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How do you stop a deadly infectious virus when there's no vaccine, no cure, no quick fix? That's the challenge in Eastern Congo right now where Ebola is spreading. Uh it's the third largest Ebola outbreak in history and experts worry it's actually much larger than is being reported. Now, for the head of the World Health Organization who's arrived at the epicenter, the answer simply seems to be listen to the locals. We're not here to tell people what to do. We're here to listen. Communities understand their own challenges and their own solutions.
Our role is to support you in implementing those solutions together. Community ownership is what will bring this outbreak to an end. Let's talk now to Eric Feigl-Ding and epidemiologist and he's the chair of the Department of Public Health at the New England Complex Systems Institute. Good to have you with us, Eric. Um we heard there Tedros talking about community ownership, that this is what will end the outbreak. Uh what's your understanding of what that actually looks like on the ground?
Yeah, thanks for having me. I think the community ownership what he's referring to indirectly is that there has not been wide community acceptance of the virus is even real. There's conspiracy theories that it's a plot by doctors or plot by some people trying to make money, trying to scare people. And most recently, Doctors Without Borders, they set up an isolation ward, but it was actually burned down by the locals a couple days ago because they had fear that it was, you know, again, this plot, Western out or the business plot. So, I think this is where the community ownership that he means that the local community needs to own that this epidemic is real and take it seriously and for everyone to work
together to contain this outbreak because without community cooperation and community ownership as he says that this is real and take it seriously, then this virus will not be contained. How does that then work? Is it sort of coming up with a with more effective public education campaigns? What exactly is this supposed to mean? I mean, the virus is fast-moving. This is this is a crucial stage. So, how do you, you know, ensure that balance between getting the message across, but also doing the hard work that needs to be done? Yeah, of course, public health containment, especially in absence of a vaccine because this Bundibugyo uh a strain of Ebola does not have a
vaccine unlike the Zaire strain. It requires direct community testing, tracing, isolation, and quarantine of contacts. But, that of course is very onerous. It's very it demands a lot of community cooperation, right? And um people actually again, we need the resources to do the testing, to do the isolation, but if they're burning down isolation wards and we don't even have the resources, especially in the absence of USAID being defunded, uh without the funding, um right now, for example, we don't many labs there can't even do the testing because they ran out of fuel to run the generators. And without the fuel for generators, then there's no electricity. Then they can't run the tests. So, there's a whole litany of compounding
factors as making this a containment so much more difficult than past strains of the Ebola. Right. You mentioned the uniqueness of this outbreak. The as you mentioned the NGO MSF or Doctors Without Borders reminded us the group's deputy director of operations Alan Gonzalez posted on X saying two weeks after the declaration of the Ebola disease outbreak in Ituri province, the situation is deeply alarming and a legitimate source of anxiety for communities and frontline health workers alike. Never before has an Ebola outbreak recorded so many cases so soon after its declaration. Um tell us more about this variant of Ebola. So this variant is different from the Zaire the more commonly seen Zaire strain. It is very fatal. It's um about
again 30 to 40% fatality, but that number is very uncertain because testing dependent. Even if it's like 10% fatal, it would still be incredibly fatal. We think they were under testing it. Uh the transmission the incubation window is either two days to 21 days. Um and it's supposedly not infectious until you have symptoms, but with something as deadly as this you can't take chances at potentially asymptomatic transmission. But um the you know the serial interval like between cases is shorter than say hantavirus, but it's much more severe. And again we don't have um a vaccines that developed for this specific strain.
They're trying to work on it um and it will take several months for between you know animal testing and then human testing. Um and even by then hopefully you know we'll have this contained because if this outbreak keeps going especially with World Cup and lots of summer travels, um if it's not contained in a few months, this virus will keep spreading and we don't want it to become the 2014 Ebola pandemic where, you know, ten tens of thousands of people died. So, that would be a very worst case scenario.
What does containment look like practically? Both um in the on the local setting, in the regional setting, global setting. How what does that look like? Well, containment means um not spreading beyond a certain geographic region. You know, they don't they do not want this virus to go global. Um but it also means containment as in like the epidemic curve slows down. Because right now the number of cases, again, that the MSF director was mentioning, it's risen more faster than any past Ebola outbreak.
