Beginning of the Decline (November–December 2014)

In November and December 2014, the Ebola outbreak began to follow different paths in different countries. Liberia experienced a significant drop in cases. The apparent declines seen in Liberia in October 2014 were real. Hospitals that were once filled beyond capacity now had only a few cases. By November 13, 2014, conditions had improved so much that Liberia let its state of emergency expire. In Guinea, caseloads remained relatively stable. Sierra Leone became the epicenter of the outbreak. During November 2014, case numbers in Sierra Leone rapidly increased and the disease reached parts of the country that had not yet been affected. Sierra Leone’s healthcare system was hard-hit. By December 14, 2014, 12 Sierra Leone doctors had been infected. In other parts of the world, the outbreak also presented a mixed picture. The outbreaks in the United States and Spain were over. In Mali, a second Ebola cluster flared up in mid-November. Ebola reached Scotland on December 29, 2014. Despite the increasing number of cases in Sierra Leone and the intermittent sparks around the world, healthcare officials began to think the worst of the outbreak might be over. Trend lines started to point downward.