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Introduction

Background

Marburg and Ebola viruses are relatively related since they result in hemorrhagic fevers. The first case of the Ebola virus was identified in Zaire and Sudan in 1976 and had an approximately 78% fatality rate (Li et al., 2016). Over four succeeding decades, the virus has presented over 30 outbreaks (Li et al., 2016). With Marburg virus, its first identified case was reported in 1967 in Yugoslavia, Belgrade, and Frankfurt, Germany, and has a case fatality rate of up to 88% (Okonji et al., 2021). Their most severe outbreaks have happened mainly in Africa in Guinea, Liberia, Nigeria, Mali, and Sierra Leone.

Conversely, COVID-19 is a global pandemic caused by a zoonotic coronavirus, SARS-CoV-2- most probably of bat origin. Its first case was reported by the end of 2019 in Wuhan, China. Its primary mode transmission is through respiratory droplets and the angiotensin-converting enzyme 2 (ACE2) located in the humans lower respiratory tract (Wilder-Smith, 2021). All three are deadly viruses to the human race, with extremely high fatality rates in the public health sector.

Problem Statement

Ebola and Marburg viruses are mostly underestimated and given less attention compared to COVID-19 since their outbreaks only affect a minority portion of the universe which results in increased fatalities in the public health sector (Abayomi et al., 2021; Lawrence et al., 2022). Moreover, COVID-19 has affected many countries globally and disrupted health services, thereby leading to the re-emergence of other infectious diseases, including Ebola and Marburg viruses. An excellent example is Guinea, where the countrys testing, treatment, and surveillance protocols were negatively impacted since the COVID-19 pandemic made accessing health services challenging for other diseases (Aborode et al., 2021).

Research Question

What is the impact of the lack of resources in combating Ebola and Marburg outbreaks compared to the COVID-19 pandemic and will it have an impact on the fatality rates?

Materials and Methods

Identifying the Research Question

The identification of the research problem underwent a series of different actions. First, different evidence-based materials that provided knowledge on how COVID-19 had ready access to human, infrastructure, or financial resources that can be used to fight against it than Marburg and Ebola viruses were analyzed. As much as all the three viruses have high fatality rates, special attention has only been allocated to COVID-19 because it is a global pandemic, forgetting the other two can severely affect the universe. Second, the practical problem of Marburg and Ebola viruses lacking resources was considered. As a result, the lack of resources in combating Marburg and Ebola created a research gap on how the available resources can be used effectively to combat all pandemics without withdrawing attention from any specific outbreak. With knowledge of how to effectively and efficiently allocate resources, mitigating any imminent pandemic will be easy as countries will be prepared to handle any disease outbreak sufficiently.

Search Methods for Identifying Relevant Studies

The research included using key terms like the COVID-19 pandemic, Ebola virus, and Marburg virus. Additionally, the challenges faced in curbing Ebola and Marburg viruses were considered, ensuring that only the required articles would be included in the research. A variety of databases were used in the research study, including the Open Library, Digi library, Science direct, the United Nations (UN) website, Publication Med, Google Scholar, and World public library.

Study Selection

The study selection section was introduced to ensure that the range of selected materials over the search activity is limited. After the search refining process, 150 articles were identified. Five more sources were found in the school library, leading to a total of 155 articles. 10 articles were then eliminated since they were duplicates, making a total of 145 articles. The articles were later screened, leading to the exclusion of 100 articles. The 45 articles remaining were assessed for eligibility, where the abstracts were checked, removing 30 articles, and remained with 15 articles.

Inclusion and Exclusion Criteria

The inclusion and exclusion criteria ensured that the materials researched met the set criteria. Only articles that provided information on the Ebola virus, Marburg virus, and COVID-19 pandemic, including the challenges or difficulties encountered while trying to curb any significant outbreaks. Moreover, articles that provided knowledge on the history and background of the three viruses were included as well. Research articles that did not include COVID-19, Marburg, or Ebola were removed. Furthermore, articles older than 10 years were excluded from the research. Additionally, thesis statements, as well as dissertation papers, were excluded from the research study.

Figure 1.0: PRISMA flow diagram for the scoping review process

Charting the Data, Collating, Summarizing

The table below portrays various researchers aims, concepts, and findings regarding the impact of resources on curbing Ebola, Marburg, or COVID-19. It shows how resource diversification and limited resources have led to challenges in reducing the spread of Marburg and Ebola. Therefore, inadequate resources are a risk factor in curbing Ebola and Marburg.

