As the Ebola outbreak continues to cause alarm, with the number of known (and acknowledged) cases passing the 10,000 mark, four distinct areas of concern can be discerned. These are overlapping, to be sure, and a response to any of them requires consideration of all, but it is worth examining the key issues separately. The four broad areas of concern are: the humanitarian and medical crisis on the ground; the possible response of some less-open countries should Ebola reach their shores; the risk faced by companies with personnel in infected regions; and the increased bio-terror threat.
Of the chief areas of concern, the humanitarian crisis on the ground in infected African countries rightly receives the most attention. It is there that most people are suffering, and there that the main response must be focussed.
We are watching this closely, as some of our sources tell us that the actual number of cases in West Africa is being vastly under-reported, in some places by a factor of 10 to 1, and that deaths are being under-reported 5 to 1. In the worst places, dogs are eating infected corpses in the street, and then spreading the infection. We will not go into the fine details of the situation in Africa in this note as it is covered so comprehensively by the mainstream media, except to say that unless the outbreak can be effectively responded to and contained close to its source no other related threats, including the other concerns raised here, can be fully mitigated. Also, if headway cannot be made against the disease, the outbreak could have a hugely detrimental effect on rapidly emerging but fragile economies.
It is inevitable that developed countries are going to see a small number of cases appear within their shores. Indeed, many would say that the full attention of the West was only focussed on the outbreak when the domestic threat increased and cases started to appear in the US, Spain and the UK. Within Western countries the number of cases is likely to remain small, especially as Ebola, although highly contagious, is not (currently) an airborne virus. What is more worrying is the possibility of the virus taking hold in a less-open country. Some officials have expressed concern that some countries might not be as transparent as is desirable if cases were to be discovered within their shores. China, for example, has form. The 2002-2003 SARS outbreak ended up being more serious than it should have been due to China’s refusal to admit, for several months, that it had a problem it was struggling to solve. There is a significant Chinese presence on the African continent, and it would seem to be a matter of when, rather than if, an infected person makes the trip back to China. Beijing might well have learnt its lesson from SARS, but only time will tell.
An even more troubling scenario would be if there were to be an outbreak in North Korea. Signals from the Korean peninsula over the last couple of days reveal that Pyongyang is taking the threat extremely seriously. Two China based tour operators have revealed that, as of Friday 24 October, North Korea has banned all foreign tourists from entering the country, regardless of where they have come from. North Korean media are carrying a great deal of information about the Ebola outbreak. In a 24 October report, the official Korean Central News Agency said the North is in the midst of a “brisk campaign” against Ebola, and that the authorities were taking measures to “develop preventive medicine against Ebola with regular sanitation and anti-epidemic work.” Rodong Sinmun, North Korea’s main newspaper, also carried a report of the rapid spread of Ebola around the world, and explained the symptoms.
North Korea’s reaction is far from surprising. Having isolated itself so comprehensively from the rest of the global community Pyongyang has few allies it could turn to for help if it found itself in the grip of an Ebola outbreak, so a firm response is really its only option. Also, by heavily covering the rest of the World’s struggle against the disease in its state media and showing how no other nation can fully protect itself, then if there is a domestic outbreak North Korea can demonstrate that it is not just its own response that was lacking, and claim that the outbreak is the consequence of other countries’ failure.
A significant concern that should not be downplayed is the risk to companies with personnel operating in outbreak-hit countries. If there is any threat at all to personnel, companies have no choice but to follow the precautionary principle and take steps to minimise the risk. This could mean temporarily shutting down operations and instructing staff not to go out, or even evacuating personnel entirely (along with dependents).The cost of the precautionary measures themselves could be very high, and the long-term cost of shutting down operations is unknowably expensive. This is the sort of situation that could cripple a company if it has sunk a great deal of investment into a project, only to find it has to stop all work on it for an indeterminate amount of time – possibly indefinitely.
The final concern outlined in this note is a security worry. For decades, malicious groups have fantasised about obtaining, and in some cases tried to harvest, wild samples of viral haemorrhagic fevers, Ebola in particular. In 1992, for example, Aum Shinrikyo operatives travelled to Africa under the cover of an ‘African Salvation Tour’ theoretically to provide relief from suffering and illness, but in truth to harvest cultures of Ebola, to add to their biological weapons programme, alongside their experiments with anthrax, botulinum toxin and cholera; fortunately they were unsuccessful. Al Qaeda is known to have flirted with the idea of harvesting samples, but if they ever succeeded it is not in the public domain. The problem in the past for malicious groups has been that finding wild samples was difficult – due to the virulent nature of the disease and the limited transport and communications infrastructure in Africa, by the time an outbreak had been reported it had already burnt itself out. But currently, and for the foreseeable future, anyone determined enough can obtain as many samples as they like. They even have the perfect cover – turn up in protective clothing and claim to be collecting samples for official purposes. Who would question them if they were dressed as MSF doctors?
It is interesting to note that of the funds provided to rapidly develop a vaccine for Ebola, US$8.7 million has been committed by the US Army to Profectus, one of the four companies known to be developing a vaccine. This is on top of US$8.6 million committed to Profectus by other US government departments last week.
All in all it is a troubling situation. It is a humanitarian crisis that has the potential to spawn myriad other threats to life, to companies and to economies. In risk assessments, these types of threat are often judged as a balance of impact against likelihood, but the problem here is that both impact and likelihood are high.