For the ongoing Ebola epidemic, 2015 seems to have ushered in a hopeful new chapter: in Liberia, treatment centres are sitting empty; in Guinea, kids are finally heading back to school; and in Sierra Leone, the president is predicting zero new cases by end of March.
On Tuesday, the World Health Organization reported 75 new infections since the day before — relatively good news considering that in October, the UN health agency was predicting up to 10,000 new cases every week by this point.
But none of this is reassuring for epidemiologists like Jordan Tustin, an associate professor at Ryerson University’s School of Occupational and Public Health. For her, only one number will let her exhale.
“We’re not good until we’re at zero,” said Tustin, 35. “We can never be complacent and think, ‘Oh it’s going down, it’s getting better.’ Until we’re at zero, that’s the only time that we can breathe.”
On Jan. 11, Tustin returned from a month-long stint in Guinea where she worked as a consultant for the World Health Organization. As an epidemiologist, she performed one of the most crucial jobs for stopping this Ebola epidemic, which has now infected 21,689 people and killed more than 8,600: finding new cases and tracking down their friends and family, a process known as contact tracing.
Anyone who watched Kate Winslet in the pandemic thriller Contagion will have already seen an epidemiologist in action. But in the mud-hut villages of Guinea’s Kankan prefecture, Tustin faced obstacles that Winslet’s character never had to worry about — for example, accessing a photocopier for her reports (the only one she could use was near the local university and powered by a generator) and getting fuel for her team, so that they could visit the villages and investigate potential new Ebola cases.
“One time during a meeting, I wrote down in my notebook, ‘Everything is about fuel.’ It was a recurring issue,” Tustin recalls. “If you have people in the field but they don’t have the tools to do their job . . . then Ebola will not go down to zero.”
As the WHO’s Dr. Bruce Aylward once said, there is no such thing as having “a little bit less Ebola,” just as there is no such thing as being “a little bit pregnant.” “This is a horrible, unforgiving disease,” he told reporters in October. “You’ve got to get to zero.”
In Guinea, Tustin learned firsthand about the kind of dread and anxiety that can come with even a single additional case.
This Christmas, she found herself feeling hopeful. After celebrating with other aid workers at her hotel — where they dined on delicacies brought from France, and even a yule log — she went to bed with the sense that the situation in Kankan was coming under control.
The very next day, someone from a nearby village reported a sick woman; she was dead by the time Tustin’s team reached the hospital, which had already released the infectious corpse to her family. When they then rushed to the woman’s village, they found her body already been washed and prepared for burial, meaning several villagers were now likely exposed to the deadly virus.
This one missed case introduced an entirely new chain of Ebola transmission — and more than 60 villagers that Tustin and her team now had to follow for 21 days, Ebola’s maximum incubation period. More than 20 hospital workers also had to be placed in quarantine.
“There were days when I felt ‘We’ve got this. We’re following all our contacts, they’re welcoming us into their villages . . . feels good,” Tustin said. “Then you get that case that pops up out of nowhere . . . It’s frustrating.”
The Guinean government now aims to become Ebola-free by the middle of March. But for Tustin, she is reluctant to make any such predictions and warns that complacency is now the biggest threat to West Africa, which still needs the world’s help to stop this terrible epidemic.
“As human beings with compassion and as countries with great resources, we need to put more efforts into the response,” she said. “We can’t become complacent just because it is not in our backyard. One Ebola case is one too many.”