Coronavirus recovery rate: is there a Senegalese exception?
With a patient recovery rate of almost 61% and only two deaths reported in a month and a half, Senegal has emerged as an exception on the continent. What is behind this miracle and can it last?
Two deaths have been reported and 60.5% of patients are back on their feet. With 314 cases reported since 2 March, including 190 recoveries and hospital discharges as of 15 April, Senegal boasts a record recovery rate on the continent.
By comparison, Morocco, where the epidemic arrived at the same time, reported on 14 April that just 11% of patients had recovered, while Algeria reported a rate of 30%, South Africa 18% and Cameroon 15%.
In addition, Senegal’s number of coronavirus-related deaths remains very low, with two deaths, i.e., 0.64% of patients, whereas Algeria reported a death rate of more than 15%.
These two statistics, “which must be interpreted with a great deal of caution”, says Dr Abdoulaye Bousso, Director of the Health Emergency Operation Centre of Senegal (COUS), under the supervision of the Ministry of Health, nevertheless seem to fuel the idea of a Senegalese exception.
Since early April, the country has even seen a decrease in the number of hospitalised patients, with 121 cases being treated in hospital as of 15 April, versus 143 ten days ago.
No drastic health measures
While reminding us that it is “still too early to predict the epidemic’s future trajectory”, Bousso hopes that this influx of “encouraging” statistics is a sign that the measures taken by Senegal’s president have been effective.
For example, the closure of the country’s aviation borders on 20 March may have partly contributed to reducing the number of cases imported from abroad which, until now, have accounted for 96% of patients (along with their contacts), says Bousso.
Yet, Senegal is far from having the continent’s most drastic health measures.
For the time being, there is no lockdown outside of curfew hours (from 8 p.m. to 6 a.m.), unlike in South Africa, which imposed a lockdown as early as 26 March.
While citizens are required to wear masks in Morocco, this is not the case in Senegal, although the measure is being discussed. Dakar, which has reported 196 cases since the beginning of the epidemic, has not even been placed under an isolation order.
Abidjan, Cote d’Ivoire, on the other hand, has banned incoming and outgoing travel since 29 March. As for the social distancing measures recommended the world over, they seem to only exist on awareness-raising signs which have popped up in the streets of Dakar.
Few severe cases
What is behind these positive results achieved by a country implementing less stringent health measures than other African nations? “Senegal has very few severe cases and is taking care of its patients swiftly: test results are available within 24 hours, all patients who test positive are systematically hospitalised, whether they have symptoms or not, and their contacts are quarantined”, says Bousso.
Perhaps the use of hydroxychloroquine has helped, as Professor Moussa Seydi – head of the Infectious Diseases Department of Fann Hospital, where some Covid-19 patients have been admitted – began taking a gamble on the treatment as early as 26 March.
“Patients treated with hydroxychloroquine recover faster”, he stated during a press conference on 2 April, although no medical consensus has been reached yet on the effectiveness or safety of administering chloroquine-based treatments to patients with the disease.
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However, Professor Ousmane Faye, head of the Virology Department at the Pasteur Institute, where testing is performed, has a more nuanced point of view: “We are far from seeing the light at the end of the tunnel.” Although the recovery rate is increasing, the number of new infections has remained stable. In April, authorities reported on average between eight and nine new cases per day.
“Keep in mind that the epidemic is in our midst”
“Just because it seems the curve is on a downward trend doesn’t mean that the epidemic is no longer spreading”, adds Faye, who served on the frontlines during the continent’s fight against Ebola and yellow fever.
While the progression of the virus is slow and contact tracing is generally being performed, the challenge from this point forward is to completely contain COVID-19’s progression. This task is being made difficult by the proliferation of community cases (i.e., cases in which the chain of transmission is unknown).
“As long as there are community cases, that means there are patients carrying the coronavirus who have slipped through the cracks, and that poses a threat”, says Lucile Imboua, WHO Representative for Senegal.
In light of these community cases and the stable rate of new infections, the Senegalese government is looking to develop a new strategy, aware that the high number of recovered patients recorded up until now will likely not be adequate to avoid a crisis. Currently, measures such as ordering a total lockdown, requiring people to wear masks and conducting widespread testing are being considered.
In the meantime, Faye has a warning: “We have to keep in mind that the epidemic is in our midst, it continues to spread and we are still in the danger zone. If the number of infections is exponential, the situation could become difficult to manage.”