Liberia - Ebola: 10 212 confirmed cases, 4 573 deaths (WHO, April 22, 2015)

[Ronan Kelly]

Re: Liberia - Ebola: 2,081 clinical cases, 1,246 deaths as of September 7, 2014 (MoH Situation Report 115)

Liberia Ebola SitRep no. 118
Ministry of Health and Social Welfare
Sept. 10, 2014

http://www.mohsw.gov.lr/documents/Liberia%20Ebola%20SitRep%20118%20Sept%2010,%202014.pdf

Highlights
JFK ETU
? Total admission - 53 including 7
Health care Workers and 7 children
? Total number of confirmed cases -30,
including all 7 Health care Workers
? New admission 15
? No discharge
? 7 deaths reported within the last 24
hours

ELWA II
? Total admission - 58
? Total number of confirmed
cases - 39 including 3 Health
Care Workers
? Total Suspected cases - 19
? Total number of new
admission - 7
? 2 survivors
? 2 deaths within the last 24
hours.

ELWA III
? Total admission as at the morning
was 93
? Total number of confirmed cases -
93
? No new admission
? 14 Discharges (12 recovered
following treatment and 2
suspected cases with negative lab
results)

? The World Health Organization (WHO) provided
motivational funds to cover transportation and lunch
for two months to the central data management unit
Bong County
? The new ETU has been officially turned over to the
County Authority and County Health Team. It is
awaiting admission of patients

Lofa
? Total number of patients in Foya Case management
center (FCMC) - 32
? Total probable cases is presently in the unit - 23
? Total confirm cases - 9
New Cases
? Total new admissions ? 4
Death
? Total number of death - 4 (2 confirmed & 1 probable
death at the ETU and 1 community death from Voinjama
District

Montserrado
? 1828 (98%) of the 1859 contacts under follow up were seen by 4
contact tracing teams.
? Of the 1859 contacts being followed, 2 became symptomatic today.
? Of the 1859 contacts being followed, 87 completed 21 days today.
? Of the 22 deaths reported 9 were from ETUs and 13 from the
communities.
? Total admission at Redemption Holding Unit - 28.
? Red Cross made available 12 contact tracers to be used in our current
tracing structure. They will be assigned in New Kru Town, where there
are more than 300 contacts as of today.
? Health promotion section completed verification of gCHVs to be
trained by UNICEF on Friday of this week
? 30 volunteers from SEARCH, a local NGO, were trained in contact
tracing

Margibi County
? 147 contacts completed 21 days of follow-up
? Save the Children discovered (15) families in the
Mamba-Kaba and Kakata Districts with a total of 40
vulnerable children whose parents have died from
Ebola.
? Affected children, rejected by the Community in Dolo
Town, are living in a school building

Nimba County
? 2 probable deaths in Sehkinpa and Ganta
? One probable death in Gbor-Gainpa (Zoe-Geh)
? Africare donated $100. USD worth of scratch cards to CHT to strength
communication and 20 gallons of gas as monthly support to each of the
District Health Teams for Surveillance/Case tracing and specimen
collection
? The Surveillance/case tracing and psychosocial teams reunited one Ebola
survivor with her family and community people in Cooper Village
Issues & Constraints
? PPEs nearing stock-out in the County
? The one ambulance for the transport of confirmed cases to the ETUs in
Monrovia is inadequate

[Sharky]

Re: Liberia - Ebola: 2,081 clinical cases, 1,246 deaths as of September 7, 2014 (MoH Situation Report 115)

It's worth pointing out that the 8 Sept report showed 2192 total confirmed/probable/suspected cases. On 10 sept, that number increased to 2415; that's 223 new cases in two days.

Those numbers are about twice as high as the established trend of a 25 day doubling time would predict. Given how noisy the data has been, that's not necessarily inconsistent, though it's definitely troubling.

