Africa braced for ‘inevitable’ arrival of coronavirus

Health centres step up preparations as World Health Organization raises fears about ability to cope with major outbreak.

People at the African Union headquarters in Addis Ababa are given disinfectant. Ethiopia is one of several African countries where coronavirus tests have so far proved negative. Photograph: Anadolu Agency via Getty Images
People at the African Union headquarters in Addis Ababa are given disinfectant. Ethiopia is one of several African countries where coronavirus tests have so far proved negative. Photograph: Anadolu Agency via Getty Images

African health authorities are stepping up preparedness for coronavirus after the head of the World Health Organzation described the outbreak as a “very grave threat for the rest of the world”.

Although the number of cases in China appeared to have stabilised and started to decline, “this outbreak could still go in any direction,” said Dr Tedros Adhanom Ghebreyesus on Wednesday.

Speaking after the WHO’s decision not to describe the status of the Ebola epidemic in the Democratic Republic of the Congo as a public health emergency of international concern, Tedros emphasised the need to improve health systems against the new coronavirus and other deadly outbreaks.

“Our greatest fear remains the damage the coronavirus could do in a country like DRC,” he said.

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Around the world, there are now more than 60,000 confirmed cases of COVID-19 infection, as the disease is now being called officially, and almost 1,400 deaths.

But the numbers outside China are relatively small, with just over 500 cases in 24 countries and one death in the Philippines. Person-to-person transmission outside China was still happening in only about 22% of cases, said Dr Michael Ryan, WHO’s head of emergencies. “We have a window of opportunity to shut this virus down.”

Ryan also urged caution after one Chinese scientist predicted that the epidemic would be over by April. Huge efforts by China to contain the virus may have had an effect, but while the slowdown – and the apparently less aggressive behaviour of the virus outside China – buys time, it does not necessarily mean it will be brought under control.

“It is no guarantee,” he said. “We are not going to speak about numbers or dates. We need to focus on the task. I think it’s way too early to try to predict the beginning, middle or the end of this epidemic right now.”

The number of African countries that can test for the virus tripled to 15 this week, with more expected to have testing labs up and running in the coming days. The head of the Africa Centres for Disease Control and Prevention (Africa CDC) said health centres were on “high alert” for new cases.

Confirmed cases of coronavirus

Updated Saturday 16 February 06.00 GMT

Note: Taiwan, 18 cases; Hong Kong, 42 cases; Cambodia, 1 case; Italy, 3 cases; Philippines, 3 cases; Spain, 2 cases; Macau, 10 cases; North Korea, 1 case; Others, 64 cases

There have been no confirmed cases of coronavirus in any of Africa’s 54 countries so far, but experts say a case is inevitable, given the large amount of traffic between the continent and China.

Michel Yao, the WHO’s head of emergency operations in Africa, warned it could happen “at any time”, adding that most hospitals would be unable to cope with large numbers requiring intensive care.

Roughly 15% of patients infected with the virus require hospital treatment, up to a quarter need intensive care and 5-10% require mechanical ventilation, according to WHO scientists.

More than 1,000 people have died of the disease in China, where almost 45,000 cases have been confirmed. Fewer than 500 cases have so far been confirmed in countries and territories outside China.

Confirmed cases of the coronavirus have risen to almost 45,000

Note: cases in Hong Kong, Macau and Taiwan counted outside mainland China. Data correct at 8.44pm, 11 February

Deaths from the coronavirus rose to 1,115 by 11 February

Note: all but two of the deaths have occurred in China. Data correct at 8.44pm, 11 February

“The lack of reagents is what delayed the capacity in African countries for confirmation,” said Yao. “We are working around the clock to ensure they receive reagents (so they can test for the virus).”

About 45 suspected cases in Africa have been reported to the WHO so far, with Ethiopia, Kenya, Ivory Coast, Ghana and Botswana among the countries affected. A total of 35 of those cases were found to be negative, while the remaining 10 have been placed in quarantine until tests are carried out.

A week ago, only six laboratories in Africa, including the Institut Pasteur in Senegal and the National Institute for Communicable Diseases in South Africa, were able to test for the virus, raising concern that undetected cases might already exist. Last weekend, Africa CDC ran a workshop in Senegal for scientists in 15 countries, sending them home with diagnostic tests including reagents.

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Seven of the countries now able to run tests are on the WHO’s priority list of countries that are especially vulnerable, mainly because of their contact with China. They include Algeria, Angola, Ethiopia, Ghana, Nigeria, Tanzania and Zambia.

The WHO is also sending kits to 29 laboratories on the continent.

Asked about the ability of health systems in African nations to cope with the intensive care needs of a coronavirus outbreak, Yao said it would present “quite a challenge”.

“I can tell you straight away the capacity to manage a large number of patients is not there in many African countries. We remain concerned. That’s why we are ensuring heath systems are on high alert,” he said.


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“With the exception of large countries like Kenya and South Africa, most African hospitals have very limited intensive care facilities. A hospital may have only 10 beds capable of intensive care. Imagine having a cluster of cases that requires intensive care. That could be quite a challenge.”

John Nkengasong, the director of Africa CDC, said the increased ability to test for the virus in Africa would encourage those with suspected symptoms to come forward, adding that one theory for not seeing cases in Africa was a shortage of testing facilities.

“The hope is that this new turnaround time, in hours rather than days, [will make] people feel, if they have the symptoms, they will report for testing,” Nkengasong said.

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“If you keep someone for days, human behaviour suggests people will stay away. Now that many countries have the ability, there is the possibility that we will see cases in the coming weeks. Time will tell.”

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