Why the Ebola Outbreak Has Been Nearly Impossible to Stop

From The New York Times, I'm Natalie. Kitroeff. This is The Daily. >> [music]. >> At the front lines of the Ebola crisis. in Central Africa, >> [music]. >> badly equipped health workers with. little outside support are losing the. [music] fight against one of the worst. outbreaks in history. Today, my [music] colleague Declan Walsh. takes us to the epicenter of the virus. to understand [music] why so far its.

spread has been nearly impossible to. stop. >> [music]. >> It's Wednesday, [music] June 3rd. Declan, thank you so much for doing. this. Where are you right now? >> I'm in Bunia, a city in the northeast of. the Democratic Republic of Congo. >> Okay. So, you've been in the DRC for. about a week and a half covering this.

horrific Ebola outbreak. So, just tell. us what you're seeing. What it's been. like on the ground. >> It's a really dire situation here right. now. This outbreak was only detected. just over 2 weeks ago, but the virus was. probably spreading for two, some groups. are saying even three months before it. was detected. And so, we just don't know. how deep, how wide it has gotten into. the population in these areas. And. that's really hampered efforts not just.

to treat the people affected by the. disease, but to contain its spread. >> And in terms of numbers, cases, deaths, where do things stand? >> So far, about 250 people are confirmed. to have died. There are about another. 1,100. suspected cases, but the true spread and. extent of this virus is thought to be. much, much wider than that. And I don't. think it's an exaggeration to say that. the virus is way ahead of the response.

at this point. Already, this is the. third largest Ebola outbreak on record, and there are groups saying that it has. the potential to become the largest. ever. Now, that's a very high bar. The. largest Ebola outbreak was between 2014. and 2016 in West Africa. That killed. 11,000 people. >> Right. >> We're far off those numbers, but the. fact that the response is so far behind. the curve makes it obviously much, much. harder to start to push it back.

>> So, what do we know about how this. started and how it went undetected for. so long? >> Because of that huge delay, there's so. much we still don't know, but one thing. that seems to be almost certain is that. this outbreak started in this gold. mining town called Mongbwalu. That's. about 50 miles north of Bunia, of the. regional capital. And so, a couple of days after I got. here with our photographer, Arlette.

Bashizi, we got in a car and we drove to. Mongbwalu to find not just the town. where it started, but also what the. response looked like in this place. where, as far as we had heard, there was. the greatest number of infections. >> And what did you find? >> Well, first, the road to get there was. quite difficult. It was really a road. just in name. It was made of mud. It was. extremely rough and bumpy, [snorts]. but all along that road, we passed these. Congolese military checkpoints, and that.

was because we were passing through. territory where at least three or four. different militias were known to. operate. So, that was complicating the. response and also preventing aid workers. from getting to this town. >> Mhm. >> And when we got to Mongbwalu itself, we. went straight to the public hospital, which we knew was the center of. treatment efforts. We were expecting really to see the. architecture of an Ebola response that.

you classically think of. >> Mhm. >> For some of us it's maybe a Hollywood. reference like movies like Outbreak and. so on, these large white tents, lots of. people walking around in sealed suits. >> Right. >> But there was almost nothing. And we went into the actual Ebola wards. themselves. We put on the full protective equipment. We spoke to the staff. We found a doctor. who wanted to take us inside.

And there, honestly, it was pretty. shocking. Apart from the doctor who brought me in, the ward was just full of people who had. come to help the Ebola patients. Usually who had come to bring food or. water because those things aren't. provided by the hospital, but they were. wearing almost no protective equipment.

>> Mhm. >> And at the end of the room in the corner. we found this young boy, 5-year-old boy. called Emmanuel, who was lying on this. bare mattress on his own hooked up to a. very simple drip. And his dad was standing over him. looking so concerned. And. we got speaking in French.

He told me that his son had been going. to school just a few days earlier when. the teacher sent him home. Apparently he. had a headache and a fever. The family tried to look after him for. the first few days, but he got worse. And then he said that the night before.

Emmanuel started to bleed uncontrollably. out of his nose. And so they rushed him. to this hospital. And when he was lying. there, >> [music]. >> he had this tissue stuffed up his nose. to try and staunch that bleeding. And what was even more striking was that. just [music] a couple of yards away, two. beds down, there was lying the body of a.

