As of 5 March 2020, official statistics show 95,333 confirmed cases of Coronavirus worldwide, including 27 in Africa. Algeria is the most affected country on the continent with 17 cases, followed by Senegal (four cases), Egypt (two cases), then Nigeria, Morocco, South Africa and Tunisia (one case each). Cases in Africa only make up 0.03% of the total number.
For doctors, the continent is clearly not “in epidemic situation”, even if vigilance is required. Controls are in place at airports, and an increasing number of laboratories are being equipped to analyse samples collected from people with symptoms. Medical staff are being trained and special equipment is being sent to hospitals and health centres.
Yet, on the streets and in the media, there is widespread worry.
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It is nowhere near the psychosis observed in some Asian and European countries, of course, but nonetheless the anxiety exists.
Director of operations for the non-governmental organization ALIMA, which has intervened to treat patients suffering from Ebola fever, Dr Moumouni Kinda says he understands the fears of his fellow citizens: “It is a new disease for which there is no treatment or vaccine to date, and we can see the extent to which it has spread in China. It’s normal for people to be afraid. But it is not a highly lethal disease like Ebola. The people who have died from the Coronavirus are mostly elderly people or people who already had other conditions.”
The figures we publish here confirm the doctor’s analysis: Covid-19 is a serious infection and potentially fatal, yes, but much less so than other well-known diseases on the continent.
The real danger, in fact, lies more in its contagiousness i.e. the ability of the virus to spread from one sick person to others. Again, Covid-19 is not the most contagious disease there is, but it can spread quickly and, more alarmingly, an infected person can be contagious before symptoms appear, and thus unknowingly infect those around him or her.
This summarises what professionals believe to be the main danger, as an explosion in the number of cases would result in a rush to hospitals and health centres, and would likely overwhelm them.
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But there is nothing African about this problem, says Dr Kinda: “No health system in the world is ready to deal with it, because the real problem is panic, a sudden influx of patients that the system cannot absorb. So the important thing is to communicate, to inform, to sort out who is really infected and who is suffering from other, less serious, illnesses.”
A Vague Definition
At the current stage of the epidemic, detecting “real cases” is crucial – the identification of cases has an influence on the figures announced and therefore on the perception that the population has of its evolution. However, since the end of February, a directive from the World Health Organization (WHO) has been recommending that any patient suffering from one of the main symptoms of the coronavirus (mainly respiratory distress and fever) and who has travelled to a region affected by the epidemic be considered a suspect case.
Dr. Kinda says: “There are still too many people who can be considered ‘potentially’ affected, a more operational definition is needed. The focus should be on those at risk. We now have people who are not suffering from the disease and, at the same time, patients who are affected but who show no symptoms are falling through the cracks, even though they are potentially contagious.”
The good news, however, is the extremely low number of cases detected in Africa and the lack of rapid spread, at least at this stage.
Dozens of hypotheses are circulating to explain this apparent exception: the climate might not be favourable for the virus, genetics could be at play, or it might simply be demographics (Covid-19 kills mostly elderly people and Africa has a young population). None of this is scientifically confirmed, but the fact remains that the disease arrived late on the continent and is not spreading quickly.
The experience gained in the control of previous epidemics may explain the effectiveness of detection, and the vigilance measures put in place by states are appearing to be successful.
Dr. Kinda also notes that the Coronavirus affects mostly people who travel by air: “So it’s not the poorest people, but people who have access to information and know to report symptoms. It would have taken longer to respond to a disease that appeared in a very poor or inaccessible area.”
Like many of his colleagues, this doctor, who specialises in humanitarian missions and emergency response, is observing with a little bitterness the media uproar and the international mobilization that is taking place around the coronavirus: “It is a shame that so much is being done when malaria or malnutrition are less and less funded and the Sahel is in a very problematic security situation. The Coronavirus must not make us forget these crises, because they cause many more deaths in Africa!”
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