Congo's Ministry of Health counted 6,186 confirmed Ebola cases and 3,007 deaths on Wednesday, up 86 cases and 57 deaths from the ministry table this paper carried Monday. [1] [2] AP led with deaths topping 3,000. The operational fact sits in a Tuesday CDC report that AP quoted and then buried: most new confirmed cases are coming from only 15 to 20 percent of known contacts. About four in five sit outside the chains responders already have on a board. [1] [3]
That is the successor to Tuesday's school-year file, which opened classrooms in Ituri while two official counts still disagreed and under-fives still died at 60 percent. It is also the successor to Monday's crossing of 6,000, when the ministry sat at 6,100 and 2,950 and WHO at 6,041 and 2,911. Keep those ledgers labeled. Do not merge Wednesday's ministry table with Monday's WHO table. Do not add Africa CDC's "possibly three times larger" claim onto 6,186. That is an undercount warning, not a third official census. [1] [2]
CDC said containment remained below established response targets. Fast expansion across many health zones indicated "uncontrolled expansion of the outbreak." [1] [3] Tedros Adhanom Ghebreyesus, speaking in Geneva on Wednesday, named the same hole in plainer language. Health authorities are not aware of every chain. "Until every chain is found and broken, the epidemic will continue; And it will continue to pose a threat to DRC, its neighbors, and the region as a whole." [1] [3] He also said the funding gap is still more than $1 billion. [3]
A round number is a caption. A tracing fraction is a diagnosis. If only 15 to 20 percent of new confirmed cases come from known contacts, the maps on the wall are describing a minority of the epidemic. The rest is walking around unlisted. Jean-Claude Angwanzia left Mambassa, in Ituri's epicenter, because he hardly saw health workers and saw infected bodies mishandled. [1] Papy Baraka, a Bunia driver, cut his passenger load. "The disease puts everyone at risk, and daily life has slowed to a crawl. We are afraid," he said. [1] Those are field reports. They are not a sitrep.
The virus has reached six provinces. Two new health zones in North Kivu were added last week, where the fatality rate is higher than in the rest of the affected provinces. [1] [2] Conflict in the east, attacks on health workers, miners on the move, unpaid staff who have struck for wages, and thin infrastructure keep pushing cases off the known lists. [1] [2] [3] WHO said the outbreak is on track to exceed the 2014-2016 West Africa epidemic, which killed 11,000 people. [1] [2] Africa CDC said surveillance and contact tracing are still weak enough that the true outbreak may be three times the recorded case count. [1] [2] That sentence is a multiplier on uncertainty. It is not a license to print 18,558.
There is still no approved vaccine or specific treatment for Bundibugyo. [1] [4] RTE, filing from Tedros's Geneva briefing at 19:21 on Wednesday, put three shots on a calendar rather than on a claim of protection. Moderna and Oxford have Bundibugyo candidates in safety trials in the United Kingdom and Canada. WHO has recommended a full-scale human efficacy trial of Ervebo, Merck's licensed Zaire-strain vaccine, to test for cross-protection. Tedros said partners are working to move all three into efficacy trials in Congo starting in October or November. [4] Kate O'Brien, WHO's vaccines chief, said Ervebo will probably enter that combined trial first because it is already licensed. Front-line workers, she said, should get it against Bundibugyo only as part of that research. [4] Trial stage is not results. A 16,250-dose batch arrived in July and vaccination of health workers began in Kisangani. [4] That is a research protocol riding a Zaire shot. It is not a Bundibugyo campaign.
Schools reopened this week in the worst-hit areas. An unnamed Congolese official told Reuters, via Al Jazeera, that remote learning was shelved because authorities concluded it would hinder students more than Ebola would. [3] That is one official, unnamed. It is not a new sitrep. Tuesday already had the classroom photographs. Wednesday's job is the tracing fraction.
The ministry table moved. The death count crossed 3,000. The CDC percentage did the work the round number cannot. Until the unknown chains are listed, 6,186 is a lower bound dressed as a total.
-- KENJI NAKAMURA, Tokyo