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Several of Amighetti’s menu items will also be available at CITYPARK beginning March 4.

ST. LOUIS – U.S. Congresswoman Cori Bush married her former campaign security guard, Cortney Merritts, last weekend. They were partners before Bush entered Congress. Merritts is an Army veteran. Chief of Staff, Abbas Alawieh, released the following statement: “Those who know the Congresswoman personally and have followed her inspiring story know that she is a survivor of [...]

The coal industry may be dying in the U.S., but its health impacts are not, report finds.

A new era has begun at St. Louis City Hall.

On Monday, St. Louis City will host an open house for a traffic study along the River Des Peres.

A man was shot in killed in north St. Louis.

A faulty traffic signal may have contributed to a fatal crash on Saturday night.

We talk to six St. Louisans to see just who is (or is no longer) using public transportation.

Strong to severe wind-driven rain and thunderstorms are expected Monday.

An hours-long standoff ended Monday morning. It involved police and a man suspected of killing one person and shooting a Dupo police officer.

The two-day block party, featuring performances from Metro Boomin and Anderson .Paak, will allow fans of all ages to come together in support of their hometown team.

In early February, the official breeding facility of the Budweiser Clydesdales announced that four colts (male horses) had been born, so we recommend going early in the spring while the babies are still, well, babies.

Nearly five years after voters amended the state Constitution to require the legislature to abide by transparency laws, the Missouri Senate is advancing a bill allowing lawmakers to withhold a wide swath of records from the public.  Any record of a state lawmaker or their staff pertaining to “legislation or the legislative process” would be […]

The post Bill carving some legislative records out of Missouri Sunshine Law advances in Senate appeared first on Missouri Independent.

State Rep. Lane Roberts is not someone most would deem a “RINO,” or Republican In Name Only. The three-term Joplin Republican served as the director of the Missouri Department of Public Safety and as Joplin’s police chief, having previously led police forces in cities throughout Washington and Oregon, where he served as president of the […]

The post Debate over minors carrying guns has implications beyond the Missouri House appeared first on Missouri Independent.

In 2014, KISS’ Gene Simmons first told Esquire magazine that rock was dead. But it seems his bandmate Paul Stanley doesn’t share his sentiment. "It’s a great soundbite, but that’s about all it is," Stanley tells the United…

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After Mayor Tishaura Jones called for Kim Gardner to 'take accountability,' the city prosecutor dodged questions, deflected blame and stoked racial divisions

Hidden and deceptive fees are seen across consumer transactions, from rental housing to prisons.

Some coal defenders amp up culture war as others welcome nuclear and batteries.

by Irena Hwang and Al Shaw

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As a devastating outbreak of Ebola spread to Tommy Garnett’s homeland of Sierra Leone in 2014, the conservationist had a hunch.

Garnett long lamented the deforestation from farming, mining and logging in the region and wondered if tree loss had anything to do with the outbreak that had swept into Sierra Leone from a forested area of Guinea. With activities in his country at a standstill due to the outbreak, Garnett asked the ERM Foundation, the nonprofit arm of a sustainability consulting firm in London, to help him analyze patterns of deforestation.

Their findings suggested Garnett’s hypothesis was valid: A particular pattern of deforestation seemed to explain a number of Ebola outbreaks they studied, including the one that began in Meliandou, Guinea.

The majority of emerging infectious diseases originate from wildlife, but understanding how, why and when a pathogen will jump from one species to another, including humans — a phenomenon called spillover — continues to be studied by academics and scientists worldwide.

One study analyzing historical outbreaks found that land-use change — such as clearing forests for agriculture — was the biggest driver of spillover, exceeding factors like climate change and the consumption of meat from wild animals.

We wondered: Is it possible to calculate the risk of a spillover event happening because of deforestation? So we set out to examine how clearing trees can increase the likelihood of such an event, using Ebola as an example pathogen.

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We found that the risk of another spillover due to forest loss has increased within the past two decades in the locations of five previous Ebola outbreaks — including the site in Guinea where the largest Ebola outbreak in history began.

As part of the reporting process, ProPublica journalists consulted with biologists, ecologists and infectious disease experts to model how the risk of spillover events has changed over time. Our analysis was based on two peer-reviewed scientific models, generating completely new results. One of the researchers we interviewed said that the analysis ProPublica performed is exactly what they would have liked to do, had they more time and resources.

Here’s how we did it.

