Vulnerable populations, including the poor and displaced, are at high risk of being affected by the potential spread of the coronavirus to Africa, the World Health Organization has warned.

Africa needs early detection of coronavirus, WHO says

By Sara Jerving, DEVEX

NAIROBI —
Recognizing the fact that high-density areas such as slums and displacement camps could serve as breeding grounds for the spread of the virus, WHO is helping countries prepare for a response. In doing so, it is also facing challenges such as limited laboratory capacity and existing outbreaks.

The United Nations health body is focusing much of its efforts on 13 high priority countries on the continent.

Outbreak of Coronavirus in 2019

The 2019-nCoV outbreak, first reported in China in December 2019, has since spread across the country and internationally. There are over 6,000 cases and over 130 deaths reported — and the numbers continue to rise exponentially.

Containing the virus has been complicated by all of the unknowns about the new virus — including the ways in which it spreads — and that there is no vaccine or specific antiviral treatment recommended for the virus.

Concerns are heightened across Africa about the potential spread of the virus to the continent, in light of increased trade relations between the regions in the past decade — leading to more frequent travel between China and Africa.

The outbreak would occur at a time when resources are already stretched thin, as national governments and the humanitarian sector juggle the responses to existing multiple health crises in Africa, including an Ebola outbreak that has persisted over a year and the world’s largest measles outbreak.

Devex spoke with Dr. Michel Yao, emergency operations program manager for WHO’s Africa Office, about preparedness measures to prevent a spread of 2019-nCoV, as well as vulnerabilities across the continent that could complicate efforts to squash the potential outbreak.

Early detection

In its efforts to help African countries prepare, WHO is emphasizing the need to detect any cases early. With this outbreak — where the epicenter of the crisis is in China — it is highly likely that a country’s first case would enter through an arriving airline passenger from China, Yao said.

In efforts to prevent a spread into wider society, across the African continent countries have enhanced health screening of passengers from China — including screening for symptoms such as fever or coughing, as well as asking passengers for information about their exposure to individuals with the virus. The Bill & Melinda Gates Foundation announced a commitment of $5 million on Monday to assist the Africa Centres for Disease Control with efforts to increase capacity to prevent the spread of the virus. The next day, Africa CDC activated its incident management system for 2019-nCoV

WHO has created a list of high priority countries in which it is focusing much of its energy, which includes countries that either have a direct flight to China or have large amounts of travelers from China, Yao said. This includes Algeria, Angola, Côte d’Ivoire, the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda, and Zambia.

While there have not been any confirmed cases of the virus in Africa, there have been suspected cases in countries including Kenya and Mauritania, he said. Suspected cases in Ethiopia and Côte d’Ivoire have tested negative.

If the virus does enter the continent, there is concern about it infiltrating high-density areas across the continent, such as slums and displacement camps.

“In Africa we have many factors that can easily increase the number of cases, such as if cases enter these highly dense communities,” Yao said. “This is actually our main concern.”

Laboratory capacity, influenza networks
In order to prevent a major spread of the virus in Africa, countries need to have mechanisms in place to detect people with symptoms, isolate them, collect viral samples, send those samples to laboratories, and then provide any confirmed cases with treatment, he said. Health workers and lab technicians also need to be trained on protocols for dealing with this virus, as well as provided with protective equipment.

Weak laboratory capacity is an issue in many countries across the continent and there is not yet a commercially available diagnostic test.

“Labs have to be updated urgently so that we can increase the detection capacity,” Yao said.

Where lab capacity is lacking, countries need to send samples to WHO referral labs in other countries. When a country needs to send a test to a capable lab in another country, the process can take a few days, he said, for reasons such as some countries don’t have a regular flight connection to a country with a referral lab.

WHO has about 28 referral labs on the continent. These labs were used for influenza, but are now receiving help to upgrade in order to build the capacity to respond to 2019-nCoV he said.

WHO is currently sending laboratories the needed reagent to test samples of suspected cases, which is used to confirm this specific strain of coronavirus, among other assistance. WHO recommends that countries send results for a second, confirmation test.

For example, Dr. Lia Tadesse, state minister of health in Ethiopia, tweeted on Tuesday that the country had isolated four suspected cases, which tested negative, but the tests were sent for confirmation to South Africa.

“In Africa, most of the countries are more or less at the same level except maybe countries that have a strong lab capacity, like South Africa,” Yao said. “Most of the countries remain quite vulnerable and … most of them need to be supported.”