New coronavirus: "We don't understand why there aren't more cases in Africa"

Text by: Aurore Lartigue Follow

While the epidemic has already left more than 2,800 people dead and more than 80,000 infected in around 40 countries, the African continent, which has so far only recorded three cases, seems surprisingly spared the virus.

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A specialist in infectious and tropical diseases, Pierre-Marie Girard is Director of International Affairs at the Institut Pasteur. He also coordinates the International Network of Pasteur Institutes, ten of which are located on the African continent.

As experts began to question the low number of cases detected on the continent, a first case of Covid-19 was confirmed in sub-Saharan Africa, in Nigeria. Why is Africa so little concerned at the moment?

Overall, we do not understand why there are not more cases in Africa . These three cases also appeared very late compared to the start of the epidemic. There are a certain number of hypotheses, notably of course that which consists in saying that there have been cases and that there are still others, and that we have missed out. You could say that a few weeks ago, but over time, it becomes more and more strange that the cases do not appear more clearly.

► See our infographic: The Covid-19 coronavirus in 7 points

What are the other hypotheses?

Other hypotheses have been mentioned. First, that few infected people have come to African soil. But this first hypothesis seems unlikely, knowing that it is estimated that one million Chinese live in Africa or make regular return trips between China and the continent, and given the population movements that there have been with the Chinese New Year celebration in early February. A second hypothesis consists in saying that the climate and tropical temperatures are not conducive to the virulence of the virus. Again, this is unlikely because in vitro , the virus multiplies very well in heat. Finally, third hypothesis: the idea of ​​a form of resistance to a genetic profile which would explain why people living in Africa are less susceptible to infection. Here too, it is not clear why. One can also imagine that there are very few serious forms or asymptomatic forms. In this case, since screening is not systematic, we could miss the epidemic for a long time.

Do you think that the number of cases will increase in the coming days?

I cannot say. Firstly, because neither in Egypt nor in Algeria did it snowball a priori. And then, because it's too early to know for the case of Lagos.

What do we know about the management of these three cases?

We only have bits of information and very little visibility on these cases. In Algeria , for example, we do not know if the investigative work, almost "police", was done to find people who have been in contact with the patient, especially since this work is not simple and that 'he asks for means. And we also don't know if other people linked to the patient have been tested.

WHO was worried a few days ago about the spread of the virus in countries with poor health systems. On the other hand, in Africa, the experience acquired with Ebola is sometimes invoked. Do you think it can indeed be used in the management of this new coronavirus?

At the international level, I think that the World Health Organization (WHO), which had totally missed the Ebola epidemic, has indeed learned the lessons. Although it took a little while to declare the coronavirus epidemic, they were much faster than for Ebola. At the country level, and undoubtedly, there has obviously been a lot of laboratory upgrades, training of technicians, and epidemic surveillance systems have been put in place. In addition, the ministries of health now have the obligation to apply the International Health Regulations (IHR), that is to say, to be able to trace epidemics early and to escalate cases, via the ministry. , at WHO level. But obviously, the continent started from far away.

Should we be worried about this case in Lagos?

What we know about this imported case [the patient returned from Italy, note], is that they were able to spot him very early and very early take very strong containment measures. Now that is official information, and here again we do not know exactly the level of precision of the investigation that was carried out around him. Statistically, we consider that only one index case [patient zero in the country, note] contaminates between two and three people, in the absence of barrier measures put in place. If you continue this little game, you quickly get to hundreds and thousands of people from a single case. Given the population density and the limited resources in a country like Nigeria, one must therefore be very vigilant anyway.

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• coronavirus
• Health and Medicine
• Nigeria
• Algeria
• Egypt
• WHO

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