JOHANNESBURG—Nearly two years after the first case was discovered, the Democratic Republic of Congo Thursday declared victory over the second-deadliest Ebola outbreak in history, but the country’s health crisis is far from over: It is also battling a new flare-up of the disease in its northwest, along with a measles epidemic and a growing number of coronavirus cases.
The challenges facing medical teams in the vast country are sizable.
Decades of conflict left Congolese and international health workers struggling to convince a traumatized population in the country’s east that the Ebola virus was real. Militias and angry locals attacked clinics and funeral teams, killing several health workers, while families tried to hide sick relatives from authorities. At least 3,463 people were infected since August 2018 in the eastern provinces of North Kivu and Ituri, with the disease killing 2,280 of them.
The distrust and violence undermined the first large-scale deployment of two Ebola vaccines and experimental treatments, which, according to the World Health Organization, dramatically reduced transmissions and death rates when administered in time.
But the vaccine—along with health screening and aggressive contact tracing—stopped the deadly hemorrhagic fever spreading to neighboring countries, averting a calamity that, health experts warned, would have surpassed the 2014-16 Ebola outbreak in West Africa, which killed more than 11,300 people.
“It hasn’t been easy and at times it felt like a mission impossible,” said Matshidiso Moeti, the World Health Organization’s regional director for Africa. An Ebola outbreak is considered over once 42 days—the length of two incubation periods—have passed since the last confirmed patient is identified.
There was little time to celebrate, though. Many of the 16,000 doctors, nurses and other front-line workers who battled the Ebola outbreak in the east have already moved on to fight other health emergencies.
Earlier this month, health workers discovered a fresh cluster of Ebola cases in Mbandaka, a city of around 1 million in northwest Congo—more than 1,000 miles away from outbreak in the east. Genetic testing of the virus found in the Mbandaka patients showed that authorities there are dealing with a new instance of animal-to-human transmission. In Mbandaka, 13 people have died out of 24 confirmed patients, and new cases continue to crop up.
At the same time, cases of the new coronavirus have now been confirmed in 12 out of Congo’s 25 provinces, with a total of 6,411 confirmed cases and 142 deaths as of Wednesday. Experts believe that the real number of cases and fatalities is likely to be higher, since Congolese labs currently run fewer than 1,000 tests a day—that is for a country of more than 84 million people.
Ebola, which is passed on via bodily fluids, is less contagious than the coronavirus, which can be transmitted through droplets in the air. Historically it has killed around two-thirds of those infected while the global mortality rate for the coronavirus has been around 5% or lower.
Congo’s health minister, Eteni Longondo, said the country’s experience with Ebola is helping the fight against the coronavirus, since many of the protective measures—such as social distancing and contact tracing—are the same.
Congo has so far eschewed a countrywide lockdown, instead focusing its efforts on the upscale Gombe district of the capital Kinshasa, where the vast majority of the coronavirus cases have been identified. The government announced on Wednesday that most businesses in Gombe would be allowed to reopen on Monday, although schools, churches and restaurants, as well as the big central market, will remain closed.
Congo’s health-care system would struggle to cope with a major coronavirus outbreak. Authorities have failed to contain a raging outbreak of the measles, a disease that can easily be prevented with a vaccine. More than 310,000 people, most of them children, have suffered from measles since early 2019 and more than 6,000 have died.
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