The deforestation model: a link between spillover and forest loss

Our inquiry began with an academic article that was a direct result of Garnett and the ERM team’s study from 2015. The ERM researchers had pitched their work to academics, hoping it could be validated and expanded in a rigorous, peer-reviewed study. Their findings caught the attention of a nonprofit scientific research institute specializing in forest science and its academic collaborators, biologists at the University of Málaga, Spain. Led by Jesús Olivero, a biologist specializing in geographic distributions of animals, the group continued exploring the link between spillover and forest loss.

Olivero and the team focused on five main categories of factors: forest loss, forest fragmentation, human population, geographic location and a measure of the possibility that Ebola was circulating in wildlife based on the environmental features of a particular area. They tested more than 100 variables related to those five factors. They did not examine other factors that may have played a role, such as how often residents came into contact with wildlife, hygiene practices or accessibility of health care.

In a 2017 journal article, the team found that a handful of variables about forest loss in the two years leading up to an outbreak were best able to explain the pattern of where and when recent spillover-induced Ebola outbreaks have occurred. They used the variables to create a model, which identified seven Ebola outbreaks that were significantly related to forest loss.

We were curious about the outbreak locations that had been singled out by Olivero’s deforestation model. We wanted to know: Has deforestation gotten worse in those places? And if so, did the loss of forest increase the risk of another spillover event occurring?

To answer the first question, we used satellite image data to quantify the degree of deforestation over time. For each of the seven outbreak locations, we defined a circular area with a radius of 20 kilometers, or about 12.5 miles, and calculated the amount of forest loss in each year from 2001 to 2021, the range of time for which data is available.

In all seven locations, deforestation had increased since the previous outbreaks occurred. But to understand how these trends in deforestation might affect spillover risk, we needed another model.

The epidemiological model: an incorporation of changes in forest loss into spillover risk over time

Around the same time Olivero’s team developed the deforestation model, a different group of researchers, led by Christina Faust at the University of Glasgow, Scotland, created an epidemiological model that calculates an area’s spillover risk by using information about its deforestation over time. This model, unlike the deforestation model, doesn’t only consider changes to forests in aggregate, but it also takes into account how the patterns of tree loss might impact risk.

It is an adaptation of a classic epidemiological model that tracks how populations of susceptible, infected and recovered individuals change over time as a virus spreads. Crucially, it incorporates information about the degree and type of deforestation that’s occurring in an area over time.

When we think of deforestation, we might picture large swaths of forest clear-cut for acres of industrial agriculture. But deforestation often occurs on a smaller scale. Activities like clearing trees for subsistence farming or gathering wood for charcoal can result in many smaller patches of tree loss, rather than huge clearings. When deforestation occurs in small patches, the total area around the “edge” — the border area around clearings where humans and potentially disease-carrying animals can interact — will often exceed the total area of cleared forest.

The researchers found that the highest risk of spillover occurs at intermediate levels of forest loss. That’s because there’s just enough disturbed forest left for adaptable species like bats to survive. At the same time, the total amount of edge around those deforested patches — the places where people are most likely to come in contact with wildlife — is at its peak. When the scale tips beyond that intermediate level of habitat loss, there isn’t as much forest to support the wildlife, resulting in less total edge where humans and animals can collide.

Using the same satellite image data that we relied on to quantify forest cover over time, we calculated the edge area for each location each year between 2001 and 2021. Then, we calculated trend lines linking total edge area to degree of deforestation for each location. We refer to these lines as “deforestation trends.”

The epidemiological model assumes a direct relationship between deforestation and the susceptibility of humans and wild animals to viral infection. As forest is destroyed, the transmissibility of a virus among wild animals is assumed to decrease, simply because there is less habitat, and thus fewer animals that can sustain the virus. Conversely, as animal habitats are destroyed, the model assumes that the number of humans increases proportionally, since the increased ability to grow food can support a larger population.

In sum, the model takes in deforestation trends and characteristics about human and wildlife populations, and it translates these inputs into risk of spillover over time.

Combining the models showed that deforestation trends have consistently increased spillover risk to levels higher than when the previous outbreaks occurred.

We took the deforestation trends calculated for the seven locations from the deforestation model and combined them with the epidemiological model. We also customized the epidemiological model code with parameter values specific to the particular Ebola strains that each location encountered. The parameters included a range of transmissibility of Ebola among humans, estimated from known Ebola outbreaks, and an estimate of transmissibility of Ebola among bats, the presumed host species for the virus.