[Ronan Kelly]

Re: Liberia - Ebola: 2,081 clinical cases, 1,246 deaths as of September 7, 2014 (MoH Situation Report 115)

Liberia Ebola SitRep no. 119
Ministry of Health and Social Welfare
Sept. 11, 2014

http://www.mohsw.gov.lr/documents/Liberia%20Ebola%20SitRep%20119%20Sept%2011,%202014.pdf

ETU UPDATES
JFK ETU
? Total admission - 57 (4
Health Workers)
? Total number of confirmed
cases - 36 (4 Health
Workers)
? Total Suspected cases - 21
? New admission - 8
? No discharge
? 2 deaths reported within
the last 24 hours

ELWA II
? Total admission - 56
? Total number of confirmed
cases 24 (1 Health Worker)
? Total Suspected cases - 32
(1 Health Worker)
? New admission - 22
? 12 discharges (All recovered
following treatment)
? 2 deaths within the last 24
hours

ELWA III
? Total admission - 87
? Total number of
confirmed cases - 86
? Total suspected cases - 1
? New admissions - 21
? 6 discharges (3 recovered
following treatment and 3
suspected cases with
negative lab results)
? 15 deaths

REDEMPTION HOLDING
CENTER
? Total admission - 53
? 18 patients being
transferred to ELWAIII

HIGHLIGHTS
NIMBA COUNTY
? 1 probable death in Glarlay Old Town ?Zoe Geh
? 2 probable deaths in Seikinpa and Flowin, both in
Sanniquelle Mah District. Burials have taken place.
? 57 new contacts listed collectively in Zoe- Geh,
Saclepea Mah and Sanniquellie Mah Districts

BOMI COUNTY
? Conducted District Stakeholders Training
? Two(2) deaths occurred in the quarantine unit
and one (1) suspected death in the community
? Fourteen (14) patients presently in the holding
center
? There is ongoing spraying of homes where
suspected/probable cases resided
? 12 Orphans currently in Bomi as a result of EVD.

GRAND CAPE MOUNT
? Two contacts in Robertsport who were showing
symptoms like fever and headache are responding to
treatment ACT drugs, PCM, and ORS.
? Active case search is ongoing at all levels

LOFA COUNTY
? Total number of patients in Foya Case management
center (FCMC) - 30
? Total probable cases -22
? Total confirmed cases ? 8
? Total number of deaths - 3 ( 2confirmed, 1 Probable)
? Total number of discharges =7 ( 3 survivors, 4
negative results)

....
National Reference lab at LIBR
? Total samples tested ? 21
? 11 Positive
? 10 negative

[Pathfinder]

Re: Liberia - Ebola: 2,535 clinical cases, 1,328 deaths as of September 11, 2014 (MoH Situation Report 119)

Hattip: Jim Oliveros

WHO: Ebola Response Road Map Update September 16, 2014

The data are current through September 13, 2014 for Guinea and Sierra Leone and through September 9, 2014 for Liberia.

http://apps.who.int/iris/bitstream/1...4_eng.pdf?ua=1

[JimO]

Re: Liberia - Ebola: 2,535 clinical cases, 1,328 deaths as of September 11, 2014 (MoH Situation Report 119)

This report provides data current through 9/13/14 and cites Liberia's SitRep #121; however, I have not seen that report.

International Medical Corps
Situation Report No. 6

http://reliefweb.int/sites/reliefweb.int/files/resources/Liberia%20Ebola%20Situation%20Report%2006%20.pdf

[Ronan Kelly]

Re: Liberia - Ebola: 2,671 clinical cases, 1,424 deaths as of September 13, 2014 (International Medical Corps Situation Report No. 6)

Liberia Ebola SitRep no. 123
Ministry of Health and Social Welfare
Sept. 15, 2014

http://www.mohsw.gov.lr/documents/Liberia%20Ebola%20SitRep%20123Sept%2015,%202014.pdf

2,812 cases with 1,492 fatalities to Sep 15th.