Table 1: Literature review findings

Author(s)	Location	Aims	Methodology	Key terms and concept	Findings
Abayomi et al. (2021)	Nigeria	To describe how the gained experience and lessons as a result of the 2014 Ebola outbreak helped inform the state of Nigeria on emergency preparedness before COVID-19.	N/A	COVID-19, disease outbreak, emergency preparedness, epidemic response.	Lagos State had steadily prepared the healthcare system using the experiences gained from the Ebola Outbreak in 2014, enabling the state to effectively deal with the COVID-19 pandemic.
Aborode et al. (2021)	Republic of Guinea	To discuss the Republic of Guineas response to the Ebola Virus Disease (EVD) outbreak in the middle of the COVID-19 pandemic as well as to expound on the priorities and difficulties encountered.	N/A	Ebola outbreak, COVID-19 pandemic, management and control.	The standard operating procedures that worked to provide guidelines for the 2016-1016 Ebola outbreak were reassigned or redirected to COVID-19.
Buseh, Stevens, Bromberg & Kelber (2014)	West Africa	To examine the economic and sociopolitical conditions that made it easy for the Ebola epidemic to take place and discover opportunities for and difficulties encountered in the control and prevention of the virus as well as its future outbreaks in west Africa.	Literature review	Ebola outbreaks and lack of health care systems.	When an outbreak attacks developing countries, they are unlikely to have sufficiently resourced and staffed health care amenities that can tackle the spread of the virus and control or manage individuals that have already acquired it.
Christie, Neatherlin, Nichol, Beach & Redfield (2020)	Democratic Republic of Congo (DRC)	N/A	N/A	Ebola and COVID outbreak, attention, and resources	Missed cases of Ebola and the realization of its 10^thoutbreak resulted and amplified due to the lack of attention as it was directed to the COVID-19 pandemic.
Idowu, Okafor, Oridota, & Okwor (2020)	Nigeria	To evaluate the perception, knowledge, beliefs, and preventive measures among rural community residents in Ogun State, Southwest Nigeria.	Quantitative and qualitative	Ebola epidemic and knowledge on the rural community.	The knowledge of EVD was poor due to many misconceptions. Additionally, society was not proactive in prevention measures that had severe consequences during an outbreak.
Lawrence et al. (2022)	West Africa	The resercah purpose is to investigate the history, origin, efforts, challenges, and transmission of Marburg during the COVID-19 pandemic. Furthermore, it explores the provided recommendation that will help tackle future pandemics.	Literature review	Ebola, Marburg, and COVID_19 outbreaks	Ebola and Marburg virus have the ability to significantly alter the health systems of African countries since they are from the same regions whose system are facing enormous challenges. This implies that the system placed to curb other infections may fail.
Khan et al. (2021)	Democratic Republic of Congo	To evaluate the efforts, possible solutions, and challenges to tackle the Ebola outbreak in the middle of the COVID-19 pandemic in the Democratic Republic of Congo.	N/A	Ebola, COVID-19, and lack of resources.	Improving communication with the population and giving correct information is essential since previous outbreaks indicated the importance of using social mobilization in reducing EVD transmission.
Mbiguino et al. (2020)	N/A	N/A	N/A	Ebola, Marburg, epidemiology, pathology, and response resources.	Regardless of vaccines and advances in therapeutics, challenges still exist. The viral target is one of them that is drugs and vaccines concentrated on one viral species among the existing eight variants.
Nachega et al. (2020)	Democratic Republic of the Congo (DRC)	N/A	N/A	Ebola, COVID-19, and mitigation resources and interventions.	The early COVID-19 pandemic mitigation intervention of the DRC enabled the multi-sectoral committee to have sufficient time and be prepared for the expected COVID-19 rise.
Okonji (2021)	Republic of Guinea	To evaluate the available evidence on the MVD epidemic in Guinea in the middle of the COVID-19 outbreak. Moreover, the article points out the difficulties and efforts made to mitigate both viruses.	N/A	Marburg disease, COVID-19 outbreak, and inadequate primary health care resources	Shortage of ambulance services and transportation, together with lack of access to primary health care services, is among the most vital difficulties faced by countries in the West African region in the mitigation of the MVD epidemic.
Uwishema et al. (2021)	Africa	To highlight how the coronavirus and the already existing viral diseases affected the continent and finally give recommendations.	N/A	COVID-19, viral infections, and limited resources.	The COVID-19 pandemic has increased the difficulty accessing health care services, testing, vaccination measures, treatments, as well as the surveillance of other infectious diseases. The limited available resources and healthcare workers were directed to combat the new pandemic.
Schneider, Eger, Bruder, Faust, & Wieler (2021)	N/A	To establish the possible consequence of pandemic-induced worries on public support for the regulating role of moral considerations in addition to development assistance and trust in government.	Quantitative methodology	COVID-19, global solidarity, trust in government, and public opinion.	The COVID-19 pandemic impacts both developing and developed nations and necessitates global solidarity and cooperation in development assistance form. Additionally, there is a positive correlation between development support and trust in government for assistance in the development and give unsure support for an association between health-related worries.
Zagefka (2021)	N/A	To examine the motivation behind people donating money to aid others from the effects of the COVID-19 pandemic, including the national outgroup and in-group members.	Quantitative methodology	COVID-19, national and global solidarity	Global solidarity in the sense of a universal common fate and identifying with the human race positively impacts helping across and within-group boundaries. Conversely, an emphasis on national solidarity has negative results or effects on prosocial tendencies concerning outgroup members
Kebenei & Okoth (2021)	N/A	The article is focused on the sustainability, availability, and significance of current advances in therapeutic options, diagnostics, and vaccines for EVD and the necessity to establish antiviral therapies as well as novel vaccines that can work effectively on all Ebola virus variants or species.	N/A	Ebola virus, vaccines, and availability of resources	Inadequate diagnostic tools are a setback to the early diagnosis, isolation, and management of the virus. Additionally, the non-specificity of symptoms portrayed in Ebola disease infection early stages also adds a burden to its management.