21-year-old woman called Christine. Barati, who had died just hours earlier. The doctor said that she had been doing. fine in the evening, and then suddenly. at about 2:00 in the morning, she fell. into a coma. And died very quickly. He said they were. unable to revive her. Her shoes were still under the bed where. she had left them. Her belongings were. in a bag. But what was so disturbing about that.

is that the body of a person who has. just died of Ebola is extremely. contagious. And yet the remains of this. poor woman were just covered by this tin. sheet, and people were walking in and. out of this ward with very little. protection, including, it has to be. said, the dad of this boy. >> Mhm. >> This just seemed to go against every. precaution that you could take against. Ebola. >> And did you get a sense of why this was.

happening? Did you talk to the doctors? What was going on? I'm sure they didn't. want that to be happening either. >> No, the doctors were very well aware of. the risks. >> What they said, "Look, what can we do? This is the space we've got available to. us. These are the resources that we. have. We only have a certain amount of. protective equipment. We can't give it. to all of our staff cuz simply we don't. have it." And frankly, they also said, "We're not really trained for this. We.

didn't receive any special training for. this. We were suddenly hit with this. declaration of an outbreak and we are. making do as best as we can." But, you. know, this young doctor who was. bringing me around. he was angry at his own government. because it took the authorities so long. to discover this outbreak, two possibly.

three months after it started. And he was also angry, more broadly, at. the international system of Ebola. response, that architecture of experts. and aid groups and so on, because so few. of them had reached this town where it. started and where the greatest number of. cases were. Even though he was wearing the.

protective gear, I could see in his eyes. and hear in his voice his intense. frustration. And as we were looking at. this scene, at one point, he turned. round to me and he said, "We are 12 days. into this outbreak. Is this the best we. can do?" [music]. >> Well, okay. To this doctor's question,

Declan, why has the response been so. slow? What have you come to understand. about that? >> Part of the reason is to do with the. virus itself, or rather with this strain. of the virus. Ebola is this highly. contagious hemorrhagic disease, which is. spread not like COVID-19 through. respiratory means, but it's spread. through touch, usually by touching. bodily fluids of a person who is. infected. Now, this particular strain of.

the disease is called Bundibugyo. It's. named after, in fact, a town in western. Uganda, about 60 mi from here across the. border, where it first occurred in 2007. And like all the viruses that cause. Ebola, it's thought to reside in the. fruit bat population. And it just. happens that there is a large fruit bat. population that roosts in the trees in. this region. But it is an incredibly. rare strain of the virus. This is only. the third Bundibugyo outbreak ever. What.

that means is that as yet there is not a. vaccine or a cure for this disease. On top of that, when Ebola spreads into. a population, it often presents in. people initially with symptoms that are. very similar to malaria or typhoid. Now, they happen to be extremely common. diseases in this area. And in a town. like Mongbwalu, people are very used to. getting these diseases. And when they.

do, they typically don't go to the. hospital. In fact, sometimes they don't. even go and see a doctor. Many poor. people, they tend to go to traditional. healers, or they'll go to some local. small clinic. All of that combined means that people. in Mongbwalu were really only going to. the hospital for medical help when they. were approaching the last stages of the. disease. >> So, people are delaying treatment. basically because it seems like they may.

think that they have one of these more. common illnesses. They just don't know. how serious it actually is. >> That's right. And then the other issue. the doctors brought up was with testing. Because it's this very rare strain, initially there wasn't even a test in. this entire region for Bundibugyo. When. they first detected what they saw as. this mysterious wave of deaths in this. town that happened all through the month. of April and then into early May, they. sent samples off to the regional lab to.

get it tested and it came back negative. for Ebola because they were testing for. an entirely different strain, more. common strain which is called a Zaire. And that it was only eventually when. health officials sent a sample to the. capital Kinshasa that they tested it for. this rare Bundibugyo strain and then. that came back positive and they. identified the disease. So, since the. outbreak has started, there's been this. chronic shortage of testing kits to.

identify who's got Bundibugyo. And that. just makes treatment at the hospital. really hard because the doctors told us. that they would send off a test and not. get a result for four, five, six days. Often times, they said, by the time the. test result came back, the patient was. already dead. >> So, all the elements are in place for. this disease to fester in this place. that, as you said, is very remote, far. from a major city, difficult to get to.