In six out of the seven locations, deforestation over the past 20 years was significant, reaching a maximum degree of forest loss between approximately 10% and 30%. We excluded one location from our analysis, a village called Inkanamongo-Boende in the Democratic Republic of Congo, where an Ebola outbreak occurred in 2014 yet deforestation has remained minimal, below 4%.

Deforestation trends varied between the six remaining locations. In some locations, increasing deforestation has been accompanied by a steady increase in total edge area. This is consistent with forest being cleared in numerous small patches. In other locations, deforestation has progressed to a point where remaining patches of forest are so spread out and isolated, overlap between the patches leads to less edge area than at lower levels of deforestation.

In all six locations, the maximum total edge area resulting from deforestation was at least twice the area of intact forest, and in some locations, it was more than three times as much. In other words, the areas where humans and wild animals were likely to interact was up to three times larger than the areas that animals have left to live in.

Integrating the deforestation trends into our customized version of the epidemiological model showed that in five of the six locations, spillover risk in 2021 — the most recent year for which data was available — was higher than during the years the original outbreaks occurred.

We observed qualitative differences in deforestation trends between locations that had experienced outbreaks of the Ebola Sudan strain versus the Ebola Zaire strain. Despite these differences, our analysis shows that local land-use change has consistently led to an increased risk of Ebola spilling over from wild animals to humans.

Deforestation trends don’t tell us everything about spillover risk, but it’s information that’s currently not used enough by global public health agencies.

It’s worth keeping in mind that these findings are based on a theoretical model, and that all models, including this one, have limitations.

We chose this model because it directly translates deforestation trends into spillover risk. However, the model does not consider other factors, like how humans are consuming or interacting with wildlife, whether multiple types of wildlife may be present or how humans are using the forest. As mentioned above, the model assumes a direct relationship between the amount of forest available and the sizes of human and wildlife populations that can be sustained.

For that reason, we cannot interpret the model’s results as a measure of absolute risk. The experts we consulted said it was best used to compare risk over time for the same location, rather than among different locations. This is why we did not use the model’s results to compare risk levels between different countries or between different locations within the same country. Instead, we reported on relative increases in risk.

Finally, the model does not tell us why, how or when a spillover event might occur.

Despite these caveats, we felt it was important to conduct this analysis because it helps to crystallize trends in spillover risk due to deforestation in these key locations. Hamish McCallum, professor of infectious disease ecology at Griffith University in Australia and co-author of the epidemiological model, noted that results like ours are important because they help to “make explicit what’s essentially intuition.”

The science clearly shows that deforestation should stop, but that doesn’t take into account the realities of the people living in these areas. Residents in Meliandou are subsistence farmers. Besides growing rice, they also venture into the forest to gather fruit from oil palms and burn trees to make charcoal to sell. Fertilizer, different crop rotations and help from agricultural specialists could improve their rice yields, but our reporting found that residents don’t have access to those things. And when there are poor harvests, like residents said they had in 2021, they are forced to continue cutting down trees to sustain their families. As governments and global agencies debate how to best prevent the next pandemic, some experts are calling for more funding to prevent spillover from happening, not just improving our preparation and response to an outbreak after it begins. Analyses like ours can highlight locations that may be prime for ecological interventions by helping us better understand the role land-use change plays in driving spillover events.

Acknowledgements

We would like to thank the following people for the time and expertise they shared in reviewing our work. Their review does not constitute an endorsement of our methods or our discussion, and any errors are our own.

Christina Faust, research fellow at the University of Glasgow

Jesús Olivero, associate professor in the department of animal biology at the University of Málaga, Spain

Heather Lynch, professor of ecology and evolution at Stony Brook University and ProPublica data science adviser

More technical details are available in the version of this article on ProPublica’s website.

Caroline Chen contributed reporting.

by Caroline Chen, Irena Hwang and Al Shaw, with additional reporting by Lisa Song and Robin Fields; Photography by Kathleen Flynn, special to ProPublica

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We’re investigating the cause of viruses spilling over from animals to humans — and what can be done to stop it. Read more in the series.

Generations ago, families fleeing tribal violence in southern Guinea settled in a lush, humid forest. They took solace among the trees, which offered cover from intruders, and carved a life out of the land. Their descendants call it Meliandou, which elders there say comes from words in the Kissi language that mean “this is as far as we go.”

By 2013, a village had bloomed where trees once stood — 31 homes, surrounded by a ring of forest and footpaths that led to pockets residents had cleared to plant rice. Their children played in a hollowed-out tree that was home to a large colony of bats.

