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ByMariaChengand Sarah Dilorenzo TheAssociatedPress LONDON As health offi- cials struggle to contain the world's biggest-ever Ebola outbreak, their efforts are being complicated by an- other problem: bad data. Having accurate num- bers about an outbreak is essential not only to pro- vide a realistic picture of the epidemic, but to deter- mine effective control strat- egies. Dr. Bruce Aylward, who is leading the World Health Organization's Eb- ola response, said it's cru- cial to track every single Eb- ola patient in West Africa to stop the outbreak and that serious gaps remain in their data. "As we move into the stage of hunting down the virus instead of just slow- ing the exponential growth, having good data is going to be at the heart of this," Aylward said. "We are not there yet and this is some- thing we definitely need to fix." "Decisions about preven- tion and treatment should be data-driven, but we re- ally don't have the data," agreed Irwin Redlener, di- rector of the National Cen- ter for Disaster Prepared- ness at Columbia Univer- sity. A week ago, the World Health Organization in- sisted at a media briefing it had mostly met targets to isolate 70 percent of Eb- ola patients and bury 70 percent of victims safely in Guinea, Liberia and Sierra Leone. But two days later, WHO backtracked and said that data inconsistencies meant they really didn't know how many patients were being isolated. Then the U.N. health agency also conceded that many of the safe burials were of people not actually killed by Ebola. Aylward said not know- ing exactly how many Eb- ola patients there are in hotspots like western Si- erra Leone means health officials might miss poten- tial contacts who could un- knowingly cause a surge of cases. Compared to other epidemics like malaria, which is more seasonal and can fade away without huge control efforts, ending the Ebola outbreak will require extraordinary attention to detail. "This outbreak started with one case and it will end with one case," Ayl- ward said. "If we can't get 100 percent of the con- tacts of cases, we will not be on track to shut it down. Unfortunately at the mo- ment, the data right now is not enough for us to get to zero." In West Africa, where health systems were al- ready broken before Ebola struck, collecting data amid a raging outbreak has been challenging. "Suddenly you have all these different sources of data that have to be compiled" from differ- ent aid agencies, said Ray Ransom, a data ex- pert at the U.S. Centers for Disease Control and Prevention. "The ability to actually collect information is a dif- ferent challenge than re- sponding to the outbreak, and the energy has been fo- cused on the response." He said local officials are good at tracking known or suspected Ebola cases and their contacts but not as re- liable relaying that informa- tion to national authorities. The software built to track Ebola outbreaks was initially designed by the CDC to have one person entering data into a com- puter. That "was perfectly fine since the dawn of time up until" the outbreak ex- ploded this summer, said Armand Sprecher, a public health specialist with Doc- tors Without Borders. The CDC has rede- signed the software so now multiple people can enter data, although that created new problems like possible duplication, Spre- cher said. When the epidemic starts to taper off, health officials should have more time to find every Ebola case and their contacts. But they may find they have to re-estab- lish trust with the commu- nity to do that. "If people were calling in cases for months and no one was coming ... and then suddenly that's no lon- ger a bottleneck, do people suddenly realize that and say, aha, if I call in today, it'll work this time?" asked Sprecher. "If you've lost the community, you don't get anywhere." VIRUS InEbolaoutbreak,baddataaddsanotherproblem THEASSOCIATEDPRESS A local resident awaits the landing of a British Navy helicopter as it drops food aid on Sherbro Island, Sierra Leone, on Sunday. By Kristen Wyatt The Associated Press DENVER Faith-based non- profit organizations that object to covering birth control in their employee health plans were in fed- eral court Monday to chal- lenge a birth-control com- promise they say still com- pels them to violate their religious beliefs. The plaintiffs include a group of Colorado nuns and four Christian colleges in Oklahoma. They are al- ready exempt from cover- ing contraceptives under the federal health care law. But they say the exemp- tion doesn't go far enough because they must sign away the coverage to an- other party, making them feel complicit in providing the contraceptives. The groups are appealing to the 10th Circuit in Den- ver, the court that ruled last year that for-profit compa- nies can join the exempted religious organizations and not provide the contracep- tives. The U.S. Supreme Court later agreed with the 10th