Doctor Explains the 2026 Ebola Outbreak: Why This One Is Different

[00:00:00]One of the things we accidentally cancelled very  briefly was Ebola prevention. I think we all want Ebola prevention. From then, until now. What do we  see? Well, this is a great chart by The New York Times of all of the Ebola outbreaks in history.  And this line right here is 2014 West Africa, almost 30,000 patients, the biggest in  history. This line is the second largest in history--reached 3,000 patients. This is  the current outbreak for the first 25 days.

[00:00:35]And compared to the other two, this line  is practically vertical. There is clearly something different about this outbreak and it's  not that the virus is more contagious. It took a long time for this outbreak to be detected. The  other two outbreaks were caused by Zaire Ebola.

[00:00:55]This one is caused by a very rare type of  Ebola called Bundibugyo. And the regular tests don't pick it up. So we don't know when this  outbreak started, but looking at this trajectory, it clearly wasn't in May when it was declared.  Maybe it was in April. Maybe it was in March.

[00:01:13]Sometime in May, someone at the national  laboratory thought, you know, we better test for some of the other species. And boom, they found  Bundibugyo. So this first 25 days that really reflects a change in the laboratory technique.  And from then until now, what do we see? Well, sh--. When the WHO declared the Ebola emergency  in May, that was just the starting gun for the international response. But the virus had been  circulating in hospitals and communities for months. It had a huge head start. To catch up,  the responders have to move faster than the virus. They have to find the patient's infected  contacts before the next chain of transmission starts. In 2014, we saw how complicated this can  be. You need to travel to villages, move patients, deliver PPE and supplies and blood samples.  But this particular outbreak is happening in a war zone. There is an armed conflict going on in  the eastern DRC between M23/AFC and the Congolese army. In addition, there are local militias too, a  huge number of them. This Johnny Harris map gives you an idea of the huge number of these armed  groups. So roads and towns and mining areas, they can all be under different systems of control.  Every roadblock or every wait for permission, that just slows down the responders. But the  virus keeps moving. Here's a map made by the DRC National Institute of Public Health. The red  zones are the ones with the highest case counts.

[00:03:12]So the INSP has overlaid movement of mobile phones  over these maps and you can see the huge flows of people in and out of actually the zones with the  highest case counts. These are not isolated rural villages. These are thriving cities and towns  and people are moving constantly. The regions' economies are driven by mines. So miners and  buyers and sellers and temporary workers, even food sellers, they're just moving in and  out of the mining sites. The miners themselves, they have cash and they know how to move around.  So if they get sick with Ebola, they're not going to stay in the same place. They're going to travel  to get the best medical care possible. That might be a couple of towns over. It's a huge blow to  health responders who have been trying desperately to slow the spread of Ebola in the Democratic  Republic of Congo. On Sunday, the country's health ministry officially reported that the disease has  reached two new provinces, Tshopo and Haut-Uele.

[00:04:15]And that's how undiagnosed Ebola can move to  different provinces. Finally, the outbreak response depends on people cooperating. And people  in this region have experienced years of violence.

[00:04:28]They don't trust institutions and they don't trust  the health care system. On Thursday, a treatment center in the town of Rwampara was torched by  angry relatives of a victim of the disease after they were stopped from retrieving his body. Health  workers across the board facing an uphill battle to contain both the outbreak and the fear that  it causes. This is more serious than not trusting the science. They don't trust the institutions  that deliver the science. If families hide a sick relative or they don't cooperate with contact  tracing or the patient just refuses to go to the treatment center, the virus gets more time. The  race is very complicated. Find the patient, trace the patient's contacts, and earn the cooperation  of the family members in the community all at the same time. That enormous West African outbreak  of Ebola in 2014, it stimulated advances in Ebola science. So when the 2018 Ebola outbreak happened  in the DRC, responders had a few scientific tricks up their sleeve. Doctors could diagnose Ebola  within hours, and if that test was positive, they could immediately start a monoclonal antibody  treatment specific for Zaire Ebola. The next day, community teams could be going out to that  patient's village to find contacts and vaccinating them against Zaire Ebola. Today, in 2026, we  don't have any of those. That scientific toolkit was developed for Zaire and doesn't work against  Bundibugyo. So we need to rebuild that toolkit.

[00:06:10]And the first tool is faster diagnostics because  one hour saved in the laboratory is an hour gained by the treatment and contact tracing teams. There  are new diagnostics that have been developed to detect all Ebola species including Bundibugyo and  we're just starting to see these new platforms being field tested in the affected areas.  Treatment is the second tool. They are starting a clinical trial of treatments that theoretically  should be effective against all Ebola species. One of them is MBP134 which is a monoclonal antib=body  cocktail and another is remdesivir which is a repurposed drug. They're going to test those two  separately and in combination against the standard of care which is just supportive therapy. They  have to enroll hundreds of patients in an armed conflict zone while the outbreak is going on.  The vaccine is going to be the hardest. Oxford has a promising candidate, but it's just in Phase  1 with some volunteers. It's a long way off. So, the virus has the lead, but the science has  started. And if everything goes well in the middle of the race, the responders might get a big  speed boost. A huge Bundibugyo outbreak was always going to be a nightmare, but letting the virus  get a head start has made the situation worse.

[00:07:37]So for example, with USAID, one of the things we  accidentally cancelled very briefly was Ebola, Ebola prevention. I think we all want Ebola  prevention. So we restored the Ebola prevention immediately and there was no interruption. He  is absolutely right about the stopping part.

[00:07:55]I mean you can see for yourself if you go to  foreignassistance.gov. In 2025, humanitarian aid to the Congo plummeted. In 2026, this has not  recovered yet. It was really the wrong move at the absolutely wrong time. It cut off a network  of health and community organizations that could have been the eyes and ears on the ground on  the front line right when the Ebola outbreak was starting. People are talking about mobilizing  $1.4 billion for Ebola in the DRC. You know, this money would have been a lot more useful last  year before the outbreak started. The US funding cuts didn't cause the outbreak, but they reduced  the margin of error at exactly the wrong time.

[00:08:44]This outbreak went vertical because the virus was  spreading before the system was able to see it.

[00:08:51]If you're interested in learning more about  how complex an Ebola outbreak response is, which includes treatment and community contact  tracing, you should check out my latest video.

[00:09:06]And come back to this channel for more updates  about the 2026 Ebola outbreak in the Congo.