Nobody knows exactly how it happened, but a virus that once lived inside a bat found its way into the cells of a toddler named Emile Ouamouno. It was Ebola, which invades on multiple fronts — the immune system, the liver, the lining of vessels that keep blood from leaking into the body. Emile ran a high fever and passed stool blackened with blood as his body tried to defend against the attack. A few days later, Emile was dead.

On average, only half of those infected by Ebola survive; the rest die of medical shock and organ failure. The virus took Emile’s 4-year-old sister and their mother, who perished after delivering a stillborn child. Emile’s grandmother, feverish and vomiting, clung to the back of a motorbike taxi as it hurtled out of the forest toward a hospital in the nearest city, Guéckédou, a market hub drawing traders from neighboring countries. She died as the virus began its spread.

Etienne Ouamouno, whose toddler Emile was the first to die. He lost two children in eight days, then his wife died.

Emile was patient zero in the worst Ebola outbreak the world has ever seen. The virus infiltrated 10 countries, infected 28,600 people and killed more than 11,300. Health care workers clad head to toe in protective gear rushed to West Africa to treat the sick and extinguish the epidemic, an effort that took more than two years and cost at least $3.6 billion. Then, the foreign doctors packed up and the medical tents came down.

This has long been the way the world deals with viral threats. The institutions we trust to protect us, from the World Health Organization to U.S. agencies like the Centers for Disease Control and Prevention, focus on responding to epidemics — fighting the fires once they have begun, as if we could not have predicted where they would start or prevented them from sparking.

But looking back, researchers now see that dangerous conditions were brewing before the virus leaped from animals to humans in Meliandou, an event scientists call spillover.

The way the villagers cut down trees, in patches that look like Swiss cheese from above, created edges of disturbed forest where humans and infected animals could collide. Rats and bats, with their histories of seeding plagues, are the species most likely to adapt to deforestation. And researchers have found that some bats stressed out by habitat loss later shed more virus.

Researchers considered more than 100 variables that could contribute to an Ebola outbreak and found that the ones that began in Meliandou and six other locations in Uganda and the Democratic Republic of Congo were best explained by forest loss in the two years leading up to the first cases.

It is now clear these landscapes were tinderboxes for the spillover of a deadly virus.

Villagers prepare a meal as they take a break from farming on the slopes of Meliandou, Guinea.

We wondered what the world had done to keep disaster from striking again. Had global health leaders channeled money into stopping tree loss or deployed experts to help communities learn how to sustain themselves without cutting down the forest?

To get a sense of the current risk of spillover from deforestation at these sites, ProPublica consulted with a dozen researchers for its own analysis, which was unprecedented in its quest for specific, real-world findings. Using a theoretical model developed by a team of biologists, ecologists and mathematicians, we applied data on tree loss from historical satellite images taken between 2000 and 2021 — the most recent year available — and tested tens of thousands of infection scenarios.

The results were alarming: We found that the same dangerous pattern of deforestation has increased around Meliandou in the past decade, putting its residents at a greater risk of an Ebola spillover than they faced in 2013, when the disease first ravaged their village.

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We ran the model for five other epicenters of previous Ebola outbreaks in Uganda and the Democratic Republic of Congo. In four of the locations, that telltale pattern of tree loss got worse in the years since those outbreaks, raising their chances of facing the deadly virus again.

“I think this is very powerful,” said Raina Plowright, a professor of disease ecology at Cornell University and senior author of the model, who reviewed ProPublica’s findings. “Even though we know the fundamental driver of these outbreaks, we have effectively done nothing to stop the ignition of a future outbreak.”

ProPublica traveled to Meliandou, where on the ground, a stark picture emerged. It’s not just that the same conditions remain that primed Meliandou to kindle the worst Ebola outbreak in history.

We found they’ve gotten worse.

It takes a half-hour to walk from the homes of Meliandou through the forest to the denuded mountainside where each family is assigned a plot of land to farm. The cacophony of village life gives way to the hum of insects as residents trek up the dirt path, some balancing basins of water on their heads. Not even the children are exempt from the work it takes to clear the ground for planting. It goes on from dawn to dusk, every day but Sunday, heedless of the heat. You know you’re close to the farms when you start to hear the sound of metal striking the earth.

One day last summer, a 7-year-old boy beat a piece of scrap metal between two rocks, forming it into the head of a hoe, then raced up the slope to join other young workers. Jiba Masandouno, the village chief, followed them, sprinkling rice seed where the land was freshly bare.

