Scientists warn of potential calamity from novel coronavirus in African countries with strong links to Chinese investment and travel while ill-prepared to detect cases and limit transmission.
A new modelling study estimating preparedness, vulnerability and likelihood of importing the new virus, called COVID-19, that is raging in China, calls for an urgent priority for increased resources and surveillance on vulnerable African nations.
The first case of COVID-19 in Africa was confirmed in Egypt on Feb. 14. The patient is a foreign visitor.
Egypt, Algeria and South Africa were classified at the highest risk of importing COVID-19 from China by researchers. These countries, however, were also among the best prepared on the continent, reducing vulnerability.
Nigeria and Ethiopia were rated among the most vulnerable.
The findings are from a new virus modelling study published in The Lancet, a prestigious general medical journal.
Although travel from China to Africa is considerably lower than from China to Europe, the potential impact of the virus on the population could be particularly damaging, researchers said. (About one per cent of people leaving China have a destination in Africa compared to about 10 per cent who are destined for Europe.)
China has made massive investments in infrastructure projects including dams, railways, ports and telecommunications networks and a huge number of Chinese nationals have started businesses.
The economic activity has significantly boosted travel between China and many countries of Africa, the continent with the fastest growing population. In Europe, most cases of initial COVID-19 importations were Chinese tourists on vacation but researchers believe importation in Africa will more likely be through business travel given the strong commercial links.
There have been preparation.
“African countries have recently strengthened their preparedness to manage importations of COVID-19 cases, including airport surveillance, temperature screening at ports of entry, recommendations to avoid travel to China and improved health information,” said study author Dr Vittoria Colizza, of Inserm at Sorbonne Université, France, in a written release.
“However, some countries remain ill-equipped.”
Colizza said that although almost three-quarters of African countries have an influenza pandemic preparedness plan, most are outdated and considered inadequate to deal with a global pandemic.
Despite World Health Organization efforts to improve diagnostic capacity, some countries do not have the resources for quick testing, meaning that tests would need to be done in other countries, she said.
Increased resources are needed to speed test results, manage confirmed cases, trace contacts more rapidly and keep strict infection control measures.
“Equally, increasing the number of available beds and supplies in resource-limited countries is crucial in preparation for possible local transmission following importation,” said Colizza.
Egypt, Algeria and South Africa were at the highest risk of importing COVID-19 but had moderate to high preparedness and low vulnerability, the study says.
Nigeria and Ethiopia had moderate preparedness, high vulnerability and large populations.
Sudan, Angola, Tanzania, Ghana and Kenya had similar importation risk and population sizes but variable levels of preparedness and high vulnerability. Morocco had similar characteristics but designated low vulnerability.
Increasing the number of available beds and supplies in resource-limited countries is crucial in preparation for possible local transmission following importation
All other African countries had low to moderate importation risk with low to moderate vulnerability and mostly low preparedness, except for Tunisia and Rwanda, the study says.
The study was based only on air travel and did not account for sea travel between China and African countries, the authors said.
“Crisis management plans should be ready in each African country, and involvement of the international community should catalyze such preparedness,” said Colizza.
Algeria, Ethiopia, South Africa, and Nigeria were previously identified by the World Health Organization as being among the 13 top priority countries for coronavirus preparedness. The WHO was sending teams to all 13.
Until last week, only two laboratories in Africa, one in Senegal and the other in South Africa, could test COVID-19 samples, according to the WHO. Ghana, Madagascar, Nigeria and Sierra Leone have now reported COVID-19 testing capability.
The WHO said it was sending kits to 29 laboratories in Africa.
The patient in Egypt is recovering, WHO officials said.