“The time is now to sound a really loud alarm about the potential Coronavirus spread in Africa,” warns Dr. Mohammed Nurhussein, Chair of the United African Congress (UAC).
“I don’t want to spread panic, but the threat is very real,” he added.
For weeks since the outbreak last December, no cases were reported in Africa. But as of this past Sunday, March 1st, three countries in Africa – Egypt, Algeria and Nigeria — have confirmed cases of the novel COVID-19. While this number currently pales in comparison to the more than 7,000 out the 87,000 reported cases detected in about 60 countries outside mainland China where the outbreak began, Africa is at serious risk.
Africa’s first COVID-19 case was reported in Egypt in early February. On February 17th, an Italian adult tested positive on arrival in Algeria. Ten days later, on February 28th, another Italian man was confirmed positive after traveling on Turkish Airlines from Milan to Nigeria, and going through the densely-packed megacity of Lagos. The man had come into contact with many fellow factory workers and was taken to hospital in an ambulance not designated for coronavirus emergencies.
Egypt, Algeria and South Africa have been identified as the African countries at highest risk for imported cases of COVID-19, according to research released on February 21 based on air travel volume. Countries named at moderate risk were Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana and Kenya.
13 African countries were prioritized by the WHO in mid-February, reported in the influential medical journal, Lancet. These are Algeria, Angola, Cote d’Ivoire, Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda and Zambia.
Recognizing the threat to Africa early on, the United African Congress took action, following its mandate as a Pan African non-profit organization to represent the interests of the African diaspora and friends, regarding health, culture and education.
Seizing the opportunity of the summit meeting of African Heads of State in Addis Ababa, Ethiopia, on February 9-10, the UAC wrote to the Chairperson of the African Union Commission, H.E. Mr. Moussa Faki Mahamat, sounding the alarm and requesting that the threat of the COVID-19 be placed on the agenda as a matter of utmost urgency.
The letter also recommended a unified continental approach to prevent the disease from spreading in Africa.
“I knew right away that COVID-19 could spread like wildfire in Africa,” Nurhusssein continued. The Ethiopian-born doctor is a Professor Emeritus of Medicine at Downstate Medical Center in New York City.
A specialist in geriatrics, he also feared that older people would be most vulnerable.
Other vulnerabilities include the pervasive fragile health system infrastructure of African nations, with inadequate resources, supplies, funding, and trained health workers. Add to that, fluid borders, government corruption, and increasing connections through trade, business and investment, with China and other countries of the world now infected.
Africans are also increasingly visiting China and other countries for business and study, increasing the possibility of bringing the infection home. Ethiopian Airlines, Africa’s largest carrier, has expanding routes and business, especially since joining Star Alliance Network.
Adding fuel to the fire is insecurity in some African regions, with armed conflict raging in varied regions, notably the Democratic Republic of the Congo already struggling with the Ebola outbreak.
Additionally, work crosses borders. About 2 million Chinese live and work on the African continent. Since many workers went home to China for the Spring holiday — when the outbreak occurred — Nurhussein worries about the spread of the infection when Chinese construction workers involved in the expansive building projects throughout Africa travel back from China to their jobs.
Nurhussein and colleagues made other early efforts to sound the alarm about the potential viral spread to Africa.
An op-ed was submitted to the New York Times. “Curiously, an article by their reporters appeared right afterwards,” he said, adding “One can draw conclusions from where they got the idea.”
Other media outlets started to report more on the situation in Africa.
Since UAC’s early efforts, the World Health Organization (WHO) declared the outbreak a “Public Health Emergency of International Concern”– highlighting the risks and need for a coordinated international response – and within a month, on the same day that the case was identified in Nigeria and within the week that in the total number of countries with confirmed cases jumped from 26 to 58, increased its COVID-19 risk assessment to “very high” at the global level.
“It’s time now to go one step further and declare a pandemic,” says Nurhussein.
Disagreement looms over that label. On one hand, leading expert on coronavirus, director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, said yesterday the disease now at “outbreak” is of “likely pandemic proportions.”
WHO admits that potential if the spread doesn’t slow, but remains hesitant. So, too, Secretary of Health and Human Services Alex Azar — called the coronavirus “czar” – who says the number of cases is not now equal to other diseases that are called a pandemic.
Philanthropist Bill Gates has no such caution, calling the outbreak a “once-in-a-century pandemic” in a New England Journal of Medicine article.
likened to the deadly 1918 influenza pandemic (colloquially called the Spanish flu) which killed about 50 million people worldwide.
“National, state, and local governments and public health agencies can take steps over the next few weeks to slow the virus’s spread,” Gates wrote in an opinion piece for the New England Journal of Medicine (NEJM, Feb 28). In addition to helping their own citizens’ respond, Gates called on donor governments to help low-and middle-income countries prepare for the pandemic.
The few numbers of cases reported now in Africa could be misleading, claims Nurhussein. Infections could go undetected, despite the fact that 29 African nations can do COVID-19 testing, according to WHO Africa, and despite preventive measures like more airport screenings, canceled flights, arrival checks and quarantines, and suspended visas.
“Danger lurks,” he says.
Some factors rumored to protect Africa are specious. Warmer and more humid weather, as in Africa, does not ensure that the infection disappears, as not enough is known about this strain of coronavirus.
Rumors of a genetically-higher immune system in Africans have been debunked.
Claims that contagion is mitigated by Africans spending more time outdoors and not living in densely populated communities, is also suspect, says Nurhussein. To the contrary, large African families live in crowded quarters, shop in overcrowded marketplaces, exchange wares, and use little protection, even tissues.