[Ronan Kelly]

Re: Liberia - Ebola: 2,671 clinical cases, 1,424 deaths as of September 13, 2014 (International Medical Corps Situation Report No. 6)

WHO: Ebola Response Roadmap Situation Report
18 September 2014
...

http://apps.who.int/iris/bitstream/10665/133833/1/roadmapsitrep4_eng.pdf?ua=1Control

[Ronan Kelly]

Re: Liberia - Ebola: 2,812 clinical cases, 1,492 deaths as of September 15, 2014 (MOH SitRep 123)

Liberia Ebola SitRep no. 125
Ministry of Health and Social Welfare
Sept. 17, 2014

http://www.mohsw.gov.lr/documents/Liberia%20Ebola%20SitRep%20125%20Sept%2017,%202014.pdf

...




Highlights
Lofa County
? Total number of patients in (FCMC) - 25
? Total probable cases-7
? Total confirmed cases - 18
? Total new cases - 7
? Total number of deaths- 5

Montserrado
? 2531 of 2588 contacts under follow up seen by
contact tracing teams
? Of the 2588 contacts being followed, 1 became
symptomatic
? 92 contacts completed 21 days of follow-up
? 3 contacts were lost to follow-up
? 23 Ebola related deaths
? 11 came from ETUs
? 12 from communities

Mobile lab at ELWA
26 samples tested
? 6 Negative
? 20 positive
National Reference lab at LIBR
64 samples tested
? 24 negative
? 36 positive
? 5 Indeterminate

[Pathfinder]

Re: Liberia - Ebola: 3,022 clinical cases, 1,578 deaths as of September 17, 2014 (MOH SitRep 125)

Hattip: Sharon Sanders

WHO: EBOLA RESPONSE ROADMAP UPDATE
22 September 2014

Following the roadmap structure country reports fall into two categories: those with widespread and intense transmission (Guinea, Liberia, and Sierra Leone); and those with an initial case or cases, or with localized transmission (Nigeria, Senegal). An overview of the situation in the Democratic Republic of the Congo, where a separate, unrelated outbreak of Ebola virus disease (EVD) is occurring, is also provided (see Annex 1).

1. COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION

5843 (probable, confirmed and suspected; see Annex 2) cases and 2803 deaths have been reported in the current outbreak of EVD as at 20 September 2014 by the Ministry of Health of Guinea, as at 17 September 2014 by the Ministry of Health of Liberia, and as at 19 September 2014 by the Ministry of Health of Sierra Leone (table 1).

more...

http://apps.who.int/iris/bitstream/1...4_eng.pdf?ua=1


Data are based on official information reported by Ministries of Health up to the end of 20 September 2014 for Guinea, 17
September for Liberia, and 19 September for Sierra Leone. These numbers are subject to change due to on-going
reclassification, retrospective investigation and availability of laboratory results.
-----------------------------
Liberia:
All:
3022 cases
1578 deaths

[JimO]

Re: Liberia - Ebola: 3,280 clinical cases, 1,720 deaths as of September 21, 2014 (MOH SitRep 129)

http://www.mohsw.gov.lr/content_display.php?sub=report2

From Liberia MoH&S Situation Report 129:

[franzpick]

Re: Liberia - Ebola: 3,280 clinical cases, 1,720 deaths as of September 21, 2014 (MOH SitRep 129)

Excuse me if I have missed some footnote or explanation.

Today's Liberian reports for 9/19-21 show a promising decline in the previously high daily new case numbers for Montserrado County, which numbers were compounding total cases at 4.5%/day over 9/15-17, and would have doubled the 9/17 case total of 1154 every 16 days: the infection rate for the last 4 days thru 9/21 appears to be only 20 reported new cases/day (down from 50/day) compounding the current Montserrado total of 1232 at only 2.2%/day, and perhaps a runaway outbreak into Monrovia's 1.2 million close-contact urban population has been slowed. The sudden reduction however from the previous 10 day average new daily case rate of 50/day, to suddenly only 20/day over 4 days to 9/21, is unrealistic, and points to missing data and other unexplained details.

WHO's needless reporting errors, omissions and delays have spread to today's Liberia MOWsw report for the past 4 days, which OMITS data for 9/18 altogether, presents 3 days data, of which the 9/20 data numbers are LOWER than the 9/19 numbers. Reconstructing these incomplete and out-of-place data points takes time, but usually the database forces some realistic reorganization that reveals a more likely data placement and consistent view of the levels and growth rate trends of the EVD infection.

