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“One month on, the Ebola disease outbreak is outpacing the response effort,” Kate White, emergency medical coordinator for Doctors Without Borders in Congo, said Monday. “No one knows the true scale or exactly where the disease is spreading in Congo.”

The medical charity said treatment centers in the epicenter of the outbreak are overwhelmed, many patients arrive in advanced stages of illness and most were not identified as contacts of infected people before seeking care.

Congo's health ministry said that while the numbers show the outbreak is spreading rapidly, it also reflects more active surveillance. “Community members are reporting suspected cases, and response teams are investigating them,” it said on X.

The number of cases in what could become history’s worst Ebola outbreak is believed to be higher because the on May 15, weeks after it is suspected to have begun.

The outbreak is caused by the rare Bundibugyo virus, which was not tested for in the early days. The more common Zaire virus, which now has a vaccine, was responsible for most of Congo’s past 16 .

The outbreak is concentrated in Congo’s eastern province of Ituri, which accounts for more than 90% of the cases. Cases have also been recorded in the North Kivu and South Kivu provinces and have spread across the border to Uganda.

Congo said the contact tracing coverage rate is 56%, a sharp decrease from last week, as authorities hurry to find people who may have been exposed.

There was no immediate explanation for the drop. Congolese health authorities previously said contact tracing has been hampered by community resistance in some areas and by the rapid expansion of the outbreak into new health zones, increasing the workload for surveillance teams.

Nearly a million people have been displaced by years of conflict in Ituri, according to the U.N. humanitarian office, making contact tracing difficult as people flee attacks or move frequently in the vast province with dense forests, poor roads and remote villages that can take days to reach.

Tracing is also difficult among the thousands of miners who regularly move among remote sites in the mineral-rich region.

The health ministry said Sunday 40 people have recovered since the start of the outbreak, and the current fatality rate of the outbreak is 23%.

Life goes on, , as the population adjusts.

The World Health Organization said Sunday it is intensifying testing and contact tracing and treatment. Tons of supplies from the WHO have arrived in Congo.

And Africa’s top health body said it is deploying technical expertise and supporting laboratory systems, case finding and community engagement efforts to accelerate the response.

“We remain committed to supporting affected countries until transmission is stopped. We call on partners and donors to urgently mobilize resources to strengthen the response and save lives,” said the head of the Africa Centers for Disease Control and Prevention, Jean Kaseya.

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Banchereau reported from Dakar, Senegal.