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Coronavirus: Are African countries ready? Coronavirus: Could Africa cope with an outbreak?
(21 days later)
Egypt has confirmed its first case of the new coronavirus - heralding its entry into Africa, a continent with increasingly close ties to China where the virus originated. Africa now has more than 30 cases of the new coronavirus, ranging from Egypt to South Africa - including Nigeria, the continent's most-populous country - although it has so far been spared a major outbreak.
The World Health Organization (WHO) has already declared the coronavirus outbreak a global health emergency - largely because of fears that poorer countries may not be able to cope with an outbreak. The continent has close links to China, where the infection originated in late December, but the cases in Africa have all so far been linked to Europe.
"The main reason for this declaration is not what is happening in China but what is happening in other countries. Our greatest concern is the potential for the virus to spread to countries with weaker health systems," said WHO chief Tedros Adhanom Ghebreyesus, who is from Ethiopia. They have mushroomed in the last week, which is of particular concern as it is feared that poorer countries on the continent may struggle to cope if it does spread.
The health systems in many African countries are already struggling with the existing workload, so can they deal with another outbreak of a highly infectious disease? The World Health Organization (WHO) admitted as much when it declared the coronavirus outbreak a global health emergency earlier in February.
Michael Yao, WHO's head of emergency operations in Africa, notes that some countries on the continent "have the minimum to start with - they're not starting from scratch". "Our greatest concern is the potential for the virus to spread to countries with weaker health systems," said WHO chief Tedros Adhanom Ghebreyesus, who is from Ethiopia, said at the time.
"We know how fragile the health system is on the African continent and these systems are already overwhelmed by many ongoing disease outbreaks, so for us it is critical to detect earlier so that we can prevent the spread." So far Algeria, Cameroon, Egypt, Morocco, Nigeria, Senegal, South Africa, Togo and Tunisia have reported cases.
What facilities are there at the moment to treat it? As Michael Yao, WHO's head of emergency operations in Africa, has noted - because the continent's health systems "are already overwhelmed by many ongoing disease outbreaks" early detection is vital.
Until early this week, there were only two laboratories in Africa - one in Senegal and the other in South Africa - which had the reagents needed to test samples. They have been working as referral laboratories for countries around the region. "We're advising countries to at least detect cases early to avoid spreading the new virus within the community - that will be difficult to manage," he said.
One of the laboratories, Institut Pasteur de Dakar, in Senegal has long been on the front line in medical innovation in Africa, including in yellow fever research. Is this possible?
However this week Ghana, Madagascar, Nigeria and Sierra Leone have announced they can also conduct tests. The continent has benefitted from the fairly slow arrival of the virus to Africa - giving its 54 countries a window to set up testing and treatment capabilities.
The WHO is also sending kits to 29 laboratories on the continent to ensure they have the capacity to deal with the virus and also help test samples from other countries if needed. Coronavirus tests should be ready "within a couple of weeks" across all African nations, according to the World Health Organization.
However it's hoped that by later this month at least 36 African countries will be equipped to carry out tests specific to the coronavirus. Currently 33 of 47 sub-Saharan African countries have testing facilities, up from only two in January (in South Africa and Senegal).
The ability of African nations to properly diagnose cases "depends on the new reagents being made available from China and Europe," says Dr Yao. In Nigeria - with one confirmed case - its Centre for Disease Control (NCDC) is publishing daily reports with updates on cases and any ongoing contact tracing. It has a free phone number and WhatsApp number for enquires and advice.
The Nigerian Red Cross Society says it has placed one million volunteers on alert. Its Secretary General Abubakar Ahmed Kende said the measure was to prevent the possible spread of the virus into the country and also contain the spiralling outbreak of Lassa fever across the country. South Africa's National Institute for Communicable Diseases also has a toll-free number.
In Tanzania, Health Minister Ummy Mwalimu announced that isolation centres in the north, east and west of the country had been identified. Thermometers have been stockpiled and more than 2,000 health workers have been trained. East Africa has no confirmed cases yet, although several people have been put in quarantine as a precaution.
Several countries including Kenya, Ethiopia, Ivory Coast, Ghana and Botswana have dealt with suspected cases, placing them in quarantine while tests were carried out. So far, all have tested negative for the virus. In Kenya, the government has just opened a quarantine centre in the capital, Nairobi, for suspected cases.
Uganda's health ministry confirmed it had quarantined more than 100 people who have arrived at Entebbe International Airport. Some of the people have been quarantined at two hospitals in Entebbe and Kampala, while others have been asked to stay in their homes. In Tanzania, the health minister announced that isolation centres in the north, east and west of the country had been identified. Thermometers have been stockpiled and more than 2,000 health workers trained.
Last month, Uganda opted for regulated self-isolation at home for a number of passengers that needed to be quarantined on arrival at Entebbe airport.
What about travel?
Airports across the continent are testing passengers' temperatures on arrival - and quarantining any suspected cases of the new coronavirus strain that causes Covid-19.
Many countries have stopped flights to China, which has close trade links with the continent.
