{"id":197,"date":"2026-05-22T21:38:46","date_gmt":"2026-05-22T21:38:46","guid":{"rendered":"https:\/\/northcarolinamovingjournal.com\/?p=197"},"modified":"2026-05-22T21:38:46","modified_gmt":"2026-05-22T21:38:46","slug":"q-a-with-dr-wohl-how-global-health-changes-could-impact-ebola-response","status":"publish","type":"post","link":"https:\/\/northcarolinamovingjournal.com\/?p=197","title":{"rendered":"Q & A with Dr. Wohl: How global health changes could impact Ebola response"},"content":{"rendered":"
\n

As the world has waited with bated breath to see if the small outbreak of the hantavirus aboard a cruise ship would multiply and spread beyond borders \u2014 another infectious disease crisis vaulted into worldview.<\/p>

Read more EPA \u2018strategy\u2019 proposes to strike enforceable PFAS standards<\/a><\/p>\n

Last Friday, the Africa CDC confirmed a new Ebola outbreak centered in the Democratic Republic of Congo. The World Health Organization quickly declared the epidemic a public health emergency of international concern. The strain of Ebola, Bundibugyo, is a different variant from the one in the massive 2014 outbreak. That difference complicated detection of the virus, because early test results using tools geared to that 2014 strain came back negative.<\/p>\n

As of Saturday, 246 suspected cases and 80 suspected deaths were reported in Ituri Province of the Democratic Republic of the Congo. The response in that province, the center of the outbreak, has been criticized as lacking, with health officials being slow to report the concerning symptoms and a lag in dispatching test samples to Kinshasa, the capital, according to The New York Times. Across the border in Uganda, two laboratory cases and one death have been reported with \u201cno apparent link to each other,\u201d according to WHO.<\/p>\n

Health officials suspect the outbreak has been going on for much longer, noting unusual clusters of community deaths with symptoms compatible with this strain. There also have been at least four deaths among healthcare workers in a clinical context, which has raised concerns about transmission in a healthcare setting and gaps in infection prevention and control measures. Those concerns are all amplified by the ease of travel between countries surrounding the initial outbreak.<\/p>\n

While the World Health Organization and associated global health entities mount a response \u2014 the United States is noticeably absent. The second Trump administration announced its withdrawal from WHO in January 2025, citing \u201cmishandling of the COVID-19 pandemic\u201d and failure to reform.<\/p>\n

The global health infrastructure \u2014 and the relationships among the agencies and nations that shaped responses to previous global health emergencies \u2014 has changed dramatically, as has the role of the U.S. Centers for Disease Control and Prevention.<\/p>\n

For North Carolina clinicians and researchers who worked through the 2014 Ebola epidemic, today\u2019s outbreak raises familiar concerns but in a markedly different global health landscape. Among them is David Wohl, a UNC Chapel Hill infectious disease physician whose work on Ebola in Liberia grew out of decades spent studying emerging infectious diseases.<\/p>\n

This interview has been edited for length and clarity.<\/em><\/p>\n

NCHN:<\/strong> What do we know about this current outbreak?<\/p>\n

David Wohl:<\/strong> There\u2019s quite a bit that we\u2019re finding out, and none of it is really good news. There has been an ongoing outbreak of Ebola with a strain called Bundibugyo.<\/p>\n

It\u2019s caused outbreaks in the Democratic Republic of Congo before, but it is not the same variant or strain that caused a big outbreak in 2014. That matters because the diagnostic tests that are used don\u2019t pick up this other strain of Ebola that is now circulating in DRC. That contributed to delays in diagnosis, recognition and response, which allowed the virus to continue to spread really widely with people moving from the Democratic Republic of Congo.<\/p>\n

Since it started in the rural area of the DRC, then people went to seek care in the capital Kinshasa, and then to Uganda nearby, and its capital Kampala. This has become a rural spreading virus that now has been transported into cities with healthcare workers getting infected, probably also now in South Sudan, which raised a whole bunch of other issues.<\/p>\n

We\u2019re talking about a region of the world where there\u2019s not a lot of resources, very rural for most of this, and where there\u2019s also civil conflict. So none of that is good news.<\/p>\n

NCHN:<\/strong> Some reports say that because there are no longer USAID people on the ground to do surveillance, it took longer to identify the outbreak. Is that true?<\/p>\n

David Wohl: <\/strong>I\u2019m sympathetic to people who are trying to imagine an alternative universe where all the resources that existed historically up until about a year and a half ago \u2014 how would that have made a difference? That\u2019s really hard. I think it makes a difference with response, but I\u2019m not so sure how it would have made a difference with detection.<\/p>\n

There\u2019s a really decentralized system in the DRC, unfortunately, especially with these rural outlying areas not having good connections to resources such as testing. Some testing was done, but I think there was not good recognition that there were people getting sick with something that looked like a serious viral hemorrhagic fever and that there were clusters. That should have set off alarms.<\/p>\n

Maybe even if we had all the resources there, I do think it wouldn\u2019t have made it different. But I do think now when you really do need to mount a response to try to contain what should have been contained already is getting very messy \u2014 that\u2019s where you want those resources and a deep bench of people, both here and there, to be able to respond. That is my concern, is that we are more of a skeleton crew than ever before.<\/p>\n

NCHN: <\/strong>In the past, people like you and (UNC Chapel Hill infectious disease physician) Billy Fisher have responded to these health emergencies because you were part of the CDC response teams. Do those still exist, and will they be able to help with a response? The United States is also no longer a member of the World Health Organization. How are all these changes going to affect response?<\/p>\n

