People should not underestimate the severity of the current Ebola epidemic in West Africa, said Jamie Childs, senior research scientist and School of Public Health professor, at a Monday evening lecture entitled “Ebola Past and Present.”
During the talk, which was the second in a three-part series of events foused on Ebola education, outreach and fundraising, Childs addressed an audience of roughly 100 students at the School of Medicine. His talk, which focused on the devastating impact of Ebola on West African people and nations, included topics such as disease symptoms, transmission and treatments. Childs emphasized the difficulties of containing and treating the disease, as well as how current and past Ebola policies have been inadequate. The lecture was planned by the Yale Ebola Task Force under public health professor and Branford College Master Elizabeth Bradley and was part of the Global Health Seminar, a weekly elective course for students in the health professions.
“As far as I know, the number of cases could double in a couple of weeks,” Childs said.
Although Ebola has not had as much of an impact as other diseases like HIV/AIDS or malaria, the current Ebola epidemic ravaging Liberia, Guinea and Sierra Leone is much larger than any other Ebola outbreak in the past. Childs said that due to underreporting, official estimates may be significantly smaller than the actual number of those affected. There could be as many as 2.5 times the number of cases as previously thought, he added.
Childs, who specializes in diseases that are transmitted from animals to humans, of which Ebola is one, also said the estimated mortality rate for the disease may be closer to 70 percent than 50 percent. Before causing death by shock or organ failure, Ebola typically results in fever, diarrhea, vomiting and bleeding.
The Ebola virus is mutating at a rapid rate because every transmission of the virus provides an opportunity for evolution, Childs said. The first case of Ebola in the current outbreak probably resulted from the transmission of the virus between a wild bat and a two-year-old Guinean child. Since then, the disease has spread between humans through bodily fluids, but is unlikely to gain the ability to transmit more easily.
“Ebola is not evolved to be transmitted by [an airborne] route,” Childs said.
So far, an effective treatment for the disease has eluded researchers and health officials, Childs said, though he mentioned that targeting proteins on the surface of the virus with drugs could be a possible treatment. He added that two Ebola vaccines are currently being developed.
Until a treatment is found, Childs said the negative human and economic costs of the Ebola outbreak may be extensive. Even tracing up to 80 percent of an Ebola patient’s previous contacts may not be able to prevent 100,000 more cases, he said, noting that current healthcare methods do not even reach the 80 percent threshold.
Childs also predicted that the economic burden on Africa would be “severe and ongoing.” Ebola poses a $33 billion threat to West Africa, and as human costs continue to grow, the GDP of Liberia may fall 12 percent in the next year, according to one estimate. The region’s lagging healthcare infrastructure could exacerbate the economic situation, Childs added.
Before coming to Yale in 2004, Childs worked at the Centers for Disease Control and Prevention and spent four weeks in Kikwit, Zaire — now part of the Democratic Republic of Congo — to study an outbreak of Ebola. He described the situation as tragic — those affected did not have the facilities or professional expertise to deal with the disease.
Rebecca Wener SPH ’18 said she attended the lecture because of the topic’s relevance. She said she was struck by Childs’ description of the lack of political efficacy in efforts to combat Ebola.
Kylia Goodner GRD ’17, who studies genetics, agreed, noting that the fact that an 80 percent successful tracing effort would still not be enough to quell the disease’s spread is frightening.
Childs’ talk came at a time when concerns about Ebola are rising in the U.S. Last Friday, after a positive diagnosis of Ebola in one New York City doctor, Gov. Andrew Cuomo of New York and Gov. Chris Christie of New Jersey mandated 21-day quarantines for health workers returning from West Africa. The governors have since curtailed their policies in response to criticism — including from the White House — that such steps are unnecessary and would hamper efforts to aid West Africa, where 4,900 people have died of the disease since February.
Childs criticized the quarantine measures, noting that keeping patients in expensive medical facilities for 21 days and away from work may not be beneficial.
“Can you imagine the cost?” he asked. “[The quarantines] may inadvertently cause much more damage than good.”
Gov. Dannel Malloy also ordered a quarantine of travelers from West Africa earlier this month after declaring a public health emergency. Currently, nine people are quarantined: a family of six in West Haven, two students at Yale and an individual who some news reports have identified as a third Yale student.
The Yale administration has updated its travel policies to comply with state and CDC protocol, although undergraduates have been banned from receiving funding for travel to West Africa since mid-September.