Publishing to Keep up with Ebola

As you read this, thread-like viruses less than one micron in length are spreading through human populations in West Africa, taking lives, wrecking communities and generally creating havoc in the countries affected. Infection with the Ebola virus results in an appalling death in about half of all cases within a few weeks, and transmission rates are high, cruelly exploiting contact with the dead or dying. The death toll stands at more 8,235, from the initial outbreak in Dec 2013 up to data available on Jan 4^th 2015.

Clearly this was no time for hanging around, and when we received a manuscript that described a new model of Ebola virus transmission, with potentially immediate implications for the management of the current Ebola outbreak, we were concerned about the conflict between responsible high-quality publishing and the pressing need to inform the ongoing ground-fight against the virus.

We straightaway asked the authors to deposit their manuscript in a pre-print server so that it would be immediately available to the public while we put it through the peer-review process. The reviewers returned their comments very rapidly, but several expressed concerns about the possibility of delivering a timely publication.

The timeliness problem arose because the manuscript uses real-life data from medical units in Liberia, and generates projections about how the Ebola outbreak will respond to various changes in clinical management and public behaviour (see the images below). Both the data inputs and the projected outputs are extremely time-sensitive, and the normal publication process ran the risk of delivering a paper that had already been rendered obsolete by the march of events on the ground.

After some editorial heart-searching as to whether it was fair to the authors to pursue a further round of revision and review at PLOS Biology, we decided that we would continue to consider the paper but only if we could expedite publication of the most up-to-date version possible.

The obvious way to do this was as a blog post, a trail already blazed by one of our sister journals, PLOS Neglected Tropical Diseases – also with an Ebola-related paper. However, luck was on our side, as that very week saw the introduction of a new production pipeline at PLOS that promised a greater speed to publication of fully typeset, copy-edited and proof-read papers.

The academic editor was happy that if he could check the final updated projections and we could publish with a couple of weeks then a meaningful – and potentially useful – publication was at least in principle possible. The expedited paper has just been published, almost exactly three weeks later (holidays aren’t the best conditions under which to roll out a brand-new production system). One step closer to the day when the printing press can out-run the virus.

Update Jan 21st – we just published a great Primer by Gerardo Chowell and Hiroshi Nishiura that sets this study in context.

Drake JM, Kaul RB, Alexander LW, O’Regan SM, Kramer AM, Pulliam JT, Ferrari MJ, Park AW. (2015). Ebola Cases and Health System Demand in Liberia. PLoS Biology, 13 (1) : 10.1371/journal.pbio.1002056

Chowell G, Nishiura H. (2015). Characterizing the Transmission Dynamics and Control of Ebola Virus Disease. PLoS Biology, 13 (1) : 10.1371/journal.pbio.1002057