Coronavirus Update: Africa’s Health Care System May Be Overwhelmed By Virus With Devastating Consequences

Public health experts worry that the coronavirus epidemic could spread into African countries with high volume traffic to China, leading to devastating consequences due to inadequate medical services on the continent.

"We can be very certain that coronavirus will be exported to Africa," said Ngozi Erondu, associate fellow of the global health program at Chatham House, a non-governmental organization based in London. "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 [number] of Chinese travelers that pass through these airports."

Some 1 million Chinese now live in Africa after years of heavy Chinese investments in the continent. Tens of thousands of Africans reside in China as students or traders.

“Our greatest concern is about the potential for spread in countries with weaker health systems,” said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization. “If the virus arrives in a country already strained by other diseases -- for example, Congo, which is still fighting an Ebola outbreak -- it will be even harder to control.”

John Nkengasong, director of the Africa Centers for Disease Control and Prevention, said: "We in Africa are watching the situation and also preparing ourselves to deal with any outbreak or cases."

An analysis published in The Lancet medical journal determined that Egypt, Algeria, and South Africa were at the highest risk of contracting the virus – although these three nations are fairly well equipped to cope with an epidemic.

Other African states like Nigeria, Ethiopia, Morocco, Sudan, Angola, Tanzania, Ghana, and Kenya have less risk of infection, but would be more vulnerable in an epidemic due to their inadequate health care services.

“Our findings should help to inform urgent prioritization for intensified support for preparedness and response in specific African countries found to be at moderate to high risk of importation of [the virus] and with relatively low capacity to manage the health emergency,” the Lancet study said.

Allyson Bear, a public health specialist and vice president for Corus International, wrote that most of sub-Saharan Africa is not prepared for another epidemic.

“It is highly likely that the under-resourced and unprepared national health systems of Africa cannot detect its presence. And its impact there could be especially devastating,” she wrote. “[Africa] needs laboratory capacity to test for this strain of coronavirus. It is flying blind without it.”

Bear also indicated that Africa does not have enough doctors and nurses to meet even the basic health care needs of its people. Another epidemic would overwhelm its fragile health care systems.

As such, most African health care facilities are not equipped for a virus epidemic.

“The problem is, even if [the infection is] mild, it can paralyze the whole community,” said Dr. Michel Yao, emergency operations manager in Africa for WHO.

Yao said the “high-priority” countries comprise Algeria, Angola, Congo, Ethiopia, Ghana, Ivory Coast, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda and Zambia.

“If turns out to be a mild virus, that’s perfectly fine. If it’s dangerous and you let it go and decimate people, you have failed in public health,” he said.

In Zambia, where the Chinese have extensive mining interests, many workers travel back and forth from the two countries.

"We're definitely not prepared [for the virus]. If we had a couple of cases, it would spread very quickly,” said Zambian physiotherapist Fundi Sinkala. “We're doing the best we can with what resources we have.”

Matshidiso Moeti, WHO’s regional director for Africa, said 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.”

While many airports in Africa can screen passengers for the virus, Tanzanian clinician Joachim Mabula said that may not be enough.

"The screening process involves looking for symptoms; people can have a disease yet not show symptoms," he said.

Erondu of Chatham House added: "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,"

An official at the Ministry of Health of the Democratic Republic of Congo, further warned that 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," he said.

No less a figure than Microsoft cofounder Bill Gates has issued a doomsday scenario for Africa.

Gates warned that coronavirus might overwhelm health systems in Africa and kill millions.

"This disease, if it's in Africa ... it's more dramatic than if it's in China, even though I'm not trying to minimize what's going on in China in any way," Gates said. "Will this get into Africa or not, and if so, will those health systems be overwhelmed?"

Gates further warned the impact in sub-Saharan Africa could be "very, very dramatic."

"If you look at Ebola, most of the excess deaths were caused because the health service shut down," Gates said. "It's not just the direct effect, it's also the panic, the overload, and the things that affect health workers because you're already at very limited capacity."

Gates put the ongoing crisis in starkest terms. “This is a huge challenge, we’ve always known the potential for a naturally caused, or intentionally caused, pandemic is one if the few things that could disrupt health systems and economies and cause more than 10 million excess deaths,” he warned.

However, very few coronavirus cases have yet been reported on the African continent, while cases are soaring in East Asia, Middle East and Europe. As of Wednesday, only two virus cases have emerged in Africa and experts are baffled.

"This is the question that everyone is asking, especially as other regions such as South America or Eastern Europe now have cases," said Amadou Alpha Sall, head of the Pasteur Institute in Dakar, Senegal. "The current figures could be the reality, it's hard to know. Maybe it's because Africa is not that connected [to the outside world]."