China is Africa's biggest trade partner and around 10,000 Chinese firms are currently operating throughout the continent. According to Chinese state media, more than one million Chinese nationals live in African countries.
It is estimated that African airlines have lost $400m (£312m) since the outbreak began with airlines like South African Airways, Royal Air Maroc, Air Tanzania, Air Mauritius, EgyptAir, RwandAir and Kenya Airways all suspending flights to and from China.
As all the cases detected so far originated in Europe, routes to Europe are likely to be affected soon and Kenya, for example, has also stopped flights to northern Italy, Iran and South Korea.
The East African nation, which hosts many international conferences, has also banned such meetings for the next month.
Have any lessons been learned from Ebola?Have any lessons been learned from Ebola?
Dr Yao was involved in dealing with the outbreaks of Ebola in West Africa in 2014-2016 and more recently in the east of the Democratic Republic of Congo. He said he was concerned that there was not enough capacity to treat critical cases of coronavirus.Dr Yao was involved in dealing with the outbreaks of Ebola in West Africa in 2014-2016 and more recently in the east of the Democratic Republic of Congo. He said he was concerned that there was not enough capacity to treat critical cases of coronavirus.
"We're advising countries to at least detect cases early to avoid spreading the new virus within the community - that will be difficult to manage," he says. Countries that dealt with the Ebola outbreak still have the isolation facilities and expertise in controlling infectious diseases.
On a positive note, many African countries were already screening passengers arriving at their ports of entry for Ebola. Countries that dealt with the Ebola outbreak still have the isolation facilities and expertise in controlling infectious diseases. But when it comes to detection, Ebola is different to the coronavirus.
But when it comes to detection, Ebola is different to the coronavirus. Ebola only became infectious when symptoms showed however there have been reports that in some cases, the coronavirus may have been transmitted before patients were showing symptoms. Ebola only became infectious when symptoms showed, however there have been reports that in some cases, the coronavirus may have been transmitted before patients showed symptoms.
Learn more about the new virus In fact, it is not yet known exactly how the coronavirus spreads from person to person. However, similar viruses are spread via respiratory droplets, such as those produced when an infected person coughs or sneezes.
What about travel between the continent and China? Plus, with richer, more developed nations also battling the new coronavirus, they may not be quick to turn their focus and assist Africa.
Increasingly close trade links between China and African countries have heightened concerns that the virus could spread. Why HIV could be a problem
China is Africa's biggest trade partner and around 10,000 Chinese firms are currently operating throughout the continent. According to Chinese state media, more than one million Chinese nationals live in African countries. South Africa, the continent's most developed economy, is arguably most able to deal with an outbreak.
There are also more than 80,000 African students in China, often attracted by government scholarships, reports the Guardian. A 21-year-old student from Cameroon was reported to have contracted the virus after a trip to Wuhan and is being treated in hospital. But there are particular concerns related to the country's long-running HIV epidemic - the worst in the world.
Chinese students are also travelling to the continent, attracted again by government scholarships. More than seven million people in South Africa live with a virus that seriously weakens immune systems, leaving many people potentially more vulnerable to Covid-19.
'Thousands of African students stranded in coronavirus province'
Danny Vincent, BBC News, Hong Kong
Students like Zambian Tisiliyani Salima have been in self-imposed quarantine for more than two weeks.
Every morning she wakes up to news of scores of more deaths and thousands of new cases of infections in Wuhan.
Despite the draconian measures taken across the city, there is little sign that the spread of the infection is slowing.
The argument that China is better equipped to deal with the outbreak of the coronavirus than African student's home nations does little to calm the anxieties of many of the African students living in the surrounding province, Hubei.
There are thought to be thousands of Africans living across the province where the virus originated.
Students from Nigeria, Zambia, Tanzania, Cameroon and Ivory Coast are starting to lose hope that their governments will listen to their calls to be evacuated.
As trade links continue to increase, so does the volume of traffic between the continent and China. The number of passengers is now a concern.
Dr John Nkengasong, director of the Africa Centres for Disease Control and Prevention, wrote in the journal Nature that the rapid spread of the coronavirus in Asia as a result of air traffic and vast population movements, should be of significance in Africa.
The 2002 outbreak of the Severe Acute Respiratory Syndrome (Sars) largely spared the continent with only one imported case reported in South Africa "but air traffic between China and Africa has risen by over 600% in the past decade as a result of the rapid expansion of Chinese investment in Africa", he writes.
Many airlines across the world have suspended flights to and from China. In response, airlines in Africa have been under intense public pressure to halt flights. The airlines of Egypt, Kenya, Morocco and Rwanda have halted flights but the continent's biggest airline - Ethiopian Airlines - has carried on with operations.
The WHO has advised against travel restrictions and instead identified 13 top priority countries in Africa, which because of their direct links or high volume of travel to China need to be particularly vigilant. It plans to have support staff in all 13 countries by the end of the week.
"A new and unknown virus is often scary and many people are worried," says Dr Matshidiso Moeti, WHO's regional head for Africa. "But all efforts to combat the novel coronavirus must be based on sound science."
WHO's top priority countries in Africa: