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1 big thing: Africa scrambles to keep the virus out

Students in Mogadishu, Somalia. Photo: Abdirazak Hussein Farah/AFP via Getty

Several African countries recorded their first coronavirus cases this week, and case numbers accelerated in countries like 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.

2. State of the outbreak: By the numbers
Expand chart
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Danielle Alberti/Axios

1. China reported no new locally transmitted cases today, and no additional cases in Wuhan, where the outbreak began.

  • Italy now has more recorded deaths than China, with 3,405 total and 427 today.

2. Italy’s national health authority finds that the median age of those who have died of coronavirus there is 79.5, and nearly all had prior medical conditions, per Bloomberg.

  • Just 17 of roughly 2,100 deaths examined in the study were of people under 50, while 9 in 10 were over 70.
  • However, public health experts in the U.S. and Europe have noted the growing number of younger people requiring hospitalization.
  • Between the lines: Oxford researchers believe Italy has been hit so hard in part because it has the world’s second-oldest population, and younger Italians often spend time with older people like their grandparents, per Wired.

3. An Imperial College London coronavirus model caught the eyes of policymakers in London and Washington, with projections that some 510,000 Brits or 2.2 million Americans would die if the virus spread unimpeded.

  • Moderate reductions in social interaction coupled with the isolation of older people cut deaths almost in half, but still left a demand for ICU beds at eight times the current capacity.
  • More draconian restrictions on movement and school closures lasting five months would significantly improve outcomes. They'd also come with massive social and economic costs, and a "second wave" of infections once lifted.

4. Russia recorded its first coronavirus death and then reversed itself, saying the patient had coronavirus but died of an unrelated blood clot. Russia’s numbers have been strikingly, perhaps suspiciously, low.

  • Russia is spreading disinformation about the coronavirus intended to cause public confusion and anxiety in the West, Axios' Sara Fischer reports.
3. The balcony vs. the virus

The message from Rome: "Everything will be alright." Photo: Andreas Solaro/AFP via Getty Images

You may have seen the viral videos of Europeans — first in Italy, then in Spain and beyond — singing and playing instruments from their balconies.

  • Quarantined city-dwellers have also come to their balconies at designated times — in France and a number of other European countries — to applaud the health care workers fighting the outbreak.
  • In Rome (as seen above), people have stepped outside simply to spread the message that Italy stands together and "andrà tutto bene" — everything will be alright.
  • It's a nice reminder that the current battle is between humanity and a virus. At least we're all on the same side.

While China's declaration of a "people's war" on the virus may have once sounded odd to Western ears, leaders in Europe and the U.S. are increasingly using similar language.

  • Angela Merkel gave her first emergency TV address in 14 years as chancellor and said Germany now faces the gravest challenge since World War II.
  • French President Emmanuel Macron has declared that France is "at war," while U.K. Prime Minister Boris Johnson has noted that the societal changes underway are unprecedented in peacetime.
  • Trump, meanwhile, says he's now a "wartime president."

The latest: Monaco's monarch, Prince Albert II, became the first world leader to test positive for COVID-19.

4. China vs. the U.S. vs. the virus

Photo Illustration: Sarah Grillo/Axios; Photos: Stringer/Getty Images, Feature China/Barcroft Media via Getty Images, Peng/Xinhua via Getty via Getty Images

Chinese diplomats and propaganda arms are doubling down on false claims that the U.S. may have created the coronavirus as a bioweapon, while President Trump is leaning into the "Chinese virus" label and hawks in Washington are blaming China for the global crisis.

Reality check: None of this will help alleviate this crisis. All of it is ominous for the future of the world's most important relationship.

What they're saying: Rep. Michael McCaul, the top Republican on the House Foreign Affairs Committee, has accused China of carrying out "one of the worst cover-ups in human history" and inflicting a pandemic and economic calamity on the world.

  • I spoke with McCaul shortly after China revoked credentials from reporters at five U.S. media outlets.
  • "If they expel our journalists, if that's their answer, I worry we will never get to the bottom of this," McCaul said. He also called on U.S. businesses to reconsider their "dependence on the Chinese Communist Party."

