This modeling study examined the impact of conflict events on disease control efforts during an Ebola outbreak in the Democratic Republic of the Congo. The model used a timeline of conflict events and an ethnographic appraisal of attacks on health care workers and treatment centers to estimate their impact on the epidemic trajectory of Ebola. Overall, the population-level effectiveness of vaccination was reduced by 43% due to disruptive conflict events. The researchers also found that declining incidence of Ebola was repeatedly reversed by conflict events. This framework can be extended to other diseases and regions experiencing conflict.
Ebola
Child vaccination coverage in Guinea decreased significantly during and after the Ebola epidemic, affecting all vaccines
During and after the Ebola epidemic in a hard-hit region of Guinea, the increasing trend of child vaccination coverage was reversed resulting in a significant decrease in coverage for most vaccines. Despite an uptick immediately following the end of the outbreak, the downward trend continued or plateaued for all vaccines.
Fear of Ebola in West Africa caused financial losses and staff shortages in Nigerian hospitals
Fear of Ebola during the 2014-2016 epidemic in 3 West African countries had a major impact on the health sector in neighboring Nigeria, where hospitals some hospitals also turned away febrile patients to prevent being associated with Ebola while staff in other hospitals abandoned their posts.
Disease outbreaks can be associated with school closures, food insecurity, and health system disruptions
In a 2018 study, researchers describe the devastating and far-reaching impacts of the 2014 Ebola outbreak in West Africa, including more than half a million people experiencing food insecurity, school closures lasting more than 7 months, tens of thousands of children orphaned, and a huge proportion of the health workforce killed by the disease, leading to infant, maternal, and child deaths due to a lack of skilled health workers and a 97% reduction in surgical capacity.
The impact of disease outbreaks on health systems and governments can cost billions of dollars
In a comprehensive accounting of the costs of the 2014 Ebola outbreak in West Africa, Huber et al. estimate the economic and social costs to have been US$53 billion, of which US$18.8 billion was attributed to non-Ebola deaths.
Vaccine-preventable disease outbreaks could cost countries billions in lost economic activity
In an analysis of a hypothetical disease outbreak scenario, based on data from the Ebola epidemic in West Africa, researchers estimated that a large-scale disease outbreak spreading to nine Asian countries could cost the US economy $8-41 billion in lost exports and put almost 1.4 million export-related US jobs at risk.
An Ebola epidemic caused economic losses of $28 billion in Guinea, Liberia, and Sierra Leone
According to the World Bank, the economic impact of the 2014-15 Ebola epidemic outlasted the epidemiological impact of outbreak, resulting in estimated losses of US$2.8 billion in Guinea, Liberia, and Sierra Leone (or 16% of their combined GDP).
Vaccinating all healthcare workers against Ebola could have dramatically reduced cases
Using data on the spread of Ebola from person to person during historical Ebola outbreaks to compare vaccination strategies, researchers found that prophylatically vaccinating all healthcare workers would have decreased the number of disease cases in the 2014 epidemics in Guinea and Nigeria by 60-80%.
Outbreaks of one illness can lead to reduced access to immunization services, increasing risk of additional outbreaks
A 2015 study projected that the crippling of immunization programs resulting from the 2014 Ebola epidemic in Guinea, Liberia, and Sierra Leone could double the number of people at risk of a measles outbreak, and could cause up to 16,000 measles deaths, surpassing the number of deaths caused by Ebola itself.