Ebola cases in Sierra Leone spiked on Sunday, with 111 new cases reported—the highest daily rate since the country's health ministry started publishing statistics in August.
The United Nations warned that the actual figures may be much higher, stating last week that cases are being underreported by up to 50 percent. A total of 4057 cases have been confirmed in the country, according to statistics released by the United Nations Mission for Ebola Emergency Response (UNMEER).
Sierra Leone's capital city of Freetown, which saw 40 new cases on Sunday and 62 total over the weekend, has some medical infrastructure in place to deal with the outbreak, in the form of Ebola hospitals built by foreign militaries—but more remote towns are without such health services and are still waiting for treatment centers. Port Loko, which is the third-most affected district out of 14 in Sierra Leone, is still waiting for construction to finish on a 100-bed clinic; while it is due to open in November, the World Health Organization (WHO) has said that cases are rising faster than treatment centers are being built.
By the time Port Loko opens its first clinic, there will be a need for 4,000 beds throughout the country, the WHO said. There are currently less than 500.
Doctors Without Borders/Medecins Sans Frontieres (MSF) has warned for months that Ebola would continue spreading without international support and aid. While the organization confirmed a decline of the disease in Liberia this week, MSF's Ebola response chief Chris Stokes told the BBC there was still a chance of a "flare up," noting that Guinea is seeing an increase in cases after two periods of seemingly getting it under control.
The region of Koinadugu is the latest to be hit by the disease. With no treatment centers in place and few resources to go around, as well as a lack of transport available for infected patients in the isolated community, Ebola spread rapidly in the area, killing at least 50 people in recent weeks.
"Nine people are now in the isolation [center] and two of these are seriously ill, with not much hope for them I'm afraid," John Marah, head of the Red Cross in Sierra Leone, told Agence France Presse on Monday. "The situation is really difficult."
The virus quickly claimed its hold last month over the mountainous region, previously the most unaffected in the country after local chiefs imposed a quarantine and forbid entry to traders and farmers. Its rapid spread was partly due to Koinadugu's inaccessibility by road and a slow response by medical organizations. The nearest treatment center is five to eight hours away by road.
Humanitarian agencies were slow to respond because "there was a lot of denial about Ebola at the beginning," Marah told AFP. About 250 people are now being monitored, he said, but the quarantine was quickly leading to a food shortage.
"There is no supply of rice there at the moment. Farmers cannot go to their farms and the World Food Programme is not getting them enough supplies," Marah told the Guardian on Monday.
Foday Jalloh, a chief in Koinadugu, told the Red Cross last week that the region was in desperate need of humanitarian aid. "We need medical supplies and medical equipment," he said. "We need intervention to give us support."