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“Perhaps the most alarming finding is that many of the newly reported deaths are people who died in their communities without ever reaching a health facility and without receiving care,” Chikwe Ihekweazu said after returning from Bunia, in Ituri province, one of the worst-hit cities. “And as of today, 80% of new cases are outside our contact lists and so are coming to us from unknown chains of transmission.”

People who die outside the health system cannot be isolated, treated or have their contacts traced promptly, increasing the risk of further transmission.

The outbreak, Ihekweazu said, “continues to outpace the response efforts.”

As of Monday, at least 1,926 people have been infected, of whom 702 have died, in three provinces in Congo from the rare , Congolese authorities said. Cases have also been confirmed in neighboring Uganda.

Ihekweazu told reporters in Geneva that his visit to Bunia had been “quite encouraging on many fronts, but also deeply concerning.”

Treatment capacity in Bunia is now close to 800 beds, with capacity increasing every week, and lab capacity has grown from 1 to 14 labs, an effort the emergency chief lauded.

However, Ihekweazu said that despite “our best efforts ... we have not caught up in the race.”

A funding gap, attacks on health centers, an ongoing conflict in eastern Congo, and mistrust among local communities have hampered the response.

Dozens of healthcare workers at an Ebola virus in northeast Congo and bonuses on Monday. On Tuesday, they agreed to resume work under the condition that the government pays them within 72 hours.

“Just one day of strike action has already caused damage. Patients were unable to access the center," the striking health workers said in a statement. “We hold the government solely responsible for any loss of life if the site closes after this ultimatum.”

The Congolese authorities declared a fresh Ebola outbreak on May 15 after the disease had been transmitting for weeks without official detection, according to the WHO. last week after researchers in the hope of fighting the virus.

The U.S. Centers for Disease Control and Prevention said on July 11 that a U.S. citizen working for a humanitarian organization in Congo has tested positive for the Ebola virus, without providing further details.

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Associated Press writer Geir Moulson contributed to this report from Berlin.