Reporting the Results

The universe is afflicted with reemerging and new outbreaks of viral diseases, as has been proven by the emergence of COVID-19, which has led to the re-emergence of other diseases such as Ebola and Marburg in countries like DRC, Guinea, and Nigeria. The main challenge in combating these outbreaks is poor public health infrastructure and the lack of adequate access to health care resources, such as inadequate health institutions and human resources (Buseh et al., 2014). The lack of health resources was mainly due to a lack of financial assets that could have helped better the health care services.

Access to basic health care services was a major challenge to maintaining good health in Africa even before the Ebola virus and Marburg virus struck. As a result, many countries were not prepared to deal with such virus outbreaks as the resources were lacking (Christie et al., 2020). Additionally, the emergence of the COVID-19 pandemic contributed to the lack of resources in combating other diseases because the attention and available resources were directed to the pandemic (Uwishema et al., 2021; Lawrence et al., 2022). Moreover, COVID-19 got the upper hand because countries previously affected by Ebola and Marburg viruses used their previous placed interventions and insights to curb the pandemic (Abayomi et al., 2021; Afolabi et al., 2020). Thus, these countries were efficiently prepared and capable of handling a virus outbreak if one occurred, making it easy for them to get COVID-19 under control.

Misinformation is another challenge that increases the spread of Marburg and Ebola viruses. This mostly happened when countries used social media and mainstream to create awareness or communicate vital information about the viruses. Additionally, misinformation occurred following the lack of qualified medical personnel that could provide accurate information on how the viruses spread and the actions to be taken if first symptoms were observed (Idowu et al., 2020; Khan et al., 2021). As a result, the information that was mostly circulating was mainly misleading and unreliable in ensuring that infected individuals would seek medical services or follow virus protocol to combat the spread of the outbreak (Muzembo et al., 2022). Therefore, distrust continued to grow between the community and medics, meaning that admissions would decrease, making it difficult to reach all the infected individuals.

Another challenge faced in combating Marburg and Ebola virus is the inaccessibility or unavailability of vaccines. Vaccines play a critical role in building body immunity to Ebola, Marburg, and COVID-19. With COVID-19, many countries were able to receive its vaccine worldwide. Additionally, the COVID-19 vaccines produced can deal with different strains (Mouffak et al., 2021). However, the available vaccines for Ebola were only for one strain and could not work for the rest of the disease variants (Ndjoyi-Mbiguino et al., 2019). This largely contributed to the lack of qualified and competent staff to carry out vaccine research (Okonji et al., 2021). As a result, a lack of appropriate and enough vaccines can be considered a lack of medical care resources, leading to increased transmission and fatality rates.

Moreover, the lack of global solidarity has resulted in inefficient resources used to combat Marburg and Ebola viruses. Compared to Marburg and Ebola viruses which affect only a few parts of the world, COVID-19 is a global problem since it affects both developing and developed countries. Due to this, all nations around the world cooperated to curb and manage the spread of the virus (Zagefka, 2021). For instance, achieving equitable COVID-19 vaccine distribution is one way of showing how the countries cooperated in allocating and sharing health care resources necessary for the fight against COVID-19 (Schneider et al., 2020). Conversely, this has not been the case with Marburg and Ebola viruses since governments have failed to recognize the global need to eradicate the outbreaks.

Analysis

Findings

The emergence of the COVID-19 pandemic has contributed to the lack of resources in combating the Marburg virus and Ebola virus. This has caused the rise in Ebola and Marburg virus cases. Some of the most affected countries include Guinea, DRC, and Nigeria. This lack of health care resources in poor surveillance, diagnosis, and treatment options led to the surge of infected cases (Okonji et al., 2021; Kebenei & Okoth, 2021; Undurraga et al., 2017). This is because the health care systems were overloaded with increased patient workload and negatively impacted patient care, which then caused the re-emergence of Marburg and Ebola viruses (Aborode et al., 2021). Additionally, COVID-19 received worldwide attention, which paved the way for the availability of resources since nations were willing to share to manage and put an end to the pandemic due to its enormous fatality rates that affect the whole world large (Tuite et al., 2019). Moreover, the outbreak was easy to handle in Ebola or Marburg-affected countries as they used their previous intervention to curb COVID-19, hence were better prepared for this occasion.

