842. Social Resistance Fuels Ebola Transmission in the Eastern Democratic Republic of Congo

Abstract

BackgroundThe second largest Ebola epidemic in history is currently raging in Eastern Democratic Republic of Congo (DRC). Stubbornly persistent Ebola transmission has been associated with social resistance, ranging from passive noncompliance to overt acts of aggression toward Ebola response teams.MethodsWe explored community resistance using focus group discussions and assessed the prevalence of resistant views using standardized questionnaires.ResultsDespite being generally cooperative and appreciative of the foreign-led Ebola response, focus group participants provided eyewitness accounts of aggressive resistance to control efforts, consistent with recent media reports. Mistrust of Ebola response teams was fueled by perceived inadequacies of the response effort (“herd medicine”), suspicion of mercenary motives, and violation of cultural burial mores (“makeshift plastic morgue”). Survey questionnaires found that the majority of respondents had compliant attitudes with respect to Ebola control. Nonetheless, 78/630 (12%) respondents believed that Ebola was fabricated and did not exist in the area, 482/630 (72%) were dissatisfied with or mistrustful of the Ebola response, 60/630 (9%) sympathized with perpetrators of overt hostility, and 102/630 (15%) expressed noncompliant intentions in the case of Ebola illness or death in a family member, including hiding from the health authorities, touching the body, or refusing an official burial team. Denial of the biomedical discourse and dissatisfaction/mistrust of the Ebola response were statistically significantly associated with indicators of social resistance.ConclusionWe concluded that social resistance to Ebola control efforts was prevalent among focus group and survey participants. Mistrust, with deep political and historical roots in this area besieged by chronic violence and neglected by the outside world, may fuel social resistance. Resistant attitudes may be refractory to short-lived community engagement efforts targeting the epidemic but not the broader humanitarian crisis in Eastern DRC.Disclosures All Authors: No reported Disclosures.

Misconceptions, Misinformation and Politics of COVID-19 on Social Media: A Multi-Level Analysis in Ghana

“…These myths and misconceptions can be dangerous, even deadly, during outbreaks such as COVID-19. In the fight against Ebola in the Democratic Republic of Congo, for instance, many did not believe the disease exists nor associated its spread with healthcare workers and therefore avoided seeking treatment (Mian et al, 2019). Given the way social media can be used to spread misconceived information in times of crisis, it is vital for countries to plan a response and share information strategically via social media in order to control the information and avoid a worsening the situation.…”