Village Chief Jiba Masandouno sprinkles rice seed. Sia Irandouno pulls weeds to clear the ground for planting.

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These are not the terraced rice paddies that rise like stairs for giants in postcards from Asia. Farming here is very time consuming and difficult, with steep slopes prone to erosion. Many farmers in the U.S. use controlled irrigation, mechanization, fertilizers and products to kill pests and disease. In Meliandou, everything is done by hand, and farmers are at the mercy of the weather and depleted soils, with no room for error. If a field produces a decent harvest one year, they’ll plant it again the next. If it doesn’t, the farmers cut down or burn another patch of forest.

The majority of emerging infectious diseases originally came from wildlife. Many might picture places with caged animals as the spots most primed for a novel virus to spread to humans. After all, one of the leading theories about the origin of COVID-19 is that the virus jumped to humans at a market that sold wild animals in Wuhan, China, and health authorities now are worried about the pandemic potential of a bird flu that swept through a mink farm in Spain last fall. But scientists have shown that land-use change, especially clearing forests for agriculture, is the biggest driver of spillover.

In Borneo, deforestation has brought macaques closer to humans; researchers believe that’s seeding outbreaks of what’s known as monkey malaria. In Australia, the clearing of eucalyptus trees pushed bats closer to homes and farms, spurring the spread of the brain-inflaming Hendra virus. And Nipah, another virus that causes the brain to swell, killed more than 100 people in Malaysia in the late 1990s, after slash-and-burn agriculture forced bats closer to hog farms, and the virus jumped first to pigs and then to humans. That horrific outbreak was fictionalized in the movie “Contagion.”

Researchers have also found that it’s not just the amount of forest cut down but the pattern of deforestation that matters. Models have shown that the more patchy a forest gets, the more edges are created at the borders of clearings where virus-carrying animals can come into contact with humans, until so much forest is cut down that it can’t sustain wildlife anymore. The theoretical model we worked with encapsulates this concept to assess risk by considering the amount of “edge” produced by deforestation. Cutting one big chunk out of a forest would create less edge than cutting out many holes.

The chance of spillover is higher where people and animals overlap, which the model assumes is along the edge of cleared forest patches. We estimated the size of these “mixing zones” within a radius of 20 kilometers, or about 12.5 miles, from Meliandou. Experts told us this was a reasonable distance for a person there to cover on foot or bicycle. We found that as the forest around Meliandou got more fragmented, the mixing zone area increased sharply, by 61% from 2013, the year the epidemic began, to 2021.

Meliandou’s Forests Have Become Patchier Since the Last Ebola Outbreak The forest, shown in green, around Meliandou declined and became more patchy between 2013 and 2021. According to our analysis, the amount of edge bordering these patches increased by 61%, meaning that wildlife and humans had many more opportunities to encounter and potentially spark a spillover. (Graphic by Al Shaw. Source: Hansen/UMD/Google/USGS/NASA, OpenStreetMap.)

While the model does not calculate the absolute risk of spillover — factors like population density and human behavior are not considered — it shows that the potential for an outbreak starting has increased due to growing patchiness of the surrounding forest. (For more details, read our methodology.)

Last summer, the mountainsides around Meliandou were dotted with light green rice shoots punctuated by tree stumps. The elders there reminisced about the lush forest they grew up in. They hated to see it shrinking, but they said the trees were a necessary sacrifice. The 2021 harvest was meager, so the village did not have money from rice sales to buy fertilizer or pesticide for the crop planted in 2022. Fearful of famine, they cleared more of the forest for farming. Some families also supplement their income by chopping down even more trees to make charcoal they can sell.

Despite the billions spent on recovery from the outbreak that began here, no one has helped the farmers adopt methods that could lessen their risk of spillover.

ProPublica shared with rice farming experts photos of the Meliandou villagers at work and asked what could be done to help them grow food without constantly clearing more of the forest. Mamadou Billo Barry, a retired researcher with the Agronomic Research Institute of Guinea, said those subsistence methods yield only about 1 metric ton of rice per hectare. In neighboring Mali, where the environment is kinder to rice growers, average yields are 4 to 6 metric tons per hectare with potential for 10. What’s more, 75% to 80% of the cultivated land in Africa is degraded; in Meliandou, the fragile soil can lose essential nutrients and organic matter after a year or two of planting.

Girls walk into the forest to wash laundry at a nearby river.