David Wohl: <\/strong>From my vantage point, I see that the opportunities \u2014 for collaboration, for data sharing, for really being around the same table \u2014 are no longer the same as they were before. That worries me. I think when you have a global threat like this, you really do want trust and good relationships. I worry that we don\u2019t have that to the same degree we did before, and that\u2019s been very, very well voiced by this administration that we don\u2019t need to do that.<\/p>

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That\u2019s not to say that people aren\u2019t talking to each other. I\u2019m sure they are, but I do worry that again without the experienced people who were part of this not present any longer, we\u2019re at a disadvantage. Are we stronger now to respond than we were before? I don\u2019t think we could really say that, and I do worry that there\u2019s diminished ability to do something that we were able to do before.<\/p>\n

That said, domestically Billy Fisher and myself co-lead one of 13 federally funded regional emerging pathogen response centers. These are designated centers to be the end of the road. After you get the patient who has Ebola or another serious infection, they come to our center, we care for them. We\u2019re training. We are funded to be able to respond if there\u2019s a need, and that would include a repatriated American who has Ebola or suspected. It could include someone with hantavirus. We are being very, very aware and alert of the situation, we\u2019re having constant meetings and I think that system remains strong.<\/p>\n

There\u2019s been chaos, there\u2019s been confusion with everything, but we\u2019re still able to function and are. All of us across the country have a sense of alert here that if we\u2019re needed, we will be available to be called upon to do what we need to do to help Americans who might be ill.<\/p>\n

NCHN:<\/strong> The administration has put in a travel ban from DRC, South Sudan and Uganda. Is that enough to stop cases from coming into the states?<\/p>\n

David Wohl:<\/strong> Probably not.<\/p>\n

I\u2019m not even sure how effective that is. Remember those travel bans are for people who don\u2019t have a U.S. passport. I don\u2019t think the virus cares whether you have a U.S. passport. If you have a U.S. passport and come from these countries, you can be allowed in. I\u2019m not sure that the travel bans will be as effective as on a local level.<\/p>\n

Given the situation, we\u2019re asking people when they check in for their appointments or come to the emergency room: \u201cHave you traveled to these countries? Are you having any symptoms?\u201d That\u2019s part of a routine travel screen that we adjust based upon where there\u2019s hot spots across the country, so there\u2019ll be less people, maybe, coming from those countries that we have to screen.<\/p>\n

NCHN:<\/strong> Someone could be in the affected area and then travel to, say, Ethiopia or something and then fly to the U.S. from there?<\/p>\n

David Wohl:<\/strong> There\u2019s holes in this system, but even if you absolutely were able to stop every single person coming from these countries in the United States, a chain of transmission could be such that it can come in with somebody else. The vast, vast, vast majority of people who will be traveling through our country would not have been exposed. It\u2019s a big, big sledgehammer. I think it may make some pragmatic sense to people and may look good, but I\u2019m not so sure how effective it will be. It can be very disruptive to a lot of people \u2014 and to even our relationships with these countries. And with personnel transfer, we want there to be a fluid transfer of people who can help respond, so we don\u2019t want obstacles placed.<\/p>\n

NCHN:<\/strong> How is Ebola transmitted, through blood and bodily fluids?<\/p>\n

David Wohl:<\/strong> That\u2019s what really makes it very \u2026 it\u2019s a scary virus. But that\u2019s what makes it different. A lot of us are scared when you hear about these emerging pathogens, when you hear about something like a bird flu that is transmitted by air, that is really to me much more of a concern because you could be close to somebody but not touch them and get infected.<\/p>\n

With Ebola, you really do have to be in physical contact with them or their fluids. It\u2019s not transmitted through the air, so while it\u2019s a devastating infection, it is harder to catch. We always want to worry a little bit. I think with hantavirus, there\u2019s a potential that these people who got off the boat could secondarily spread it to other people. I think there\u2019s some really good reasons to be watching those folks carefully. But with Ebola I\u2019m less worried about secondary spread. I\u2019m not really seeing that happen in the United States. We\u2019re so different than Africa, as far as that\u2019s concerned.<\/p>\n

NCHN:<\/strong> Looking at these two outbreaks, hantavirus and then Ebola virus, it speaks about the need for ongoing surveillance. What is the worldwide status of our public health surveillance system?<\/p>\n

David Wohl:<\/strong> Personally, I can\u2019t say that we\u2019re stronger, and there\u2019s good arguments to say we\u2019re weaker: \u2026 We have fewer staff, when we have people who were in divisions of the CDC that were dedicated to emerging pathogens that don\u2019t exist anymore.<\/p>\n

You can\u2019t tell me that makes us stronger. When we hear a lot of discussion about chronic diseases, nutrition and environmental health toxins, and to some extent say, \u201cyou really should be turning our back away from the focus on infectious diseases and emerging pathogens.\u201d This shows us why we need to do both.<\/p>\n

This is not just coincidence. This is not just bad luck. This is going to happen; this is predictable. We know that emerging pathogens are happening more frequently, that they\u2019re getting more serious and their scope is widening. If anything, we should be strengthening, right now, our surveillance systems as climate change, urbanization, migration, civil conflict, all these things predispose to emerging pathogen outbreaks. We should be doubling an investment in our efforts, because these things hit us too.<\/p>\n

This article first appeared on North Carolina Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.<\/em>\n

\"\"<\/figure>\n<\/p>\n

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