Circuit in the case brought by the Hobby Lobby arts- and-crafts chain. The birth-control rule has been among the most divisive aspects of the health care overhaul. Some advocates for women praise the mandate, but some re- ligious groups have decried it as an attack on religious freedom. The Denver nuns, called the Little Sisters of the Poor, run more than two dozen nursing homes for impov- erished seniors. Last year the U.S. Supreme Court of- fered the nuns a short-term reprieve on the exemption pending their appeal. The government was to argue Monday that its 2013 rule on religious groups and contraceptives, which requires only that a reli- gious group sign "a self- certification form stating that it is an eligible orga- nization," does not make that religious group com- plicit in providing contra- ceptives. The rule "does not re- quire nonprofit religious or- ganizations with religious objections to contract, ar- range, pay, or refer for that coverage," lawyers for the federal government wrote in a 2013 filing. The nuns' lawyer, Mark Rienzi of the Becket Fund for Religious Liberty, said the government is free to provide contraception cov- erage on its own without needing any action at all by the religious institu- tions. The government, he said, simply wants such cov- erage to come through the institutions' own plans. "It's our plan, that's what they want to control," Rienzi said. "Millions of people around the world get con- traceptives with no nuns involved. It's almost laugh- able." Under the health care law, most health insurance plans have to cover all Food and Drug Administration- approved contraceptives as preventive care for women, free of cost to the patient. Churches and other houses of worship are ex- empt from the birth con- trol requirement, but affili- ated institutions that serve the general public are not. That includes charitable organizations, universities and hospitals. BIRTH CONTROL Religious nonprofits challenge health law in federal court THE ASSOCIATED PRESS Sister Mary Grace visits with a resident in the dining room at the Mullen Home for the Aged, run by Little Sisters of the Poor, in Denver, on Jan. 4. Little Sisters of the Poor is among the faith-based nonprofit organizations objecting to covering birth control in their employee health plans and were in federal court on Monday. By Kelli Kennedy The Associated Press MIAMI When Olivia Papa signed up for a new health plan last year, her insur- ance company assigned her to a primary care doc- tor. The relatively healthy 61-year-old didn't try to see the doctor until last month, when she and her husband both needed authorization to see separate specialists. She called the doctor's office several times with- out luck. "They told me that they were not on the plan, they were never on the plan and they'd been trying to get their name off the plan all year," said Papa, who re- cently bought a plan from a different insurance com- pany. It was no better with the next doctor she was as- signed. The Naples, Flor- ida, resident said she left a message to make an ap- pointment, "and they never called back." The Papas were among the 6.7 million people who gained insurance through the Affordable Care Act last year, flooding a pri- mary care system that is struggling to keep up with demand. A survey this year by The Physicians Founda- tion found that 81 percent of doctors describe them- selves as either over-ex- tended or at full capacity, and 44 percent said they planned to cut back on the number of patients they see, retire, work part-time or close their practice to new patients. At the same time, insur- ance companies have rou- tinely limited the number of doctors and providers on their plans as a way to cut costs. The result has further restricted some patients' ability to get appointments quickly. One purpose of the new health law was connecting patients, many of whom never had insurance before, with primary care doctors to prevent them from land- ing in the emergency room when they are sicker and their care is more expen- sive. Yet nearly 1 in 5 Amer- icans lives in a region desig- nated as having a shortage of primary care physicians, and the number of doctors entering the field isn't ex- pected to keep pace with demand. The Association of American Medical Col- leges projects the shortage will grow to about 66,000 in little more than a de- cade as fewer residency slots are available and as more medical students choose higher-paying spe- cialty areas. For now, experts say most patients are receiving the care they need, even if they have to drive farther, wait longer or see a nurse practi- tioner or physician assistant rather than a doctor. AFFORDABLE CARE ACT Health law impacts primary care doctor shortage ServingRedBlufffor30years Look to us for Expert Eye Care. Board Certified byAmerican Board of Ophthalmology Clinical Professor at UC Davis Medical Center Daniel M. 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