Coronavirus: in Africa, some countries are "unable to absorb the shock"

The appearance of new cases of Covid-19 coronavirus contamination in South Korea, Iran, as well as in Chinese hospitals and prisons, relaunched Friday, February 21, concerns about the spread of an epidemic that has already made more 2200 deaths worldwide. The World Health Organization (WHO) is now calling on the international community to "strike hard", without delay, against this virus. Eric d'Ortenzio, epidemiological doctor at the National Institute of Health and Medical Research (Inserm), participated in a study on the vulnerability of Africa, China's main trading partner, which does not count for the only one known case.

So far, there has been only one case of Covid-19 in Africa in Egypt. Is it credible?

ÉRIC D'ORTENZIO. This one declared case intrigues us too, we epidemiologists. Perhaps the virus has already entered the continent already or perhaps not? In any case, no supercontaminator, in other words one person who would have contaminated dozens of others, was spotted. This is already good news.

Are you worried that Africa will become the next hotbed of the epidemic?

For the moment, I'm pretty confident. We are almost two months after the start of the epidemic in Wuhan (Editor's note: in China) , and Africa seems to be spared. Given the heavy air traffic with China, its first trading partner, one could effectively fear an increase in imported cases.

Does Africa take the threat seriously?

We feel a concern, the authorities are mobilizing in any case. Since SARS, Ebola and the Seas, they have become very sensitive to epidemic risk, they have also learned to manage it much better.

Just ten days ago, there were only two laboratories, in Senegal and South Africa, in a continent of 54 countries, capable of testing saliva samples likely to contain Covid-19. Where we are ?

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Things have progressed a lot. Twenty-four African countries are now able to diagnose the virus themselves, without having to send the samples abroad or to a neighboring country. Eighteen others should be able to do so. It's a big step.

The challenge is the detection of the first case, in order to isolate it. But how do you spot a person who doesn't even have access to a doctor?

This is indeed the difficulty. That said, WHO is used to it. She learned a lot during the Ebola crisis. Currently, it deploys trainers so that locally, in the field, the right questions are asked so that we are able to identify cases.

What would be the worst scenario?

That the virus spreads within a large megalopolis whose sanitary system is very precarious. Imagine, for example, the Covid-19 hitting a city of nearly 20 million people like Lagos, the capital of Nigeria. There, the situation would become really difficult!

Egypt, Algeria, South Africa estimated to be at highest risk in Africa, but have most prepared health systems and are least vulnerable. Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya are at lower risk of importing cases, but are less prepared and more vulnerable. pic.twitter.com/tT4MAKfgNH

Are there other countries with an equally explosive profile?

The study we just published in The Lancet shows that Ethiopia, the second most populous country in Africa after Nigeria, but also Sudan, Angola, Tanzania, Ghana and Kenya, have the same degree of vulnerability to coronavirus. Their health system would be completely incapable of absorbing the shock. They would soon be overwhelmed.

More than 2.5 million passengers passed through China and Africa in 2019, via Addis Ababa. Ethiopian Airlines continues to operate 5 weekly flights to Beijing, Shanghai and Canton. Is it responsible?

Each country is sovereign and the WHO has not issued any restriction on movement to China. But it is obvious that this increases the risk of imported cases.