- After the announcement last Friday of a first case of coronavirus on the African continent, the WHO, African governments and experts are examining the effects that an epidemic could have in these developing countries.
- Limiting transmission would be a first bet in countries where health infrastructures are very limited.
- And if it were necessary to confine and treat thousands of patients, these territories, which are already fighting against other deadly diseases, would experience great difficulties.
What if the danger for the coronavirus was not limited to China, but risked to increase in magnitude if the disease landed in Africa? Since the first case on the African continent was announced on February 14, world health authorities have worried about the ability of African countries to cope with a possible epidemic.
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What do we know about this first African case?
The Egyptian Minister of Health announced Friday, February 14, that a patient, the first infected with Covid-19 from the African continent, has been transferred to the hospital and placed in quarantine for treatment. The Centers for Disease Control and Prevention (CDC) dedicated to Africa later clarified that it was a 33-year-old man, who is not of Egyptian origin and had no symptoms . The 17 people with whom he was in contact have been tested and are not infected with this coronavirus, but are kept in quarantine at home.
As of Friday, West African health ministers decided in Bamako (Mali) to strengthen cooperation between their countries to deal with the new coronavirus.
Important ties to China
The first reason for the concern is that many African countries welcome Chinese nationals. As of Friday, January 31, WHO had released a list of thirteen African countries that drew its attention, both to increase prevention efforts and to receive aid, based on the volume of trips from China : South Africa, Algeria, Angola, Ivory Coast, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, Uganda, Democratic Republic of the Congo, Tanzania and Zambia.
"But many of the Chinese concerned have lived in these African countries for a long time, and very few of them have traveled to Hubei province [the epicenter of the epidemic]", says Frédéric Tangy, a researcher at the Pasteur Institute. This trend should not change, given that the Chinese region has been confined for weeks. This is not without consequences for the economies of these emerging countries, including tourism, industry, trade increasingly depend on the Chinese giant ...
First challenge: detection
No other cases have been confirmed in the rest of Africa since. Difficult, however, to say that this absence is not due to a lack of means to detect the sick. "We cannot assure today that there is no such virus in other African countries," says Ghassan Abou Chaar, deputy emergency manager of Doctors Without Borders (MSF). Especially since the symptoms can be mild, they can be confused with the symptoms of the flu or a simple death. And that not all countries benefit from laboratories capable of analyzing the tests.
“MSF teams, present in some of the African countries, promote the ability to take a patient, test on the spot or send this sample to another country which has a laboratory capable of analyzing it. Little by little, governments, the World Health Organization (WHO) and the Africa CDC are making machines available to carry out these tests in laboratories. »What precautionary measures have been taken? Some airports have suspended flights to China, notably to Egypt, and health facilities are sorting at the entrance…
Deficient health structures
If a case was detected in a sub-Saharan African country, the challenge would be to limit transmission. "However, these populations very rarely consult a doctor and find it difficult to get to a hospital," notes Frédéric Tangy. And it is this second component of the hypothetical coronavirus equation in Africa that is of more concern: the health structures of some of these very poor countries do not have the means to limit the transmission of the epidemic. "The situation would depend on many variables: the patient's condition, where he is detected and the capacity of this area to manage the situation," said Ghassan Abou Chaar, of MSF. Hospitals should then be prepared to screen, test and treat these patients. "
Some of these countries do not just lack hospital beds or doctors. "In some areas, there is no sewer, no electricity, no roads, no drinking water," says the researcher. Imagine confinement when in some hospitals, patients sleep under sheet metal roofs, without doors, where all kinds of insects can enter, it's complicated… ”
"In Africa, we die from measles"
Especially since the health infrastructures are already saturated by other epidemics. Malaria, cholera, yellow fever, Ebola virus, AIDS cause hundreds of thousands of deaths every year. "In Africa, we still die from measles today, while in other countries, this disease was eradicated thanks to the vaccine, recalls Frédéric Tangy If we are not able to suppress this disease, you can imagine that it is difficult to manage an epidemic like this coronavirus! Pneumonia that kills 2.5% of patients, when we know that Ebola has a mortality rate of 55%, I am not even sure that we notice it given the health challenges. "
Precisely, while some countries are still fighting against Ebola, what lessons can humanitarian workers learn from this fight to better contain an epidemic? "The existing healthcare system must be helped instead of creating parallel hospitals, and we must work with the populations to explain and put in place suitable restriction measures," says Ghassan Abou Chaar, of MSF. We have realized, in the Democratic Republic of Congo, that people are more willing to remain isolated and to receive treatment in the care structure of their neighborhood rather than in a large center created expressly. If many questions remain around this coronavirus and its potential arrival in Africa, there is no doubt that these countries would need colossal help to meet these challenges.
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