A month ago, at the time when no Coronavirus cases were reported in Africa — nor in the US or South America — Nurhussein raised awareness about the virus at an event at the United Nations headquarters in New York City. The event, held on February 6th in a large UN conference hall with hundreds of attendees, to honor World Interfaith Harmony Week, featured spiritual leaders from varied faiths offering solutions to current challenges of climate change, religious and racial conflict, pervasive violence, and widespread disease like the epidemics of Ebola and the emerging Coronavirus.
Nurhussein pointed out the UAC’s forewarning track record, evident in hosting major awareness-raising events early in 2014 about the Ebola epidemic, when others were leery to confront the crisis. Speakers at the events included Ambassadors of the three most-affected African countries, the Ambassador of the United States to the UN, then-Secretary General Ban Ki-moon, and various celebrities.
While the viruses are different- Ebola is contracted by direct contact with body fluids of those infected, and COVID-19 by more common contact– all epidemics, including HIV/AIDS and SARS, all have some similarities in approaches to prevention, treatment, detection, and education.
Health officials are now looking to lessons from Ebola in Africa to apply to COVID-19. For example, Nigeria staved off infection by the government’s early use of social media messaging to educate the public.
Many such public health education campaigns are reported in my book, The Psychosocial Aspects of a Deadly Disease: What Ebola has taught us about Holistic Healing,” documenting lessons from my mission to Sierra Leone during the outbreak, projects in Hong Kong during SARS, and efforts about HIV/AIDs, providing psychosocial advice and support to dispel fears and stigma.
In response to outbreaks of the virus in the US, President Trump and CDC experts insist Americans are at low risk, and can remain confident and calm with the “best health system in the world” looking out for them.
“Africans do not have the luxury of good health systems,” Nurhussein points out. A member of the Ethio-American Doctors Group, Nurhussein and fellow doctors in the USA and around the world, raised millions of personal money to start building a comprehensive state-of-the-art hospital center in Addis, Ababa, Ethiopia, for which ground has been broken.
Other health projects are in process in Africa, but in early stages. Plans for a comprehensive medical facility in Sierra Leone and for the extended Mano River Union were presented by the First Lady of Sierra Leone Mde. Fatima Maada Bio at an event during the United Nations General Assembly –when world governments gather to present their policy and programs — this past September. (insert hyperlink of my report in BSN)
Pundits and experts emphasize there is no need to panic, but tempers are inevitable rising given the spread of cases worldwide and economic fallout, evident in plunging stock markets.
Psychologists have to come to the rescue, advises Nurhussein, to help people cope with the severe emotional impact. Little has yet been said in mass media about the psychological implications of the epidemic, nor professional advice offered.
At the UN event, I did just that, pointing out, and offering advise about, emotional suffering. My 4 S’s: combat shame, silence, and stigma, and offer psychosocial support.
One of my Chinese graduate students in my class at Columbia University Teachers College, Jiawen Long, described her own, and fellow Chinese students’ reactions, of crying, fears, sleeplessness, and worries for family.
In response, UAC:
* Calls for extensive and intensive public awareness and education campaigns, especially as cases of community-spread infection increase, to model the success of social media campaigns like that in Nigeria that prevented the spread of Ebola in 2014.
* Urges outreach to support African students abroad in the many affected countries. About 4,600 African students are in Wuhan, the epicenter of the epidemic.
* Acknowledges and supports of efforts by WHO, WHO Director-General Dr Tedros, and the WHO regional Africa office, working in partnership with the Africa Centres for Disease Control and Prevention (Africa CDC) to prepare African countries for the potential spread of the virus to Africa.
* Applauds and supports the Africa Taskforce for Coronavirus (AFCOR), established by Africa CDC to share information and best practices, build technical capacity, support policies, and coordinate border control. This is analogous to the UN Mission for Ebola Emergency Response (UNMEER) set up during the 2014 Ebola outbreak in West Africa.
* Urges the United Nations to convene similar briefings and funding pledge conferences at UN headquarters in New York City as were held during the 2014 Ebola outbreak.
* Calls for all parties, especially the private sector, to contribute funding, building on the US$15 million released from the UN’s Central Emergency Fund, to help finance global efforts to contain the spread of the COVID-19 coronavirus, particularly in vulnerable countries with weak health care systems. Bill and Melinda Gates have committed to donate up to US$100 million to kickstart a global response to the health crisis.
* Urges the international community and private sector to bolster the Africa CDC, the Nigeria CDC and the Ethiopia Pubic Health Institute and similar health bodies in African nations, to provide resources, like diagnostic, laboratory and treatment facilities and trained staff.
* Urges all parties to take a holistic view to health, paying attention to mental health needs in Africa facing COVID-19 outbreak, consistent with the equity in mental and physical health outlined in the first paragraph of the Universal Health Coverage Political Declaration adopted by governments at the UN last October 2019.
*Recommends vigilance not panic.
* Strongly suggests that civil society, public health professionals and NGOs experienced in crisis interventions coordinate efforts to help, partnering with the African Union and other local, national and international agencies and government entities, and that the latter reach out to these groups.
* Points to the need for special attention for already vulnerable countries, like the Democratic Republic of the Congo, already suffering from the Ebola viral epidemic which is abating but which could easily re-ignite and cause a double crisis if COVID-19 spreads. Countries that suffered hardest from Ebola in 2014 are buffering protection efforts, but could still fall prey to infection.
* Suggests implementing lessons learned from other infectious disease outbreaks.
* Urges preparing children worldwide who could be frightened and/or stigmatized, as well as preparing teachers, schools and parents, especially in the event of school closings.
* Advises governments and media worldwide to be transparent in reporting.
*Advises all: be alert not anxious.
“We stand ready to act with all parties — the African Union, United Nations, NGO colleagues, business, media, all government and civil society actors, and any public and private groups,” says Nurhussein. “For now, and for the long-term, as the effects will last a long time.”
Bill Gates is right. “There is no time to waste.”