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This is not the first crisis for Professor Moussa Seydi, head of the infectious diseases department at the Centre Hospitalier Universitaire (Chu) de Fann University Hospital in Dakar.
In August 2014, his team treated Senegal’s only Ebola patient during an epidemic that killed more than 11,000 people between 2014 and 2016, most of them Africans.
With 34 coronavirus patients to date (including two cured), spread between Dakar, Diamnadio, and the holy city of Touba, Senegal is one of the most affected sub-Saharan countries, along with South Africa and Burkina Faso.
While Seydi seems confident about the country’s ability to contain the epidemic, he warns of the inability of African countries to cope with levels of contagion similar to those experienced by many Asian or European states.
Senegal recently announced several strong measures, such as a ban on public gatherings, the closure of schools and universities, and the suspension of air links. How are these measures necessary?
Moussa Seydi: They are not necessary, they are crucial. Large population gatherings are one of the main fuels of this epidemic. The coronavirus is transmitted through coughing or sneezing, through contact, such as greetings, or through inert surfaces.
A dry object can carry the virus for up to three hours. If you are very close to someone, you are at risk after five minutes. Without these measures, we would be heading for disaster. Today, they are helping to contain the disease in Touba and Dakar.
A lot of false news is circulating about this disease: it would not resist the heat, Senegal would have found a vaccine… How can we make sure that people are aware of the danger and respect the safety instructions?
In Senegal, there are still people who think that the disease doesn’t exist! I myself have contacted the Ministry of Health so that action can be taken [against people spreading false news]. The Ministry filed a complaint against these people, who were heard by the courts. You can’t mobilize so much energy against the disease and let people tell such dangerous things. It is also necessary to broadcast prevention spots so that such information no longer circulates.
After China, it is Europe’s turn to be hit by an exponential increase in cases of Covid-19. Is such an increase inevitable in Africa and Senegal in particular?
In Senegal, we now count 34 infected people, which are only imported cases [people from abroad] or related to them. If we can isolate these cases and treat them, we can stop the epidemic. Here at Fann Hospital, we have 12 beds and we have the possibility to build a 24-bed centre within a week and to requisition another ward if necessary. For the time being, we are not worried, but we have to prepare for the worst.
At what point can we consider the situation to be truly worrisome?
At each stage of the epidemic, I make a request for equipment or personnel, which is handled by the Ministry of Health and the World Health Organization (WHO). But I have no illusions: if we reach 1,000 or 2,000 patients, the authorities will not be able to give us everything we need. Once we reach a certain threshold of patients, it will be impossible to take care of all of them and that will be a disaster.
How do we avoid this catastrophic scenario?
Countries with a single confirmed case would do well to take the same measures as ours, even if they are extreme. We must take the lead: when experts advise two measures for a given situation, it is better to take three.
Why is that?
Because we don’t have the resources of Italy, France or China. Our fight is here: in prevention. The Italians and the French have waited, but today they regret it! They can no longer take care of their patients properly, they need breathing apparatus, places in intensive care units… They are completely overwhelmed.
If these countries have problems with care, the same situation in our countries will lead to bloodshed. We do not have the same means as Europe to deal with this crisis. It would be suicidal for Africa not to learn from what is happening in Europe.
How can we explain the fact that the epidemic is still well contained, if not non-existent, on the African continent?
Since the virus travels with humans, the first explanation is the remoteness of the outbreak and the fact that air traffic is less developed in Africa. Secondly, the epidemic began in countries that were very organized and rigorous in their fight against the virus. What China did, few countries could have done.
You yourself took care of the only diagnosed Ebola patient in Senegal in 2014. What have we learned from managing this epidemic?
If we hadn’t had Ebola, we would have had a much harder time today. We have learned a lot from managing this epidemic. Our experts have been all over the place, in Congo, Sierra Leone, Guinea, in the epicentre of the epidemic, to help manage it. Professionals had organized themselves, structures had been created, such as the Centre des opérations d’urgence sanitaire (COUS) in Senegal.
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It was therefore necessary to readapt what had been done for Covid-19. Our only fear was that we did not have the means to take care of our patients. In my department, we are well equipped, but I don’t know what the situation is like inside the country.
Are the African countries working together against the spread of the virus?
We have contacts, we have exchanges between professionals, but unofficially. To my knowledge, there is not an African doctors’ organisation to deal with this crisis as such. Yet the disease has no borders.
In order to fight terrorism, the countries in the region are organising among themselves. As far as the coronavirus is concerned, it is the same thing: the virus passes through airports, ports, roads, and so on. The West African Health Organisation (WAHO) is a state organisation that could lead this common fight.
What is the state of research today to find a treatment or a vaccine for the disease?
Remdesvir [an antiviral produced by an American firm] is an interesting and advanced treatment. The combination of hydroxychloroquine and azithromycin should make it possible to shorten the carrying time [of the virus] in order to speed up the healing process.
In Marseille, Dr Didier Raout published encouraging preliminary results. Vaccines have also been under study in the United States for the past few days; another vaccine will be tested in humans by April. In a few months, we will have results and we will finally find effective vaccines. The problem will be to produce millions of doses and see how much they will be charged by the laboratories. If they are very expensive, our countries will not be able to buy them.
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