CDC projects Ebola at 550,000 to 1,400,000 cases by January 20, 2015 & becoming endemic to humans

I got to this by way of LA Times. Text from CDC web page:

Estimating the Future Number of Cases in the Ebola Epidemic—Liberia and Sierra Leone, 2014–2015

Summary

This week’s Morbidity and Mortality Weekly Report MMWR, Estimating the Future Number of Cases in the Ebola Epidemic—Liberia and Sierra Leone, 2014–2015, estimates the future number of cases if current trends continue. The MMWR also adjusts the number of cases based on estimated underreported cases.

-- By September 30, 2014, CDC estimates that there will be approximately 8,000 cases, or as high as 21,000 cases if corrections for underreporting are made.

-- Without additional interventions or changes in community behavior, CDC estimates that by January 20, 2015, there will be a total of approximately 550,000 Ebola cases in Liberia and Sierra Leone or 1.4 million if corrections for underreporting are made.

-- Cases in Liberia are currently doubling every 15-20 days, and those in Sierra Leone and Guinea are doubling every 30-40 days.

-- Halting the epidemic requires that approximately 70% of Ebola cases be cared for in Ebola Treatment Units or, if they are at capacity, at home or in a community setting in which there is a reduced risk of disease transmission and safe burials are provided.

Key Messages

-- If conditions remain unchanged, the situation will rapidly become much worse.

-- We know how to control and eventually stop the epidemic. Halting the epidemic requires placing up to 70% of patients into either an Ebola Treatment Unit or in a community setting in which the risk of disease transmission is reduced and safe burials are provided.

-- The cost of delay will be devastating. The number of cases is doubling about every 20 days. Every month of delay in reaching the 70% target will increase the number of patients, which means more cases and more deaths and the need for even more beds and other resources.

There's more.

CDC also gets to the issue of societal collapse in West Africa. They are not optimistic.

Endemic means that Ebola won't need the fruit bats any more. It will be able to sustain itself moving among humans. Yeah, a permanent disease unless we can find a vaccine.

Pinning hopes on ZMAPP is misguided:

"The ZMapp three-antibody cocktail isn’t a vaccine. Instead, it provides an artifical immune response against sugar-tagged proteins on the outside of the Ebolavirus.

"This general biotherapeutic approach is called passive immunity. By injecting the patient with ready-made antibodies raised in the laboratory to latch onto specific parts of an infectious agent, their body can mount an immediate immune response. Passive immunity is therefore different from a vaccine that might require weeks for the person to make their own antibodies against the virus."

For some it works. For others, not. And it may require presence of Ebola virus to maintain itself. It is not a vaccine, which would be permanent with no Ebola in the system.

I ran an old demographics-driven simulation tool a couple months ago. Getting to 1,400,000 cases is realistic. My scream then was that $5,000,000,000 is the right number for the budget line.

Whatever it takes to get a vaccine, we need to do this work ASAP.