Africa scrambles to contain coronavirus

Several African countries recorded their first coronavirus cases this week, and case numbers accelerated in countries including South Africa, escalating fears that Africa could be the pandemic's next frontier.

Why it matters: While there are still just 600 cases across Africa — fewer than several European countries are recording each day — many countries will find it difficult to control the spread once it begins, or treat those who fall most seriously ill.

Driving the news: Tedros Adhanom Ghebreyesus, the World Health Organization’s first African director-general, called on Africa today to “wake up” to the threat it now faces.

Several countries have.

• South African President Cyril Ramaphosa has declared a “national disaster” and announced steps including school closures and a ban on mass gatherings. South Africa now has 150 cases, but no deaths.
• Nigeria has banned travel from 13 countries with large outbreaks, including the U.S. Tanzania has banned hugging and handshakes. Kenya waived fees for money transfers to discourage in-person and cash transactions.
• Before it even had a single known case, Uganda banned mass ceremonies including weddings and religious services.
• Enforcement varies widely. Burkina Faso has officially banned public gatherings, but Ruth Maclean reports for the NY Times that life has largely carried on as normal.

Between the lines: The policy responses and recommendations sound similar to those rolled out in Europe, but there are limitations.

• Sub-Saharan Africa has high rates of poverty and self-employment. Leaving the home every day is often an economic necessity.
• Washing hands frequently is impossible where fresh water is scarce, and it’s difficult to practice social distancing or isolate older relatives in crowded neighborhoods where multiple generations often live together.

Some characteristics of sub-Saharan Africa are cause for optimism.

• The median age is under 20 while only 3% of the population is over 65, so outcomes could be better than in older populations like Italy’s.
• While the dangerous rumor that Africans cannot catch the disease is clearly false, experts do hope it won’t spread as easily in hot weather.
• High rates of HIV, TB and other diseases are worrying, though, given the increased risks for those with existing health conditions.
• And while sub-Saharan Africa has built up its public health infrastructure and has experience in containing diseases like Ebola, most Africans lack access to the ICU-level care that is keeping many European patients alive.

Where things stand: After several weeks of relative quiet, 33 countries have now reported cases. Many were linked to travelers returning from Europe.

• Limited access to testing could allow the disease to spread undetected.

The pandemic has already had massive economic implications in Africa, where oil exports and trade with China are crucial to many economies.

• Political ramifications are coming as well, notes Judd Devermont of the Center for Strategic and International Studies.
• Leaders in Kenya and Nigeria have faced backlash for their tepid early responses, he says.
• Meanwhile, the outbreak provides “an opportunity for incumbents to entrench themselves, delay elections, and outlaw street protests on public safety grounds.”

The bottom line: African countries are beginning to take action despite having relatively few cases to date. But Devi Sridhar of Edinburgh Medical School contends that they have only two weeks to protect themselves.

What to watch: If sub-Saharan Africa is hit hard by the coronavirus, China may be its best hope for help. Beijing is attempting to take on a global leadership role as the U.S. and Europe contend with their own growing outbreaks.