The lack of appropriate and adequate vaccines has also resulted from the lack of access to proper health care resources. With a lack of vaccines and special attention, it is nearly impossible for another virus outbreak not to occur (Nachega et al., 2020; Aborode et al., 2021). Qualified staff is essential in ensuring the development of vaccines that gives the upper advantage in the fight against epidemics like Marburg and Ebola disease infections (Ndjoyi-Mbiguino et al., 2019). Misinformation is another difficulty that has emerged due to the lack of resources, especially competent and qualified staff (Loignon et al., 2018; Shoman et al., 2017). This is because infected persons would lack the correct information on the steps to be taken in a virus outbreak

Inadequate resources in the fight against Ebola and Marburg Viruses have been contributed mainly by a lack of global cooperation and unity or solidarity. This follows that Ebola and Marburg viruses most affected developing countries, meaning their healthcare systems are already strained, making it difficult to fight the virus without support (Kobayashi et al., 2020). However, COVID-19 received worldwide attention, and all nations worked in unison by sharing their resources to stop the spread of the deadly virus (Zagefka, 2021). With the available resources and vaccines shared, it became easy to prevent the spread of COVID-19.

Differences

The main difference between efforts in combating COVID-19 has vaccines that can inhibit the spread of the virus across all viral strains. This is because Marburg and Ebola lacked the appropriate resources that could aid in the search for working vaccines across all stains (Ndjoyi-Mbiguino et al., 2019). Another difference is that, unlike Marburg and Ebola virus, COVID-19 does not affect only a few parts of the world. As a result, the pandemic received maximum universal attention, which paved the way for the availability of resources. The attention directed to COVID-19 was accompanied by universal solidarity because the virus was considered a global pandemic different from Marburg and Ebola infections that only affect a few countries.

Advances

COVID-19 has had successful outcomes in the search for vaccines that work across all variants. This is after the US Food and Drug Administration (FDA) approved the administration of Moderna, Pfizer-BioNTech, and Janssen COVID-19 vaccines. There has also been an FDA-approved medication for a specific type of Ebola virus, the Zaire ebolavirus (EBOV), with a combination of one monoclonal antibody medication (Ebanga) and three monoclonal antibodies (Inmazeb).

Gaps

There are significant challenges in lack of health care resources or insufficient health care systems. This makes it difficult to fight off multiple diseases or infections, especially with Marburg and Ebola viruses, without losing attention to one that might get out of control and cause an increase in fatalities cases. The lack of effective infection control and prevention measures creates gaps in response aptitude that necessitate urgent attention in outbreaks.

Limitations

The most significant limitation in the research lies in the methodology used. This is because it is solely based on the literature review. In addition, there is a lack of articles that have focused on the Marburg virus hence the provided information cannot be reliable since it is lacking.

Conclusion

Solutions

Ebola and Marburg viruses require further research in identifying treatments for all variants, starting with having adequate, qualified, and staffing competent with advanced medical systems. All this can be made possible if the countries collaborate universally in sharing their resources in the fight against these viruses. Access to adequate resources will ensure that optimum is placed on the virus infections to control or manage future outbreaks.

Implications

The research findings play a vital role in providing essential data and information on the importance of having adequate resources, especially when dealing with viral and infectious diseases, including the Marburg virus, Ebola virus, and COVID-19. The results suggest that lack of resources limits the diagnosis, treatment, prevention, and containment of viral infection, which can lead to heightened case fatalities.

Significance

The result of the study has indicated or shown the importance of having adequate and efficient health care systems in the effort to combat the Marburg and Ebola viruses. The research has also shown that resources can be easily accessed if countries can work in unison against the spread of these viruses.

Recommendations

Contact tracing or surveillance should be invested in and given maximum attention to limit the spread of Ebola and Marburg viruses. Moreover, governments should ensure that the health care system is adequately equipped with facilities that can help trace and isolate cases to prevent the spread of the viruses which in turn result in increased fatality. Additionally, countries with inadequate health care systems should request support from the international community or multilateral organizations such as the World bank or the WHO to provide them with the required resources to curb the diseases. Healthcare systems should be equipped with qualified staff to help create awareness and circulate accurate information on the viruses to prevent misinformation. Moreover, scientific communication and community engagement which will help bring in the infected individuals and follow the restrictive measures set by the public health department.

References

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Schneider, S. H., Eger,

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