To date, African nations have been spared an outbreak of the coronavirus that has posed a public health crisis, international transit nightmares and potential economic upheaval with the continent’s leading commercial partner.
If what has transpired in Wuhan, China, is any indication, an outbreak in Africa could be catastrophic.
Though new cases have been dwindling in China since the pneumonia-like symptoms were first reported just under two months ago, the toll has been devastating with 75,569 reported cases, resulting in 2,239 deaths, according to the World Health Organization.
The Corona Virus Disease—abbreviated COVID-19 by WHO—has now spread outside of China to 26 countries with 1,200 cases and eight deaths. On the continent, WHO has reported just one instance, which was in Egypt.
African health ministers and government officials are working to keep that number as a lone single digit.
“Our biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems,” WHO Director-General Dr. Tedros Ghebreyesus said in an emergency ministerial meeting yesterday with authorities from the African Union and the Africa Centres for Disease Control and Prevention.
“Several African countries have tested suspected cases of COVID-19, but fortunately they have been found negative,” Dr. Ghebreyesus said. “We’re working hard to prepare countries in Africa for the potential arrival of the virus.”
High Risk Nations
Ever-expansive economic ties between China and Africa could now be cause to sound public health alarms.
China has been Africa’s largest trading partner, and more than 2,500 Chinese companies have been established in more than 50 African countries, according to a 2015 World Bank report. Also, Africa has emerged as China's second largest market for overseas contracting, the report stated.
Because of their direct links or high volume of travel to China, there were 13 nations WHO identified last month as being high priority countries: Algeria, Angola, Cote d’Ivoire, The Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda and Zambia.
A modeling study published Thursday in The Lancet medical journal examined the “Preparedness and Vulnerability of African Countries Against Importations of COVID-19” by Marius Gilbert, et al.
A team of researchers determined the capacity of various countries to detect and respond to cases by using WHO guidelines to measure preparedness and the Infectious Disease Vulnerability Index to measure vulnerability.
Egypt, Algeria, and South Africa were identified by the researchers to have the highest importation risk and moderate to high capacity to respond to outbreaks. The study designated Nigeria, Ethiopia, the Sudan, Angola, Tanzania, Ghana and Kenya as moderate risk countries with a variable capacity and high vulnerability.
“We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country,” wrote the researchers.
Borders of Defense
Last week, WHO's Regional Office for Africa reported that 24 countries across the continent have confirmed that they are ready to test for potential COVID-19 cases.
Several WHO reports have been touting the efficacy of the infrastructure left in place after the recent Ebola outbreak, allowing experts to better diagnose, isolate and treat COVID-19.
For months, WHO reported, those leaving the Democratic Republic of the Congo have been checked for early signs of Ebola; now those entering the country are being checked for signs of the coronavirus.
“This is a great example of how investing in health systems can pay dividends for health security,” said Dr. Ghebreyesus.
In the Congo, Kinshasa International Airport is testing its readiness for handling a suspected case with simulation exercises. Kinshasa International is one of four airports, along with three ports and strategic border crossings where COVID-19 screenings have been established.
If any person is suspected of having the coronavirus, they are transported from an isolation tent by an ambulance to the nearest treatment center. A swab is taken from the nose or throat and forwarded to a testing laboratory. The clinical samples are taken to the National Institute of Biomedical Research in Kinshasa.
About 11,000 health workers on the continent have been trained using WHO’s free online courses on COVID-19 at OpenWHO.org. And more than 30,000 sets of personal protective equipment have already been distributed to some nations across the continent, and the number of shipments will double in the coming weeks, Dr. Ghebreyesus told authorities during the briefing.
A Strategic Preparedness and Response Plan, he added, has been published with a call for $675 million to support countries that are most vulnerable.
A Fighting Chance
“With every day that passes, we know a little bit more about this virus, and the disease it causes,” said Dr. Ghebreyesus. “We know that more than 80% of patients have mild disease and will recover.”
The other 20% of patients can have symptoms ranging from shortness of breath, septic shock to multi-organ failure, he warned. “These patients require intensive care, using equipment such as respiratory support machines that are in short supply in many African countries. And that’s a cause for concern.”
Fatalities occur in 2% of reported cases, Dr. Ghebreyesus said, adding that the risk is greater among elderly patients and those with underlying health conditions.
“We are calling on all countries to invest urgently in preparedness. We have to take advantage of the window of opportunity we have to attack the virus outbreak with a sense of urgency,” said Dr. Ghebreyesus.
He signed off the meeting by expressing WHO's commitment to preventing the transmission in all African countries and detecting and treating cases as early as possible.
WHO offered these tips to prevent transmission of COVID-19:
- Wash your hands with soap and water or alcohol
- Cough and sneeze in a tissue or your flexed elbow
- Keep a meter distance from people, especially if they're sick
- Don't touch your eyes, nose and mouth
- Avoid raw or undercooked animal products
- Practice extreme caution when visiting animal markets