Congo's government situation report, published Thursday and dated September 1, still counted 6,250 confirmed Ebola infections and 3,039 deaths, a case fatality rate of 48.6 percent, with 1,439 recoveries across 60 health zones in six provinces. [1] Africa CDC official Wessam Mankoula told an online briefing the same day, "We're still early to say that we're controlling the whole outbreak." The outbreak, he said, "is still evolving." [1]
Thursday's file held that ministry table and a Flowminder phone-mobility map built because surveillance still could not see most new infections. Friday does not move the ledger. It does not re-run the Vodacom method. Death-toll copy will sell 3,000 spreading again. The operational fact is control language Africa CDC will not use, 51 zones still active, and most of the newest deaths occurring outside treatment centres.
Four health zones have interrupted transmission after more than 42 days with no new case. Five more sit in a "control phase," 21 to 42 days quiet. Transmission remains active in 51 zones. [1] Mankoula said the last two weeks show a decline. "We are almost at the plateau phase." He also said it is "very early to say we have sustained decline in this outbreak." [1] A June plateau was followed by an increase. "This is why we are cautiously interpreting those data." [1] A plateau they refuse to call control is not a closing. It is a warning about the last time the curve looked like this.
India Today's Friday pickup, from the same Africa CDC briefing, put the deaths where the clinics are not. At least 63 percent of deaths recorded in the past week took place outside Ebola treatment centres. [2] That is not a new case count. It is a location. People are dying before they are reached. Yap Boum, Africa CDC's head of emergency preparedness and response, said authorities are shifting to a village-centred approach because trust is the gap in Ituri, where the outbreak is concentrated and where rebel conflict makes trust-building harder. "Building that trust in the middle of an outbreak is quite complex," he said. [2]
Contact tracing is the other unfinished fraction. Teams have followed 81 percent of listed contacts. Listed is the word that does the work. Africa CDC estimates that cases confirmed in the last three weeks should have generated about 97,600 contacts, at an average of 60 per confirmed case. Only 19 percent of those expected contacts have been traced. [2] An 81 percent follow-up rate on a short list is not 81 percent of the epidemic. It is a board that still cannot see most of the people the virus already met.
Do not add a threefold undercount onto 6,250. That remains an earlier warning, not a successor census. Keep Monday's WHO table of 6,041 and 2,911 labeled and unmerged. Thursday's 6,250 and 3,039 is a date stamp, not a Friday incidence print.
The vaccine graf is one, not a third commission. There is still no approved vaccine or treatment specifically targeting Bundibugyo, the strain of this outbreak. Ervebo, licensed against Zaire ebolavirus, is being used under compassionate-use rules for front-line workers. Vaccinations began August 27. As of September 1, 1,124 health-care and front-line workers had received it. [1] Placide Mbala Kingebeni, Africa CDC's director for research, clinical trials, and innovation, said Ervebo's efficacy against Bundibugyo "has not been demonstrated yet." [1]
Director-General Jean Kaseya said Wednesday the outbreak "remains extremely serious and continues to spread." "Despite the considerable efforts of the (DRC) government and partners, we are not yet where we need to be." [1] Uganda recently declared its own outbreak over. Active transmission in Congo's eastern provinces that border Uganda is still a cross-border risk. [1] Incremental measures, Mankoula said, are no longer effective. "This is the time for scaling up all different responses to control the situation on the ground." [1]
Death-toll copy still sells 3,000. Africa CDC will not call control. The ministry table did not move. Most of last week's deaths were outside the tents built to catch them. Those are the Friday facts. A plateau is not a closing until the people dying on the path are on the list.
-- KENJI NAKAMURA, Tokyo