No confirmed case on the continent yet but fears grow the deadly disease will reach countries with weak health systems.
Countries across Africa are ramping up measures to prevent an outbreak of a new coronavirus that has killed more than 250 in China and spread to several Asian countries, and as far afield as the United States, Europe and Australia.
As scientists race to find a vaccine, the World Health Organization (WHO) on Thursday declared a public health emergency of international concern amid rising fears the virus could reach countries with weak healthcare systems.
In Africa, where past viral outbreaks have stretched already-strained healthcare systems in a number of countries, there have been no confirmed cases to date – but several countries have reported suspected cases of the rapidly spreading disease that originated in the central Chinese city of Wuhan late last year.
Amid the mounting concerns, medical experts appear certain that the deadly virus will also infect people on the continent, pointing to the deepening trade and travel ties between China and Africa that has seen many countries on the continent become popular tourist, business and investment destinations for the Chinese.
“We can be very certain that coronavirus will be exported to Africa,” said Ngozi Erondu, associate fellow of the Global Health Programme at Chatham House.
“There is a large amount of travel between China and Africa; hubs such as Addis Ababa, Cairo and Nairobi are at particular risks due to the large amount of Chinese travellers that pass through these airports.”
Speaking at the African Union headquarters on Tuesday, John Nkengasong, director of the Africa Centres for Disease Control and Prevention (Africa CDC), said the institution was working closely with their Chinese counterparts, adding that, “We in Africa are watching the situation and also preparing ourselves to deal with any outbreak or cases.”
Three days later, the WHO announced it would be scaling up preparedness in Africa, particularly in 13 top priority countries: Algeria, Angola, Ivory Coast, the Democratic Republic of the Congo (DRC), Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda and Zambia.
Authorities in most of these countries have set up active screening at airports, it said, calling on governments to “step up their readiness”.
“The quicker countries can detect cases, the faster they will be able to contain an outbreak and ensure the novel coronavirus does not overwhelm health systems,” said Matshidiso Moeti, WHO regional director for Africa.
Africa’s most populous nation, Nigeria, is among the countries that have issued a travel advisory telling citizens to delay travel to China unless “extremely essential”.
Chikwe Ihekweazu, director general of the Nigeria Centre for Disease Control (NCDC), said lessons had been learned from the Ebola outbreak that swept through Liberia, Sierra Leone and Guinea in 2014-16, killing about 11,300 people in West Africa.
“Over the last three years, we have invested resources in improving infectious disease surveillance and response capacity. Our National Reference Laboratory has the capacity for molecular diagnosis of pathogens and we are receiving guidance from WHO on the primers and reagents that will be used to test suspected coronavirus cases.”
Elsewhere, Ugandan physician Sabrina Kitaka also cited the Ebola response as an example of how the country has successfully managed previous infectious and said authorities were taking all precautions at border entries to deal with the new coronavirus, officially known as “2019-nCoV”.
“This is a new virus with very scanty information on the virulence and transmission dynamics,” said Kyeng Mercy Tetuh, a Cameroonian public health expert and epidemiologist.
In the case of Cameroon, Tetuh said while health authorities have stressed the country’s preparedness, this may not be the case in areas affected by insecurity such as the Anglophone regions.
“A challenge in containing Ebola in the DRC has been insecurity,” she said, referring to an ongoing outbreak of the deadly disease that has seen medical teams came under attack from armed militias in eastern DRC.
For its part, Mauritius announced that all passengers coming from Wuhan are being quarantined, while others from China would be monitored by healthcare workers.
Mozambique said it was suspending visas for visitors from China and blocking travel to the country, while in neighbouring South Africa, Minister of Health Zweli Mkhize said temperature screenings using non-invasive thermometers would be conducted at 12 port of entries and health officials would go on board international aircraft to determine any sick travellers.
Ivory Coast, where the continent’s first suspected case was reported, has also installed thermal imaging cameras at airports.
Yet, Tanzanian clinician Joachim Mabula said airport screenings may not be sufficient.
“The screening process involves looking for symptoms; people can have a disease yet not show symptoms,” he said.
He added that many African countries do not have the required laboratory capacity to respond to an infectious disease like the new coronavirus, an issue also highlighted by Erondu.
“Unfortunately, many disease surveillance systems throughout African countries are weak and most of the continent lack diagnostic capability, for example, laboratory capacity, so identifying cases and controlling the outbreak could be difficult, especially in resource-constrained countries,” Erondu said, even as she pointed out that the continent is home today to “stronger” and “more experienced” institutions such as Africa CDC, the NCDC and the Ethiopian Public Health Institute.
In Mabula’s opinion, African countries should cancel flights to and from China – so far, African carriers that have taken such a step include RwandAir, Kenya Airways, Royal Air Maroc, EgyptAir, Air Madagascar and Air Mauritius, while Air Tanzania has postponed its maiden flight to China.
An official at the DRC’s Ministry of Health, who chose to remain anonymous, supported such a move: “In the DRC, Ebola and measles have claimed thousands of lives; an outbreak of coronavirus is the last thing we need, thus cancelling flights is sensible.”
The official added, “Screening and healthcare systems vary in strength from country to country, therefore if the virus reaches one African country from China, it may be difficult to stop it spreading to others.”
In the official’s opinion, another concern is the spreading of fake news: “This leads to mass panic. African governments need to be transparent with all information.”
Suzana da Lomba, a teacher based in Angola’s capital, Luanda, said fake news was already having an impact.
“The hysteria and lack of information globally means friends are warning each other to not go to Chinese-owned shops and restaurants.”