Experts said that one way to improve the soil’s fertility is to plant cover crops, which add nitrogen to the soil, are left to decay in the fields and slow soil erosion. Erika Styger, a professor of tropical agronomy at Cornell University, said the villagers could divide the fields into sections and rotate what’s planted in each area — rice one year, cassava the next — then let that section rest with cover crops for several years. This, along with targeted fertilizer application, could increase the organic matter in the soil and gradually triple or quadruple their yields compared with what they’re harvesting now.

The bigger expense would be to support an agricultural specialist to build trust with the farmers and figure out what works best so they can avoid clearing more of the forest. A program in Madagascar, which set out not to prevent spillover but to save trees, has succeeded in doing this.

The world has produced more than 40 reports on what went wrong during the epidemic that began in Meliandou and how to avoid similar disasters in the future. Yet Barry, the Guinean farming expert, said the authors of those reports never asked him or his colleagues for advice.

First image: Residents cook as the sun sets over Meliandou. The village has no electricity, but some people have solar-powered lights. Second image: Masandouno, the village chief

But the link between farming and health is always on the mind of Masandouno, the village chief, whose brow seems permanently furrowed in an expression of concern. As he strides up and down the slope, flinging handfuls of rice seed, he is aware that any excess crop can be sold to pay for medications. He remembers neighbors who have died in recent years of appendicitis and hernias and during childbirth, unable to afford going to the hospital because their harvest was too bare. He knows that villagers, especially children, catch rodents in the forest to fill their bellies, despite the fact that rats in Guinea can carry Lassa fever, which can cause deafness and death.

“We are suffering,” Masandouno said with a tired gaze. “The government has forgotten us. The international community has forgotten us.”

The failure to imagine ways to prevent spillover is rooted in who gets a chance to weigh in when it’s time to make policies and spend money to protect the world from the next big one.

After the Ebola epidemic, Suerie Moon, co-director of the Global Health Centre at the Geneva Graduate Institute, helped lead one of the more influential studies of what needed to change to avoid another epidemic. The 2015 report focused on preparing for and responding to outbreaks, she said, because that was the expertise of the people in the room, including policy wonks fluent in global crises, infectious disease epidemiologists and a representative from Doctors Without Borders, the nonprofit that sent medical workers to the epicenter of the outbreak. Experts in agriculture, conservation and ecology — those most attuned to the forces that drive spillover — were not present, and they are largely excluded from conversations about how to spend pandemic prevention money.

Though the research tying deforestation to outbreaks has piled up since then, the mindset hasn’t changed. The Biden administration’s pandemic preparedness plan, published in September 2021 after COVID-19 had ripped across the globe, identified five areas for action — all of which focused on responding to an outbreak that has already begun. And the International Health Regulations, established by the WHO to govern how the U.S. and nearly 200 other countries address infectious threats, are “largely built on the assumption that disease outbreaks cannot be prevented, only contained and extinguished,” Moon and her co-authors wrote in an article calling for more investment in prevention.

The U.S. has invested in preventing spillover, but its most notable projects haven’t attempted to stop the kind of deforestation that can lead to outbreaks.

In 2009, the U.S. launched what became a 10-year, $207 million project called PREDICT to serve as an early warning system for contagions emerging from the wild. The idea was to identify possible threats and give the world a head start in responding if one of those pathogens jumped to humans. The project discovered 949 novel viruses extracted from bats and other wildlife, trained thousands of people to do disease surveillance and strengthened more than 60 labs across Africa and Asia. Though it assessed risks of deforestation, PREDICT wasn’t designed to stop tree loss. After Ebola burned through West Africa, the program searched for wildlife that transmit the virus and, to help communities reduce their risk, created and distributed a picture book called “Living Safely with Bats.”

A bat hangs from a tree in Conakry, the bustling capital of Guinea.

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Despite its emphasis on virus hunting, PREDICT didn’t identify the coronavirus that sparked the COVID-19 pandemic. And one of its core partners became embroiled in controversy for collaborating with researchers at the Wuhan Institute of Virology in China on risky experiments that manipulated coronaviruses to gauge their spillover potential, using a grant from the National Institutes of Health.

A federally funded successor program called Stop Spillover briefly considered planting trees in one Ugandan district to entice bats away from homes to prevent Ebola and a related virus called Marburg. But potential problems emerged, among them that bats pollinate the cacao crops that villagers rely on for income and drawing them too far away could hurt the harvest. Instead, the program has focused on decreasing contact between people and bats, partly by teaching residents how to keep the creatures and their excrement out of food, water and homes.

