Health experts globally have continued to be puzzled by the low incidences of the pandemic coronavirus.

Nigeria became the first sub-Saharan country to report an official case of coronavirus on February 24, when an Italian, working in the country came back from Milan, carrying the virus.

Whether it’s a matter of faulty detection, climatic factors or simple fluke, the remarkably low rate of coronavirus infection in African countries, with their fragile health systems, continues to puzzle and and worry experts.

To date, only three cases of infection have been officially recorded in Africa, one in Egypt, one in Algeria and one in Nigeria, with no deaths.

This is a remarkably small number for a continent with nearly 1.3 billion inhabitants, and barely a drop in the ocean of more than 86,000 cases and nearly 3,000 deaths recorded in some 60 countries worldwide.

Shortly after the virus appeared, specialists had warned of the risks of its spreading in Africa, because of the continent’s close commercial links with Beijing and the fragility of its medical services.

Head of World Health Organisation, WHO, Tedros Adhanom Ghebreyesus, had said, “Our biggest concern continues to be the potential for Covid-19 to spread in countries with weaker health systems,” while speaking to African Union health ministers’ gathering in the Ethiopian capital of Addis Ababa on February 22.

In a study published in The Lancet medical journal on the preparedness and vulnerability of African countries against the importation of Covid-19, an international team of scientists identified Algeria, Egypt and South Africa as the most likely to import new coronavirus cases into Africa, though they also have the best prepared health systems in the continent and are the least vulnerable.

Why the pandemic in not widespread, as expected in the African continent remains unknown, according to Professor Thumbi Ndung’u, of the African Institute for Health Research in Durban, South Africa, saying, “Perhaps there is simply not that much travel between Africa and China.”

But Ethiopian Airlines, the largest African airline, never suspended its flights to China since the epidemic began, and China Southern on Wednesday resumed its flights to Kenya. And, of course, people carrying coronavirus could enter the country from any of the other 60-odd countries with known cases.

To head of the infectious diseases department at Bichat hospital in Paris, Professor Yazdan Yazdanpanah, “Perhaps the virus doesn’t spread in the African ecosystem, we don’t know.”.

This hypothesis was however, rejected by Professor Rodney Adam, who heads the infection control task force at the Aga Khan University Hospital in Nairobi, Kenya.

He said, “There is no current evidence to indicate that climate affects transmission. While it is true that for certain infections there may be genetic differences in susceptibility…there is no current evidence to that effect for Covid-19.”

The study in The Lancet found that Nigeria, a country at moderate risk of contamination, is also one of the best-equipped in the continent to handle such an epidemic.

But the scientists had not anticipated that the first case recorded in sub-Saharan Africa would be an Italian working in the country. 

Little more than a week ago, an epidemiologist at the University of Bordeaux and one of the co-authors of the report, Mathias Altmann, said, “Our model was based on an epidemic concentrated in China, but since then the situation has completely changed, and the virus can now come from anywhere.” The short shelf-life of studies testify to the speed of the epidemic’s spread.

The Italian who tested positive for the coronavirus in Lagos had arrived from Milan on February 24, but had no symptoms when his plane landed. He was quarantined four days later at the Infectious Disease Hospital in Yaba.

For Altmann, an expert in infectious diseases in developing countries, the fact that coronavirus appears to have entered sub-Saharan Africa through Nigeria is “actually good news”, because the country appears to be relatively well prepared for confronting the situation.

He said that in a continent that “has had its share of epidemics and whose countries, therefore, have a huge knowledge of the field and real competence to react to this kind of situation,” Nigeria is in a very good position to confront the arrival of Covid-19.

He added, “The CDC [Center for Disease Control] responsible for the entire region of West and Central Africa is located in Abuja, the capital of Nigeria, which means that their organisational standard in health matters is very high.”

Renowned for “succeeding to pretty quickly contain the Ebola epidemic in 2014,” it took the Nigerian authorities only three months to eradicate Ebola in the country. The World Health Organization and the European Centre for Disease Prevention and Control at the time congratulated Nigeria for its reactivity and “world-class epidemiological detective work.”


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