>> Yes, and you'd think that that isolation. would prevent the spread of the disease, but in fact, there are several factors. that, in some respects, made this town. an ideal place not just for the disease. to take off, but also to spread across. the region. So, it's this gold mining. town that has a huge population of. migrant laborers. And because mining has. money, it brings traders, it brings gold. smugglers, it brings sex workers, and.

these are all people who move in and out. of the town as well. >> Mhm. >> That also, incidentally, has possibly. been a factor that provided vectors for. the disease to spread elsewhere. >> I want to ask, we've been hearing a lot. about the Trump administration pulling. back on foreign aid. How much of an. impact did that have in the spread of. Ebola in this case? >> Well, if you speak to people in the aid. community, for them, there's no doubt. that if USAID and American aid more.

generally were still in place, that this. virus would have been detected sooner. than it was. The other point that aid. workers brought up is that the US was. providing a lot of funding for general. humanitarian aid in the Congo, and some. of that money went to funding small. Congolese groups, and they weren't all. necessarily working in health. They. might have been just community. organizations. But the fact of their existence provided.

a network that could be activated at. short notice in response to a crisis. And now, that network really just wasn't. available when it was needed this time. >> And did things change once this was. declared an outbreak? Once it became. clear just how fast Ebola was spreading? Like, did the US or other international. aid groups step up? >> Yes, I mean, the aid machine has started. up, and the experts are coming into this. area. Aid is starting to arrive.

But then it turns out that there is. another obstacle to pushing back this. outbreak. And that's the fact that many. of the people in some of the. worst-affected communities have a deep. mistrust for the people [music] who are. trying to save them. >> [music]. >> We'll be right back.

Okay, explain what you just said that. people have this distrust of aid groups. of the people trying to contain this. virus. What's going on there? >> Look, a huge obstacle to fighting this. outbreak has been the fact that a lot of. people in these communities are still in. denial about the virus. Either they. don't accept that it exists at all or. they see it as somehow a curse or they.

see it as a conspiracy theory. When we. were there, we heard so many stories. about how people saw this disease as. some sort of conspiracy between doctors. in the local hospital and these foreign. aid groups who they thought were. bringing this disease to the community. In fact, it was a story that we heard. that Doctors Without Borders which had. Jeeps that have extremely high antennas. sticking out of the roof that Doctors. Without Borders were using those.

antennas to somehow spread the disease. among the community. Now, there is, strangely enough I think, a. sort of logical explanation for this. >> Mhm. >> And that goes like this. This community. had been grappling with this wave of. mysterious deaths until this outbreak. was finally detected and declared. And so, by the time we had an. explanation for it which was Ebola, there were already hundreds of cases.

So, this community is faced with this. tidal wave of infections and deaths and. people are searching for an explanation. They're going to the hospital too late. to get treatment. By the time they get. there, many of them are dying. And so, people in a certain way logically are. starting to associate the hospital. as a place where people go not to have. their lives saved, but to die. >> Right. >> And so I think that really is partly at.

the root of some of these wild. conspiracy theories that were going. around. But what that meant in practice. for the medical staff at the hospital. is that they not only were grappling. with this incredibly dangerous disease. and chronically under-equipped to fight. it, but they were also dealing with this. intense hostility from the community. >> And what did that hostility actually. look like? How did it play out? How did. you see it? >> So when we got to Mbandaka, the huge.

issue was how to deal with a body of. this popular pastor who had just died. the night before. His name was Sylvestre. Atoma. He was this charismatic Catholic. preacher in the town who had a pretty. big following. And when we arrived at the hospital, the. director told us that his followers had. gathered at the gate of the hospital, and they were demanding to get his body. so that they could bury it in the. traditional Congolese fashion. Now, the. hospital director refused because he.

said that would have been a disaster for. the spread of the disease in the town. >> Why? >> Because traditional burial practices in. the Congo involve large numbers of. mourners touching the body of a deceased. person. And so a funeral can become a. super-spreader event, and that in fact. has been a problem in previous. outbreaks. >> Okay, makes sense. >> But the refusal to give up this body by.