Whether it’s Ebola or COVID-19, the way the world responds when viruses ricochet across the globe has a predictable rhythm. In public health circles, this is known as the “cycle of panic and neglect.” At the end of every major outbreak, nations panic and vow to do what’s needed to do better the next time. But after the shock fades, so too does the commitment. The pot of money often winds up far smaller than what was initially recommended, leaving various groups to fight over the scraps.

After the Ebola epidemic, the world invested in virus-testing equipment and training scientists so that African countries could identify contagions as soon as cases popped up. Guinea’s lab infrastructure has improved dramatically; elsewhere, capacity dwindled as resources faded. Dr. Marcel Yotebieng, a New York City infectious disease researcher who often works in the Democratic Republic of Congo, said he often arrives to find equipment in need of maintenance due to a lack of sustained funding. At a lab where he does HIV testing, samples from infants have been known to sit for two years.

First image: A newborn receives a blessing during a church service in Meliandou. Second image: Malé Dembadouno washes clothing in the forest.

There are signs the cycle is repeating now in the denouement of the COVID-19 crisis. G20 countries last year agreed to set up a global fund for pandemic prevention, preparedness and response. The World Bank and the WHO estimate that $10.5 billion is needed annually, and the fund is expected to run for eight years. But as the world focuses on returning to pre-pandemic life, countries and major philanthropies so far have pledged just 15% of the original goal.

At first, it looked like prevention might finally get its day. In a report last fall, staff at the World Bank championed investments in preventing spillover, including suggestions for curtailing deforestation in biodiversity hot spots around the globe. But the World Bank announced in December that the first round of money in the Pandemic Fund will go to the usual things: disease surveillance, laboratories and hiring public health workers.

The jockeying for money began early. Experts convened at the request of the WHO acknowledged that deforestation was leading to more collisions between humans and wildlife, but last June, they argued that spending much of the fund on spillover would be a waste of money. The “almost endless list of interventions and safeguards” needed to do so, they said, was so vast, it was akin to “attempting to boil the ocean.”

Scientists warn that this defeatist attitude is setting our world up for another catastrophe. Studies have shown that spillover events are increasing. In Guinea and other parts of Africa, new roads are being built every day, making it easier for someone to travel from a remote village to a major city. The chances of a spark igniting a multicountry blaze is higher than ever.

The experts convened by the WHO are not wrong about the gargantuan effort it would take to reduce the chances of spillover worldwide. Some researchers have estimated that putting a dent in global deforestation alone would cost up to $9 billion a year, but they argue that the expense would be a drop in the bucket compared with the hundreds of billions of dollars in economic losses from outbreaks each year, not to mention the cost of lives lost.

Meliandou is surrounded by a ring of forest with patches cleared over the years for subsistence farming.

Nobody knows how many other Meliandous are out there, swaths of forest pocked with enough holes, and shared by enough people and wildlife, for a virus to break into humanity. But we do have a rough sense of where these places might be. The World Bank and the United States government have funded heat maps that can be used to target such places for long-term research and resources.

Instead of worrying about doing everything everywhere, the international community could have started small. A medical desert frequented by disease-carrying bats, Meliandou could have been a testing ground, a chance to make an outsized impact.

A visitor would think that the world invested heavily in Meliandou. At its entrance, a long-departed aid group erected a sign that boasts of the village’s recovery, listing accomplishments including “community resilience to epidemic diseases, the sustained resumption of education, community protection of vulnerable children, the restoration of social cohesion and economic recovery.”

Those who live there consider the sign a bitter joke. Though the group helped them build a school, there’s still no running water or electricity. Etienne Ouamouno, whose toddler Emile was the first to die, is tormented by the reality that, should one of his surviving children get sick today, Meliandou remains just as ill-equipped to help.

Ouamouno stands at the door of his home in Meliandou.

Before the disease struck, Ouamouno was known in the village as a charismatic young man, someone the elders said they could count on to lead work projects. But there is only so much pain someone can take. “Emile was everything to me,” he said, a long-awaited son after four daughters. He lost two children in eight days. Then his pregnant wife began to bleed. The midwife shooed him out of the house. Grasping for hope, Ouamouno thought that perhaps the stillbirth could mean his wife, his childhood sweetheart, would be spared. But, he said, “I learned from the cries of the women that my wife had also died.”

