Experts mystified why Africa isn’t in virus’s grip – but it’s ‘early days’

By GRAEME HOSKEN

Pure luck or strong genes? Experts say the mystery continues as to why the deadly coronavirus has yet to establish a grip on Africa.

As the virus wrecks havoc across Asia, the Middle East, Europe and North America, with the death toll climbing, Africa and south and central America continue to report the world’s lowest infection rates.

However, virologists warn that complacency will be detrimental to the more than 1.4 billion people living on the continent.

To date there have been fewer than 10 confirmed cases of the novel coronavirus, or Covid-19, in Africa with no reported deaths. Those countries reporting infections are Egypt, Nigeria and Algeria.

Since December, when the virus was first detected, more than 3,000 people have died, with nearly 90,000 infected globally, the majority of them in China, the virus’s epicentre.

Its rapid spread, which has hot spots developing in Italy and Iran, has left virologists mystified as to why it has yet to take hold in Africa.

In the latest edition of The Lancet, which looks into the preparedness and vulnerability of African countries and the coronavirus, SA, Egypt, Algeria, Ethiopia and Nigeria are reported as the African countries most at risk to the virus.

“Early detection of Covid-19 importation and prevention of onward transmission are crucial challenges … Onward transmission potentially occurring in countries with weaker health systems is a major public health concern.”

The authors say Algeria, Ethiopia, SA and Nigeria were among the 13 top-priority countries identified by the World Health Organisation on the basis of their direct links and volume of travel to China.

They say that while flight bans implemented by some African airline companies serving China may alter future risk, they were not expected to prevent virus’s importation.

“Previous and current evidence indicates that realistic travel restrictions would have a limited effect in containing the epidemic and would delay the risk that the outbreak extends to new countries by only a few weeks.”

While the authors say the results of their studies should be interpreted carefully, “the overall risk of importation to Africa is lower than that to Europe (1% vs 11%, respectively, according to our estimates on the current situation)”.

But they warn the continent’s response and reaction capacity is lower than elsewhere and that despite countries recently strengthening their preparedness against the coronavirus, many states remain ill-equipped, especially when it comes to laboratory testing, which will “affect possible disease transmission”.

“National public health capabilities and infrastructures remain at the core of global health security, because they are the first line of defence in infectious disease emergencies.”

Prof Wolfgang Preiser, Stellenbosch University Medical Virology Division head, said it was difficult to say why the virus had yet to establish a foothold in Africa.

“Maybe it’s due to good luck or pure chance, but I firmly believe that it is just a matter of time before this changes.

“The northern hemisphere is in the middle of winter when respiratory diseases, such as flu, increase. We are approaching our winter which means the worst is still to come, especially when our overstretched medical facilities will be dealing with ordinary influenza cases. We are likely to see hospitals being overwhelmed by patients.”

He said he believed the transportation links between China and Africa were not as strong as between China and Europe and China and the US.

“There are many Chinese nationals working in Africa but not many come and go as they would in the northern hemisphere.”

He said another theory was that the detection rates in Africa were lower.

“While this is possible to happen in some African countries, in South Africa we have a well-recognised detection system. Potential cases, which have all be followed up on, have all come back negative and it is definitely not yet in the country.

“If there are more cases within Africa we will know shortly as we have gained important time to build up early detection systems and properly prepare for the potential avalanche of cases.”

Prof Thumbi Ndung’u, deputy director of the Africa Health Research Institute, said it was too early to say why there were so few cases in Africa.

“It could be a matter of time. There is far more human traffic between Europe and China than China and Africa.”

He said the virus was still being researched to establish exactly how it was transmitted and who was susceptible to it.

“There are many possibilities. It could be environmental conditions or the genetics of the population, but one needs to be careful to say that there is something different about Africa which has not seen it spread on the continent.

“Complacency will be to the continent’s detriment.”

Ndung’u believes it is merely a question of time before the virus has a foothold in Africa.

“What is a welcome relief is that the virus’s non-presence has provided Africa the crucial time needed to improve surveillance and early reporting networks.

“It is as though we have been forewarned. It is a blessing in disguise, especially given the devastation it has caused globally.”

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