the director enraged his supporters. >> [music]. >> who didn't believe his explanations. about why this was an incredibly unsafe. thing to do. And so the day before they had stormed. into [music] the hospital compound, and. the director told me he had been chased. through the compound with people. throwing rocks at him. And in fact, parked outside his office, I could see his vehicle which had a hole. in one of the windows where he said. people threw rocks that didn't hit him,

but they hit his car. >> They're literally attacking the hospital. director. >> They are literally attacking him in. order to get this body. [music] They. refused. And then, said that the security forces. were called to try and bring peace. Then we turn up the next day. Then that. evening, we went back to our hotel in. the town, and just as we were settling. in after dark, we hear these gunshots going off. >> [music]. >> And it turns out that a crowd of over. 100 young men, again supporters of this.

cleric, had converged on the hospital. yet again in an effort to spring out. this body. >> My god. >> The police and the soldiers were firing. their weapons in the air to try and. disperse [music] them. Then this crowd. of people went around the back of the. hospital, tried to attack it from. another side, and this running battle. went on for 5 hours all through the. evening. >> until 11:00 at night [music]. when the police finally got the. situation under control.

>> [music]. >> And then, the next morning, after. careful negotiation with the church. authorities, the body was escorted. [music]. by a line of soldiers from the hospital. down to the local cemetery where it was. safely buried. >> [music]. >> Okay, so this sounds like a particularly. extreme incident. How common is this reaction to the.

hospital workers, to the aid workers, to. the people who are directly working on. the front lines of the virus. >> Well, I would say this incident was. exceptional because it involved this. very prominent local figure who [snorts]. had a huge following. But the dynamic, unfortunately, is very common because. across the city Red Cross workers who. were trying to carry out these what they. call safe burials of these bodies. In.

other words, instead of allowing a lot. of people to come and touch the body, the body would typically be disinfected. It will be placed in a sealed bag and. these workers will ensure that while. there is a dignified burial, it's not. going to turn into an event where many. other people become infected. So, the. teams of Red Cross workers trying to. carry out these burials often run into. the same kind of resistance. They've. been threatened. They've been attacked. >> Wow.

>> Because people. effectively don't believe the virus. exists or else they don't believe that. it poses a threat to them or frankly, I. think they just feel overwhelmed by the. scale of the calamity that has befallen. their community. And so they take it out. again on the people who are trying to. ensure that this disease doesn't spread. even further. >> And do you have an understanding from. your conversations with health officials. of just how big of an obstacle this is.

in the effort to get the outbreak under. control? Like how much is it actually. stymieing the response, do you think? >> It's huge. When you talk to health. officials or aid workers and say, "What. do you need to push this back?" The. first thing, of course, they say is we. need equipment. We need protective. equipment. We need medicine. We need. funds. The second thing they say is we. need education. We need an immediate. urgent effort to communicate to people. about the nature of the danger that they.

face. >> We have some experience with this kind. of thing from COVID. Even in the United. States, there were a lot of conspiracy. theories. There was a lot of mistrust of. the medical establishment, of hospitals. It strikes me that this is a harder. thing to solve than even perhaps getting. the resources to where they need to be. I mean, building trust is not an easy or. a quick thing. >> It's very challenging.

But there is precedent. I mean, in previous outbreaks in West Africa in. 2014-2015, in the second largest outbreak, which. was also in Congo, health workers ran. into similar problems. And so, there are. tools, there are techniques, there are. ideas for combating this problem, but it. really does take a concerted, intensive. effort. While we were in Mongbwalu, I. went to see the local parish priest, the. Catholic priest, because this preacher.

who had just died was a Catholic. And I. said, "What what are you doing to try. and address this problem?" And he said, "At mass last Sunday, in my sermon, I. appealed to people to carry out safe. burials, to adhere to the correct. practices." But he said, "Until now, people are not listening." He said it's. going to take a much bigger and more. intensive effort to try and convince. these communities about what they need. to change in their own lives in order to.

