The viruses of COVID-19 and Ebola
As the world continues to grapple with the Covid-19 pandemic, it’s easy to forget that other highly infectious and deadly disease that ravaged Africa from 2014 – Ebola.
Only a few other infectious diseases – like rabies, anthrax and pneumonic plague – are as deadly as Ebola, which can have up to a 90 per cent mortality rate.
And yet, even as Africa battles a new outbreak of the Ebola virus, last month a surprising and devastating milestone was reached. More people in Africa have now died from Covid-19 than have died from Ebola, Forbes reports.
According to the World Health Organization (WHO), in July the Number of deaths from Covid-19 in Africa hit 11,959 – overtaking the 11,308 deaths from Ebola in the continent’s worst outbreak of the illness from 2014-2016.
But considering coronavirus has a much lower death rate (globally the rate is 2.2 percent, but by country, it ranges anywhere from 0.5 percent up to around 10 percent), how is this possible?
Covid on the African continent
For a continent that remembers only too well the devastation of Ebola, Covid is now sweeping across Africa, with many countries battling their third wave of the illness.
New variants, such as the highly infectious Delta strain which Australia is also battling at the moment, combined with a very low immunization rate is seeing case numbers spiral.
In mid-July, 21 African countries saw weekly rises in case numbers by over 20 percent, according to the World Health Organization.
Nigeria has seen an increase of more than 4500 cases since July 10, with its seven-day rolling average of daily new cases more than doubling.
In Liberia, where only 0.18 percent of people have had both doses of the vaccine, case numbers rose 144 percent from June 1 to July 21.
In Senegal, which had been ahead in the fight against the virus, numbers rose from 380 on July 10 to 1700 on July 18, the highest number since the pandemic began, according to the Ministry of Health.
Under-reporting is an issue too. The main cemetery in Dakar, Senegal is seeing large numbers of funerals, and it is suspected many of these were due to Covid-19, though they have not necessarily been recorded as such.
Less than 2 percent of the continent has been fully vaccinated, and it is expected that 70 percent of African nations will not meet their 10 percent WHO vaccination target by the end of September.
Supply is a problem, with countries struggling to get hold of vaccines. Pfizer recently announced it will make its vaccine locally in Africa to be used in the continent from next year, Fortune reports. But experts say it may be too late.
“From day one, our goal has been to provide fair and equitable access of the Pfizer-BioNTech Covid-19 Vaccine to everyone, everywhere,” Pfizer CEO Albert Bourla said.
Oxfam America senior advocacy manager and spokesman for the People’s Vaccine Alliance Robbie Silverman called the announcement “good news”, but added: “It is simply not enough.”
Memories of highly deadly Ebola
Ebola was first discovered back in 1976 but it was the outbreak in West Africa in 2014-2016 that brought it to global attention, with heartbreaking images of people dying as the disease ravaged communities.
According to the World Health Organization, Ebola Hemorrhagic Fever usually starts with a sudden onset of fever, intense weakness, muscle pain, headache, and sore throat.
“As the disease progresses, people commonly develop vomiting and diarrhea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.”
People can become infected either by coming into contact with someone with the illness or through contact with infected animals.
But because people aren’t infectious until they show symptoms, those most at risk are family members and healthcare workers.
The average fatality rate is around 50 percent, though death rates have varied from 25 percent to 90 percent in past outbreaks.
The Zaire species of Ebola kill somewhere between 40 percent to 90 percent of its victims and usually upwards of 60 percent of infected people die, according to Forbes.
Mosoka Fallah, who was head of the case detection in Liberia during its 2014 Ebola outbreak, said: “During the worst period of the Ebola outbreak in Liberia, in July, August and September 2014, I saw people die in the streets.
“The world largely left us to combat a global health threat alone. One Ebola treatment unit built for 34 people had to serve 74 patients. The sick would wait for someone to die to free up space.”
A new Ebola outbreak has recently hit the Democratic Republic of the Congo. Six new cases were identified, with four of those people dying from the virus.
“This is a reminder that Covid-19 is not the only health threat people face,” WHO director-general Tedros Adhanom Ghebreyesus said in a statement.
So why is Covid-19 deadlier than Ebola in Africa?
Although Ebola is far deadlier than Covid-19, the nature of its illness is different from coronavirus.
Dr. Mark Kortepeter, a US biodefense expert, explained in an article he wrote for Forbes that most viruses “don’t really like to kill their hosts”.
“This allows them to circulate in the community much longer and spread far and wide across the world for far greater impact,” he said.
“When someone becomes ill with Ebola virus, they become bedridden very quickly. It’s really hard to be out in the community spreading the disease if you are vomiting or having massive diarrhea.
“The people who are at greatest risk for Ebola infection are those who have very close contact taking care of the sick, bedridden victims – whether they are in the home or the hospital.”
This is echoed by Mosoka Fallah.
“The number of graves being dug each day in Liberia recalls the 2014 Ebola catastrophe. Like Ebola, Covid-19 infects and kills a disproportionate number of healthcare workers, and Liberia already has far too few.”
Dr. Kortepeter also explained another key difference between coronavirus and Ebola, which has led to a higher death rate.
“Ebola virus doesn’t spread until the victim has symptoms. This makes determining who is infected with Ebola and deciding who to isolate and quarantine much simpler than with Covid-19.
“Some infected people can spread Covid-19 without symptoms or before they have symptoms. Such individuals won’t be bedridden at the time they are contagious. Instead, they can hang out at a beach party or in a bar and be spreading the virus without even knowing they have been infected.
The more contagious a human host is, and the more social interactions they have in the community, the more opportunities there are for a virus to spread during those interactions, and the more it will spread.”
He said it underlines the importance of the social health measures that have been promoted from the beginning of the Covid-19 pandemic, including quarantine, isolation, social distancing, and masks.
“This is the bedrock behind the measures that public health authorities have been championing since the beginning of the Covid-19 pandemic,” he said.
“We don’t know by looking at someone whether they are infected.”