Uh and we and that's despite a lack of testing and resources and a lack of, you know, with the absence of USAID, you know, tracing and testing. So, even with that, this virus is compounding much faster. We want the virus curve to eventually flatten. Remember the flatten the curve from the COVID era? The issue is right now there's no sign that this has flattened. Anywhere they do testing, albeit limited, they're finding a lot of cases. And without that much number of people tested as well. So, that means there's a lot of undetected cases as well. And the frustration is when people first show up at the hospital, it could the symptoms are very similar to say typhoid and malaria. So, at first you don't know
what it is and unless you know what it is, you don't want to be treating this Ebola like you treat with malaria drugs. That wouldn't work at all. So, you need the testing, but the containment for that requires testing again, tracing, and then, you know, isolation and quarantine. But, without good testing, you're you're very much driving in the dark. And we've seen countries like neighboring Uganda where there've been measures at the border, for example, trying to limit travel. I'm I'm just wondering whether we'll see more countries bring in some of these measures. Yeah, of course, many other countries need to react, not just the Democratic Republic of Congo. But, Uganda, Rwanda, and, you know, some countries like the
US and others have started imposing travel bans. But, I don't think international flight travel bans is enough. They really need to do testing, you know, tracing, because there's a lot of cross-border land travel. And this virus it seems to be perniciously spreading without, you know, it's spreading within this region without any major international air flight. Cuz so, the international travel thing is not the major source of this outbreak keep that keep spreading. It's just that it's contagious and there's very lack of resources of health care resources are very limited there. And there's even less than before because USAID has completely disappeared. And I think, you know, if we don't contain this, again,
much easier to contain it early than to contain it later. And right now, we've not done that at all. And that's my worry that this is a very fast-rising Ebola outbreak and seems to be much more contagious than past Ebola outbreaks. And again, also no vaccines to, you know, ring vaccinate a community after you identify a case. The traditionally you would do with you know testing tracing and ring vaccination, but we don't have that resource. So that's why it's even spreading faster and I think it'll reach further than we think. Not to mention that Eastern Congo is an area already torn apart by conflict rebels controlling many parts close to a million people packed in camps for the displaced. I suppose that further complicates the issue, doesn't it?
Yeah, absolutely. And this is where I think Dr. Tedros flew down because the community ownership, you know, it's they say we're here to give advice, you know, WHO doesn't have the resources to impose a military type of quarantine and even then the country is very splintered. Stopping a pandemic requires cooperation. I think the local rebel groups and factions need to inherently, you know, wave some white flag you know, ceasefire so that they can cooperate to stop this because if this virus gets out of control, everyone will suffer. This is not just any one faction. All people will suffer without better control on public health containment.
What can the rest of the world do to support this because yes, it's a DRC problem, but as you mentioned, there's also been the issue of slashing of foreign aid. Yeah, I think with lack of USA, other countries need to send resources directly. Now, there are have been discussions that basically we set up military containment camp military hospitals or just you know, foreign aid hospitals. I think we should do that again because in the 2014 epidemic, we sent entire hospital ships and military hospitals to Liberia. And I remember vividly that's how we stopped the outbreak in West Africa in 2014 with, you know, large-scale military hospitals to fly
in. Unfortunately, Trump administration is not going to do that on a large scale. I think they're only going to do like one, but I think Europe and many other countries need to step up because, you know, containing the virus, you know, benefits themselves as well, but it benefits the world and without USAID, you know, the Democratic Republic of Congo, Rwanda, Uganda definitely needs these resources and wealthier countries definitely need to step up. And in the absence of that stepping up, should people elsewhere in the world outside of the affected region be worried about a further spread beyond where Ebola is at the moment?
Yeah, I think regionally there's still concern. I don't think this will be like COVID. It's definitely not going to be any Hantavirus was not a was a fad. It's it's not going pandemic. This virus we know from past experience with other Ebola that can go pandemic and that this seems to be spreading faster. That's what's the worrying thing. We don't have much data, but it seems to be spreading faster than the previous Ebola strains and again, also lack of vaccine. So, I think regionally this could spread even further in sub-Saharan Africa beyond this these Central African countries, but um you know, the these are diseases of lack of health care resources as well. And I
think, you know, the African Union needs to step up, not just, you know, relying on foreign aid beyond Africa. I think this is where people often times in the world of public health, it's too little too late by the time you realize you've lost control. And then by the time you react, it's too late. An ounce of prevention is worth a pound of cure. Uh an ounce of public health resources sent to Central Africa right now will be worth um millions or billions of dollars of reactionary uh cures and reactionary uh resources deployed later. And this is why early reaction is so important. But public health is something that, you know, it's become very politically um treacherous for many and also prone to conspiracy theories, as
you know from COVID and monkeypox. So, we definitely need to work together to contain this. Okay, epidemiologist Eric Feigl-Ding, it's been a pleasure having you with us. Thank you very much. Thank you. Stay safe. Right. And what do you think? The WHO wants to work together with local communities to curb the spreading of the virus, but regarding the cuts in foreign aid, how realistic can this approach actually be? And what role do foreign aid cuts play? Let us know in the comments. And if you like this video, please hit the like button. If you haven't already, don't forget to subscribe. Thank you for watching.
