NAIROBI – Despite a steady daily rise in COVID-19 infections, African countries have begun to ease lockdown restrictions amid warnings from international experts the continent must remain alert and do wider testing.
Since the first African coronavirus case was detected on Feb. 14 (a Chinese citizen in Egypt), 2,400 people have died, 70,000 infections have been recorded and 24,000 patients have recovered.
Although these figures are growing steadily in 53 of the 54 African sovereign states (Lesotho has not reported any confirmed infections) they are still a long way off countries like the United Kingdom, with more than 227,000 cases and 32,000 deaths, or the United States, with around 1.3 million infections and 82,000 fatalities.
Five African countries have been identified as hotspots on the continent of almost 1.3 billion people: Algeria, Egypt, Morocco, South Africa and Nigeria.
The rapid reaction against the virus from African countries received international praise.
With just a few cases but aware of their vulnerable health systems, they adopted drastic public and social health measures, including curfews and lockdowns.
In the last 10 days nations such as South Africa, Nigeria, Ghana, Senegal, Kenya, Uganda, Rwanda, Botswana, the Democratic Republic of the Congo and Djibouti have started to ease some restrictions.
Nationwide lockdown “cannot be sustained indefinitely. Our people need to eat, they need to earn a living. Companies need to produce and trade,” said South African President Cyril Ramaphosa on April 24 after ordering a strict shut down in March in the country that has reported the highest number of cases in the continent, more than 11,300.
It is about striking a difficult balance between fighting the pandemic and mitigating the devastating economic impact on millions of people who “depend on working daily to survive,” Nigerian doctor Adaora Okoli told EFE.
“Without government palliative measures, many people would starve and a lot would rather die of COVID-19 than of hunger. So it is a dicey situation,” said Okoli, who works as a resident doctor at Tulane University in the United States.
A one-month lockdown in Africa would cost the continent 2.5% of its gross domestic product, the equivalent of about $65.7 billion, according to the latest report from the United Nations Economic Commission for Africa (UNECA).
The Africa Centers for Disease Control and Prevention described the response to the virus is “a marathon, not a sprint.”
The organization has warned against a premature de-escalation while asking for a balanced easing of measures in a bid to prevent a rebound of the outbreak.
Relaxing restrictions carries risks. Ghana’s President Nana Akufo-Addo promised not to let his “guard down” as he eased lockdown measures in cities like the capital Accra and Kumasi last month.
Akufo-Addo announced on Sunday that a worker at a fish processing factory in the coastal city of Tema, near Accra, infected another 533 employees with coronavirus.
“I believe that easing of lockdown without adequate preparations is a disaster waiting to happen (…). Businesses have to be ready to apply physical distancing and infection control and prevention measures,” Okoli said.
The World Health Organization estimated that between 83,000 and 190,000 people could die from COVID-19 and as many as 44 million could become infected in Africa if measures to contain the pandemic fail.
For WHO the strategy is clear: “We need to test, trace, isolate and treat.”
Clear but complicated to manage since, as the organization has reported, there are “on average nine intensive care unit beds per one million people on the continent.”
Carrying out mass coronavirus testing in a bid to know the true magnitude of the pandemic is not an easy task either.
“Lack of access to diagnostics is Africa’s Achilles heel,” John Nkengasong, director of Africa Centers for Disease Control and Prevention, told EFE.
Last month, the institution developed a plan to distribute one million tests, although it recognized that at least 15 million are needed to stop the epidemic.
Countries with successful testing strategies, such as South Korea and Germany, reached at least 1% of their population, according to a study published in The Lancet medical journal last week.
According to the research, Africa is far from that goal.
South Africa, one of the African countries that has carried out the highest number of tests, had completed 161,000 by April 26 but would need to carry out 593,000 to cover 1% of its population.
“Testing should be ramped up so that countries can monitor the spread of the infection,” said Nigerian epidemiologist Ngozi Erondu, a researcher at the Chatham House Universal Health Center and one of the study’s co-authors.
“Random testing of communities will help us get an understanding of the test positivity rate (percentage of individuals that test positive in a population).
“If this is high then countries may have to restrict movement in certain areas, if it’s low, then restrictions can be relaxed.”
However, the continent finds it difficult to acquire these tests because “supplies have already been purchased for use in North America and Europe,” according to The Lancet.
The publication said it is “immoral” that Africa has “less access and more difficult options than others.”
If that situation is not fixed, the injustice will extend to access to a COVID-19 vaccine, although several African countries are taking part in clinical trials to develop a treatment.
Erondu said that vaccine development “can traditionally take up to a decade.”
“With new technology such as mRNA-based vaccines, some scientists predict that we could have a vaccine in one year,” he added.
“This has never happened but fingers crossed it will happen for COVID-19.”