The Lib MOH "9/20 report #128" numbers are BELOW data for 9/19, and above data for the 9/17 report, so it may fit the database as actually the data for the missing 9/18 data, which then leaves NO DATA for 9/20.

Then looking at the difference between the 9/21 totals and the 9/19 numbers as 2 days of numbers, as I've had to do before with WHO and other national MOH omitted days, gives an indication of whether or not the last totals given are realistic, or represent missing days, data and understatement.

[franzpick]

Re: Liberia - Ebola: 3,280 clinical cases, 1,720 deaths as of September 21, 2014 (MOH SitRep 129)

The 10 day average of all-Liberia new daily case numbers from 9/8 to 9/17 was 80 new cases/day, and the average of the last 5 days to 9/17 was 83 cases/day, showing an increasing rate of EVD infection.

Montserrado County's daily average declining from 50 cases/day to only 20/day should have led today's 9/21 report HIGHLIGHTS list, and the national 4 day 9/18-9/21 new case increases of only 255 and a noticeably lower 4 day average of only 64 cases per day, down from 83/day, should have been the report's 2nd HIGHLIGHT, but for some reason these 2 striking trend change features are ignored.

Once again incomplete and misplaced data with dramatic unexplained rate and trend changes leaves us waiting for the delayed totals from the next report in 6-7 days to reassess today's poorly presented 9/21 information, and the real rate of Liberian EVD infection growth.

[sharon sanders]

Re: Liberia - Ebola: 3,280 clinical cases, 1,720 deaths as of September 21, 2014 (MOH SitRep 129)

Thanks Jim and franzpick.

I think we can not focus on only 2 or 3 days data to extrapolate any kind of trend.

Missing from Liberia numbers are all the people who have refused treatment and/or did not realize how critically ill they were and did not seek treatment. There is no way to know this number. The videos of the ebola conditions in Liberia tell me that there is probably no practical way to gain control of the situation unless the population voluntarily self quarantines for 3 weeks after contact with suspected/probable ebola cases. People can not go without food and water for 3 weeks and I think the infrastructure does not exist to support such quarantines.

An impossible situation.

Thanks both of you for trying to quantify the numbers we do get.

[franzpick]

Re: Liberia - Ebola: 3,280 clinical cases, 1,720 deaths as of September 21, 2014 (MOH SitRep 129)

Thanks Sharon. Certainly civilian quarantine avoidance and private social/burial habits result in very questionable data capture rendering all statistics incomplete, but the rapidity of the infection growth suggests to me the possibility that the ratio of unreported/unrecorded cases and deaths to recorded cases/deaths may remain steady enough so that some reasonable analysis of the reported portion of case/death rates may approximate the actual infection/death rates of the total of unrecorded and reported cases, even if no inference of the national total case/death levels is reasonable.

As for not being misled by daily fluctuations, I have applied varying weighted moving averages of 7-14-21 days for the various portions of the almost 60 days of 3 country/county numbers now in my database, and am comfortable with it as it reveals relatively steady trends, as well as sudden, otherwise unexplained and unrealistic rate jumps or drops, such as today's report of Montserrado's rising 10 day average of 50 cases/day suddenly dropping to only 20 cases/day for 4 days, which to me indicates lost data and reporting errors, which will become apparent in subsequent reports, rather than meaningful changes in the EVD infection rate.

The virus burning itself out, as many claim to be the likely resolution, or else gaining access to increased exponential growth in a million-plus urban Monrovian population, will make short-term 7-14-21 day infection rate and trend analysis meaningless, but I still believe that the relation of shorter to longer smoothed moving averages (oscillators) will prove to have been the first indication of major accelerations or slowdowns in this EVD saga, as well as the warning of data and reporting errors along the way.

[JimO]

Re: Liberia - Ebola: 3,369 clinical cases, 1,779 deaths as of September 22, 2014 (MOH SitRep 130)

Note: Official ebola numbers are most likely a huge undercount.

From Liberia Situation Report 130:

http://www.mohsw.gov.lr/content_display.php?sub=report2