The flipside: China is earning praise from leaders in Serbia and Italy for its offers of help, while simultaneously waging a disinformation campaign about how the outbreak began.

Axios' Bethany Allen-Ebrahimian has a fantastic timeline on the first weeks of the outbreak. Summing it up:

  • The first known cases in Wuhan came in mid-December. By Dec. 27, Wuhan health officials were briefed on a new SARS-like virus. Doctors were reprimanded for discussing it on WeChat on Dec. 31.
  • President Xi Jinping first became involved on Jan. 7. Public gatherings continued in Wuhan as normal.
  • China did not acknowledge that the virus could be spread between humans until Jan. 20. Lockdowns began three days later. By then millions had traveled from Wuhan, some of them overseas.

Read the full piece

5. Israeli intelligence buys the wrong tests

An Israeli scientist conducts coronavirus tests in Tel Aviv. Photo: Jack Guez/AFP via Getty Images

Israel's foreign intelligence service, Mossad, stepped in to help secure much-needed coronavirus tests from countries with which Israel does not have diplomatic relations, only to find they were the wrong ones, Axios contributor Barak Ravid reports.

Why it matters: Israel has serious shortages of medical equipment needed to fight the outbreak, leaving Israeli embassies and even intelligence agencies scrambling to get their hands on everything from medical masks to test kits.

The backstory: Prime Minister Benjamin Netanyahu had requested Mossad's help, hoping the intelligence service could use its web of secret contacts around the world to find relevant medical supplies.

  • Mossad starting approaching Arab and Muslim countries that were better supplied, and it ultimately bought 100,000 tests which arrived in Israel last night. Mossad quickly briefed reporters about the achievement.
  • Unfortunately, they were a different type of test kit than the one the ministry of health needed.
6. What I'm reading: Bolivia after Evo

A funeral procession for Morales supporters killed by security forces moves toward La Paz. Photo: Ronaldo Schemidt/AFP via Getty Images

Many Bolivians agree there was a coup last November. They disagree about who carried it out.

  • Critics of Evo Morales, a left-winger and Bolivia's first indigenous president (2006–2019), accuse him of illegitimately seeking a fourth term and then manipulating election results to avoid a run-off.
  • Morales' supporters say it was right-wing ideologue Jeanine Áñez and the military, which endorsed Áñez's claim to the interim presidency after urging Morales to step down, that carried out the coup.

The New Yorker's Jon Lee Anderson recently met with both leaders. He reports from the Andes in this week's New Yorker:

  • "In the wealthier neighborhoods of La Paz, the graffiti called Morales an assassin, a dictator, a narco; in the poorer, more indigenous districts, slogans proclaimed 'Evo Sí' and 'Áñez Fascista.'"

Flashback: "On November 12th, the day that Áñez took office, she deployed the police and the Army, and soon offered immunity for any crimes they might commit in their efforts to reassert social control. Within days, the security forces were involved in two massacres of Morales supporters."

  • After months of upheaval, politicians in La Paz seem "ready for a grudging compromise," Anderson writes, but in indigenous areas that supported Morales "effigies dangle from nooses attached to street lights."
  • Áñez has now announced she will run in May's elections. Morales plans to manage his party's campaign from exile.

The bottom line: "Morales’s alleged electoral fraud, and his party’s acceptance of new elections without him, makes it difficult to call his ouster a coup. Áñez’s behavior makes it hard not to," Anderson writes.

Read the piece

7. Stories we're watching

A lonely walk over Charles Bridge, Prague. Photo: Lukas Kabon/Anadolu Agency via Getty Images

  1. In photos: Top destinations before and after coronavirus outbreak
  2. Podcast: The race for a coronavirus vaccine
  3. The environmental impact of China's coronavirus shutdown
  4. Olympics in doubt
  5. Oil plunges and pain spreads
  6. Trump calls for Austin Tice to be released
  7. Iron rain on an alien world

Quoted:

"The Department of State advises U.S. citizens to avoid all international travel due to the global impact of COVID-19. "
— The world we live in, as of today. Before the outbreak, State's "Level 4" travel advisory applied to countries like Libya, North Korea and Syria. Now, it's the entire world.