top of that, we've got the fact that they are really having to lean now.
05:18Because they don't have the tools, they don't have the vaccines or therapeutics for this particular strain, they're having to
05:24lean a lot on community messaging.
05:26And that is quite a tough sell.
05:29You often need people on the ground that are trusted to really convey that message.
05:34And habits can take quite a while to change.
05:37The DG of Africa CDC was speaking about dignified burials.
05:42And so one of the things with Ebola is that the mortal remains really can't be touched.
05:48The virus can continue to spread if you handle a body.
05:52And so trying to be sensitive to customs of the region but still make sure that there is a safe
05:59burial.
06:00So a dignified but safe burial.
06:01That is one of the messages that they are trying to get across.
06:04Jess, let me just ask you lastly about the parallel that we've been drawing to 2014 and 2016.
06:09Bearing in mind, as you've pointed out, this is a different strain than we were seeing back then.
06:14What can that outbreak tell us or how does that inform the response that we should see or that we
06:18are seeing in DRC now?
06:21Does it provide any kind of playbook here?
06:23Are we really dealing with a circumstance that's not, if entirely different, a different circumstance?
06:30In theory, we should be dealing with a much better circumstance because we do have vaccines and therapeutics.
06:36Unfortunately, they're not specific to the strain.
06:39And so in some ways, there are lessons that have been learned from the 2014 to 2016 epidemic
06:46in terms of how secure the facilities need to be, you know, how contained they need to be.
06:54Whether they can actually get those facilities up and running quickly is another story.
07:00I do think, though, that we are seeing a sense of urgency across various agencies, various countries.
07:06And so support is being flown in.
07:09We heard yesterday that during the course of the day, India had promised to send several tons of equipment in.
07:18And so I do think that that sense of urgency and speed is definitely different this time around.
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