DR Congo Ebola Deaths Top 4,000 as North Kivu Cases Surge and Unpaid Health Workers Strike

Since the Bundibugyo strain of Ebola was officially detected in mid-May, the Democratic Republic of Congo's outbreak has become the country's deadliest ever. Congolese health authorities said Friday, October 2, that confirmed deaths have passed 4,000 for the first time, hitting 4,018 among 8,300 confirmed cases across seven provinces, with 2,162 recoveries. That puts the case fatality rate at 48.4 percent, according to the Ministry of Health, as reported by Euronews, Xinhua, RTL Today, and CGTN.

This is the second-largest Ebola outbreak ever recorded worldwide, trailing only the 2014-2016 West African epidemic that killed more than 11,000 people across Guinea, Liberia, and Sierra Leone, the Epoch Times reported.

North Kivu is where it's getting worse

Doctors Without Borders (MSF) said in an October 2 statement that North Kivu province has seen a sharp surge since the start of September, now accounting for nearly 40 percent of new confirmed cases, up from 24 percent at the end of August, according to the Epoch Times. Stéphanie Hoffmann, head of MSF's Ebola Treatment Center in Butembo, said it is "impossible to contain this large-scale epidemic as long as new outbreaks continue to multiply as the virus spreads in northern North Kivu," warning "we can only fear a worsening of the situation in the coming weeks."

The numbers support her assessment. North Kivu's case-fatality rate stands at 59.3 percent, well above the 48.4 percent national average, according to CIDRAP, which cited Africa CDC epidemiologist Wessam Mankoula.

More than 21 days have passed without a new case in 18 health zones, and the 278 infections confirmed near the end of September mark the lowest weekly case count since mid-June, with weekly deaths down to 192 from a mid-August peak of 364, CIDRAP reported. Mankoula was blunt about what that means. "This curve doesn't mean that the outbreak is totally under control, because we need to understand the reason for this falling," he said. He pointed to community resistance and security problems in Katwa, Beni, Butembo, Nizi, and Nia-Nia that have stopped surveillance teams from doing their jobs. MSF separately warned the "true toll (is) likely higher due to gaps in surveillance and case detection," according to Xinhua.

Unpaid workers, a burned camp, an infected aid worker

Health workers in Bunia, the Ituri capital at the heart of the outbreak, gathered to demand unpaid wages this week before being dispersed by officials, ITV reported. Surveillance team members, whose job is tracking down people exposed to infected patients, carried signs reading "No money, no data!" and "No payment for months." Frontline staff have gone on strike multiple times since May, each time slowing an already strained response.

Fifty healthcare workers have died of Ebola since the outbreak began, Africa CDC said in a briefing cited by CIDRAP. One more was added to the casualty list this week when an MSF staff member tested positive for the Bundibugyo virus on September 29 and was medically evacuated to the Netherlands, where Leiden University Medical Centre confirmed the worker was placed in a high-level isolation unit, according to ITV and CIDRAP.

A transit center for Ebola patients in Kigonze, on Bunia's outskirts, burned down this week after soldiers searching for weapons entered the site and displaced residents fled, according to the UN and reported by ITV, CIDRAP, Euronews, and RTL Today. The fire forced roughly 19,000 people from the camp. Julien Harneis, the UN's senior Ebola coordinator, said losing the center means losing capacity his team built at great cost. "When we lose a centre, that means we lose capacity, we lose investment, and we have to start again," he said. "Above all, it means that people do not get access to the care that they really need."

Money, conflicting figures, and an open question

International response money is flowing, but the sources don't agree on how much from the US. Euronews reported Washington is releasing "a further €237 million" to fight the outbreak, while RTL Today put the figure at $267 million. Neither outlet specified an exchange-rate conversion or original currency, so the discrepancy is unresolved. France has allocated €13.4 million to the response between January and July, Euronews reported, and French Foreign Minister Jean-Noël Barrot visited Bunia on Friday to show Paris's support, though no source indicated additional French funding was announced during that visit.

Whether that money reaches surveillance teams and treatment centers fast enough is a fair question given health workers are striking over months of unpaid wages in the same province receiving the aid. No source in this reporting documents where the US or French funds have actually been disbursed inside DRC's health system, and no investigation into fund allocation has been announced.

Vaccine trials continue. As of late September, 6,300 healthcare workers had received the Ervebo vaccine as part of a clinical trial, with 1,066 additional doses administered to volunteers, CIDRAP reported. Ervebo's proven efficacy is against the more common Zaire strain, not the Bundibugyo strain driving this outbreak.