Ouamouno became “like a fool,” he said, tempted to run but with nowhere to go. He felt abandoned by everyone. His neighbors shunned him, terrified that they would be next. They only called on him to help bury their dead. Then, the foreign aid groups who promised all sorts of help moved on as Ebola spread into more populous towns.

Today, his resting face is grim; his demeanor, anxious and withdrawn. He didn’t make it to the village chapel on a Sunday last summer as the preacher said, “God is the only one who can give us support when we are abandoned by all.” He didn’t participate in the moment of silence the congregation held that day for their dead, as they have every Sunday in the nine years since Ebola arrived. Ouamouno wanted to hear nothing more about the virus that destroyed his life. He disappeared into the forest, heading to his farm.

Sia Irandouno, Ouamouno’s second wife, washes rice before cooking a midday meal.

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Ouamouno works on his farm. Ouamouno’s daughter Kani, 6, looks out from a shelter on her family’s farmland.

If Ebola or another deadly disease emerges from that forest today, it will fall to Catherine Leno to spot it. The 25-year-old midwife, with a sweet voice and a warm, motherly demeanor, is the sole health care provider for Meliandou and also sees patients from more than 20 neighboring villages. The job comes with serious risks: One of her predecessors died of Ebola. Her clinic has three patient beds and a birthing room with a bare mattress, stirrups and a single IV pole. There are a couple of solar-powered lights, which Leno uses sparingly. Outside is the only bathroom in Meliandou, an outhouse with tiles placed around two holes in the ground.

When patients arrive, they wash their hands in the same bucket. Leno weighs them, takes their temperature and jots details of each visit by hand in a record book with a tattered yellow cover. Medication is stacked in a wooden cabinet: malaria treatments, one kind of antibiotic and common remedies for fever, dehydration and stomach troubles, as well as medicines to control excess bleeding in childbirth. She obtains the medicines on credit from Guinea’s Health Ministry, sells them to patients, then pays back the ministry at the end of the month. Leno said she picks drugs that she knows people can afford, eschewing treatments that are more effective but more expensive. She worries they will expire in her cabinet if patients can’t pay for them, leaving her on the hook for the bill.

First image: Midwife Catherine Leno in the birthing room at the village health clinic. She is the sole health care provider for Meliandou and also sees patients from more than 20 neighboring villages. Second image: The Meliandou clinic’s supply cabinet. Leno said she chooses affordable drugs, eschewing treatments that are more effective but too expensive.

Magassouba N’Faly, the former head of the hemorrhagic fever lab in Conakry, a full day’s drive away from Meliandou, told ProPublica he was optimistic that Guinea could respond quickly to a new outbreak of Ebola or other infectious diseases. There are 38 infectious disease treatment centers now, he said, one for each district, stocked with personal protective equipment and syringes. Guinean health authorities were able to intervene quickly when lab workers in 2021 detected a case of Marburg virus, a cousin of Ebola. “For our country, we are quite ready to respond to anything,” N’Faly said. Though he still works as a technical adviser to the lab, last summer a new director was installed after a military coup.

Leno’s clinic looks nothing like the new treatment centers — she has no such PPE. During a visit to the clinic last June, there weren’t even any masks in her cupboard; the ones she distributed to villagers earlier in the COVID-19 pandemic were used up long ago. “We’re not prepared,” she said. “If I have certain equipment, I can try my best to a certain level, but if not, I will call for an ambulance.”

The ambulance from Guéckédou can take up to an hour to arrive, slowed by the jolting dirt road. Sometimes it doesn’t come, and Leno’s only option is to take the patient herself, calling a motorbike taxi to carry her and a patient together into town — potentially setting off the same chain of transmission that allowed Ebola to tumble unannounced into the more populous areas of the country.

One thing in Meliandou has changed. The hollowed-out tree is gone, set ablaze by the community. Its decayed stump has been swallowed by the forest. But the bats remain. Hundreds of them return to Meliandou every fall after the rainy season. They found a new tree, this one even closer to the residents’ homes. It towers by the entrance to the village, a few paces off the dirt path, just opposite the sign that promises that after Ebola, everything got better.

A sign at the entrance of Meliandou, erected by an aid group around the time of the Ebola outbreak, boasts of the village’s recovery.

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Lylla Younes and Gabriel Kamano contributed reporting. Translation by Youssouf Bah, Gabriel Kamano, Zujian Zhang, Sia Maria Justine Teinguiano. Photo editing by Peter DiCampo. Design and development by Anna Donlan. Illustrations by Katherine Lam.