keep themselves safe. >> Declan, what do we know about how far. it's spread outside of the DRC at this. point? >> There has been one death in neighboring. Uganda, and I believe about eight or. nine suspected cases at the moment. There are great fears that it is also. spreading into South Sudan. But for now, this virus has, for the large part, remained confined in Ituri province, and. there have been some cases in two other. Congolese provinces as well. But again,

I got to stress that we just don't know. enough about the extent of this virus. just yet. And that brings us to another. key part of the effort to fight the. virus that they haven't frankly even. started on in earnest yet, which is. called contact tracing. >> Right. Contact tracing meaning trying to. understand where everybody who is. infected has been, who they may have. seen, touched, been in contact with. >> That's right. The problem is that.

because this is such a rare strain and. because there are such limited testing. facilities, they've barely started the. work of tracing those contacts yet. And. all the experts in this field say that. until you trace the contacts, you cannot. cut the chain of transmission and you. can't really expect to contain the. spread of the disease. >> Okay. Obviously, there is a lot of. uncertainty here. There are a lot of. unpredictable factors at play. But from.

your reporting, Declan, what is your. understanding of the best-case and the. worst-case scenario for containing the. spread right now? >> Well, the worst-case scenario is that. this outbreak goes on for several years. and that the numbers soar. Not just the. numbers of people affected, but that the. death toll rises possibly to the level. that we saw back in West Africa in. 2014-2015. But you know, it doesn't have to be that. way. There is an outcome here where the.

scale of international assistance rises. to meet the challenge of this outbreak. So, I think it's still an open question. about which way we're going to go. because don't forget we are very early. into this outbreak. That's kind of in a. way what's so worrisome about it. It's. only been 2 weeks since it was. officially declared and I've been. speaking to people on the ground here. and they say it already feels like. they've been at this for months because.

it's been such an intense start. Most. Ebola outbreaks start with a handful of. cases and then it spreads. The challenge. with this one is that from day one there. were hundreds of suspected cases and. many deaths and those numbers are just. going up and up at the moment. >> [snorts]. >> Declan, I can't stop thinking about Emmanuel, the 5-year-old boy who you met in the. clinic with his dad.

Do you know how he's doing? >> I do. I've been in touch with his dad. He's been sending me messages every day. and. a couple of days ago he sent me a. message and he said that his son had. been sitting up, had been. drawing numbers because he'd just been. learning to count and that he was asking. for his toys. >> Amazing. >> And then today he said that Emmanuel's. been discharged and he's gone home.

>> [music]. >> Wow. So, >> [snorts]. >> one moment of hope at least in all this. Declan, thank you so much. We really. appreciate your time. >> Thank you, Natalie. >> [music]. >> We'll be right back. >> Here's what else you need to know today. >> Look, [music] we're not moving forward. with the fund, period.

>> The Trump administration is abandoning. plans to create a $1.8 billion fund for. people who said they were victims of. [music] unfair government prosecution, including January 6th rioters. The fund had drawn fierce opposition. from the courts and Congress, including. congressional Republicans. [music]. During testimony before a House. committee on Tuesday, acting [music]. Attorney General Todd Blanche, who just. days ago advocated for the fund, told.

lawmakers that it was now [music] dead. >> Not moving forward ever? >> Correct. >> Oh, there's no more fund then? >> Well, to the extent [music] there was a. fund, remember the fund wasn't set up. yet. There was a. >> And President Trump signed an executive. order on Tuesday asking tech companies. to give the government oversight of new. AI models before [music] releasing them. Under the order, tech companies would. give the government 30 days to review. their models before making them. available to the public. And the. Treasury Secretary [music] would study.

security vulnerabilities discovered by. the models. This is the administration's. [music] biggest step toward regulating. AI, and it marked a change in approach. for Trump, who had previously promoted a. hands-off [music] stance toward the. technology. Today's episode was produced by Claire. Tensegetter, [music]. Stella Tan, and Chris Benderev with help. from Adrian Hurst. It was edited [music].

by Chris Hacksaw with help from Mark. George and contains music by Leah Shaw. [music] Dameron, Rowan Nemi Sto, Pat. McCusker, and Sophia Landman. This. episode was engineered by Alyssa Moxley. Special [music] thanks to Brad Kimbrell. That's it for The Daily. I'm Natalie. [music] Kitroeff. See you tomorrow.