Faulty detection, climatic factor or simple fluke? The very low number of cases of coronavirus detected in African countries, with the most fragile health systems, continues to question and even worry experts.
To date, only two people have been officially infected with the Covid-19 virus on the continent, one in Egypt, the other in Algeria, for no deaths.
A drop in the ocean of the 80,000 cases and 2,800 deaths recorded in fifty countries, mainly in China, where the first focus of the epidemic appeared in the city of Wuhan, according to the World Organization of Health (WHO).
Shortly after the virus appeared, specialists pointed out the risks of the disease spreading in Africa. Because of its close commercial links with Beijing and the weaknesses of its medical network.
Last week, WHO even warned that the continent was ill-prepared to deal with the epidemic.
“”Our main concern continues to be the potential for dissemination of Covid-19 in countries with more precarious health systems,” said his boss, Tedros Adhanom Ghebreyesus.
Modeling published in the medical journal The Lancet made Egypt, Algeria, and South Africa, which announced on Thursday the repatriation of 132 of its nationals from Wuhan, the three most threatened countries of the continent.
They are also, according to the study, the least vulnerable because they are the best prepared to spot the infection.
But despite numerous alerts, the epidemic does not seem to have developed significantly on the continent so far.
– Vulnerability –
Why? Epidemiologists get lost in guesswork.
“Nobody knows,” says Professor Thumbi Ndung’u, of the African Institute for Health Research in Durban (South Africa). “Perhaps there is simply not so much travel between Africa and China,” he said.
Ethiopian Airlines, the largest African airline, has however never suspended its links with China since the start of the epidemic. And China Southern has just resumed its flights with Kenya.
So some are advancing the path of possible climate protection. “Perhaps the virus does not grow in the African ecosystem, we do not know,” sketches Professor Yazdan Yazdanpanah, head of the infectious diseases department of Bichat hospital in Paris.
A hypothesis rejected by Professor Rodney Adam, of the Aga Khan University Hospital in Nairobi (Kenya).
“We have no evidence of any influence of the climate on the transmission (of the virus)”, he assures, “at present, it seems that the vulnerability of Africans is the same as that of others elsewhere”.
Others are tempted to attribute the low number of confirmed cases of coronavirus to possible failures of the detection systems deployed in the countries of the continent.
“It is true that there are certain countries, certain regions of which we are not sure of the capacity, if only for lack of resources, to implement the diagnostic procedures”, says Dr. Daniel Levy-Bruhl, from the French health agency Sante Publique France.
– Systems in place –
“There is a risk that little-known chains of transmission exist today in some countries of the world,” he adds.
Specialists, however, rule out the risk of massive detection errors. “But if there were massive cases in Africa, I think we would know because the WHO is on alert and many people are very attentive,” said Dr. Amadou Alpha Sall, head of the Institut Pasteur de Dakar (Senegal).
“All the systems are in place,” confirms Dr. Michel Yao, in charge of emergency plans for the WHO in Brazzaville (Congo).
The number of African countries with laboratories capable of identifying Covid-19 has increased in a few weeks from two (South Africa and Senegal) to 29, welcomes Dr. Yao.
The precautionary principle was also imposed. Thursday, Madagascar prohibited its territory, popular with tourists, to all travelers who have recently stayed in Iran, Italy or South Korea, important centers of the epidemic. For its part, the government of the Cape Verde tourist archipelago decided on Thursday to ban for three weeks all flights from Italy.
A weak point persists, however, underlines Dr. Yao, the capacity to contain the epidemic and to treat its victims.
“Most African countries would not be able to deal with severe cases requiring intensive care,” he said, “capacities are limited in capitals (…) and outside, they are even weaker.”
But rather than considering a catastrophic scenario, specialists prefer to be satisfied with their current good fortune.
“It is difficult to say why” so few cases have been identified so far in Africa, underlines Professor Thumbi Ndung’u, “perhaps we are just lucky”.