Some African countries will have more than 10,000 coronavirus cases by the end of April, health officials projected Thursday, as the continent least equipped to treat serious infections has an "enormous gap" in the number of ventilators and other critical items.
Coronavirus cases in some African countries will begin to pass the 10,000 mark by the end of April, health officials said Thursday, as the continent least equipped to treat serious cases has an "enormous gap" in the number of ventilators and other critical items.
While cases across Africa are now above 6,000 at what has been called the dawn of the outbreak, the continent is "very, very close" to where Europe was after a 40-day period, the head of the Africa Centers for Disease Control and Prevention, Dr. John Nkengasong, told reporters.
The virus "is an existential threat to our continent," he said. Local transmission has begun in many countries. Just five of Africa's 54 nations have not reported cases, but Nkengasong said it's just a matter of time until they get the virus.
He said authorities are "aggressively" looking into procuring equipment such as ventilators that most African countries desperately need, and local manufacturing and re-purposing are being explored.
"We've seen a lot of goodwill expressed to supporting Africa from bilateral and multilateral partners," but "we still have to see that translate into concrete action," he said.
The World Health Organization doesn't know how many ventilators are available across Africa to help those in respiratory distress, regional director Dr. Matshidiso Moeti told reporters. "We are trying to find out this information from country-based colleagues. ... What we can say without a doubt is there is an enormous gap."
Some countries have only a few ventilators. Central African Republic has just three.
A small percentage of people who are infected will need ventilators and about 15% may need intensive care, said WHO official Dr. Zabulon Yoti.
The health officials pleaded for global solidarity at a time when even some of the world's richest countries are scrambling for basic medical needs, including face masks.
"Countries like Cameroon just reached out yesterday, Ivory Coast, Burkina Faso, asking, 'Look, we need tents because we're running out of hospital beds already,'" Nkengasong said.
Even if equipment is obtained, getting them to countries is a growing challenge with Africa's widespread travel restrictions, though countries have made exceptions for cargo or emergency humanitarian flights.
Simply gauging the number of coronavirus cases in Africa is a challenge, even in South Africa, the most developed country on the continent, where authorities have acknowledged a testing backlog.
Other countries suffer from the widespread shortage of testing kits or swabs, though 43 countries in the WHO Africa sub-Saharan region now have testing capability, up from two in early February.
As more African countries impose lockdowns, both the WHO and Africa CDC expressed concern for the millions of low-income people who need to go out daily to earn their living. That's a "huge challenge," Moeti said, noting that hundreds of thousands of children are now out of school as well.
It is too soon to tell how the lockdown in places like South Africa has affected the number of cases, she added.
"Don't lock down the whole country," Nkengasong said. "Lock down cities or communities where there's extensive community transmission so .. social harm is minimized. But if infection is spreading across the entire country, you have no choice."
Health experts in Africa are rushing to understand whether factors such as Africa's youthful population — some 70% of the continent's people are under age 30 — will be a benefit in fighting off the virus and how the widespread problems of malnutrition, HIV, tuberculosis and malaria might affect people's ability to fight off infection.
"Our greatest fear" is that programs tackling those perennial issues will be sapped by the current crisis, Nkengasong said. "The time to advocate for those programs is not when COVID is over. The time is now."
Dr. Meredith McMorrow, Medical Officer in the U.S. Centers for Disease Control and Prevention's influenza division, acknowledged to reporters that the U.S. is "suffering right now" and that limits the U.S. ability to respond with overseas aid. But she said the U.S. is helping African nations procure overseas equipment "as rapidly as possible."
The latest African nation to report its first virus death was Zambia.
A shaken South Africa on Friday announced its first two deaths from the coronavirus as the country's cases rose above 1,000 and a three-week lockdown began, with some police screaming at the homeless on emptying streets.
The health minister said the deaths occurred in Western Cape province, home of Cape Town. South Africa has the most virus cases in Africa, with the total across the continent now above 3,200.
Security forces with megaphones screamed at people shortly after midnight in downtown Johannesburg, the country's commercial hub. Homeless people scattered, looking for places to shelter, to the astonishment of residents who lined up on balconies and filmed the patrols with their mobile phones. One baton-wielding officer took chase.
Some motorists were pursued, stopped and searched. "Go home," security forces shouted. "You cannot be outside ... You are so selfish." Around 3 a.m., sustained gunfire echoed through the streets.
South Africa's military helped to enforce measures that include bans on sales of cigarettes and alcohol, even dog-walking. After daybreak, police and military forces again surrounded a few dozen homeless people in downtown Johannesburg close to the main train station.
The risk of abuses was a concern. In Rwanda, which imposed a lockdown over the weekend, police have denied that two people shot dead on Monday were killed for defying the new measures.
South African President Cyril Ramaphosa, in full military uniform, on the eve of the lockdown told troops to be a "force of kindness" and reminded police that "our people are terrified right now and we should not do anything to make their situation worse."
People are meant to go outside only to obtain essentials such as groceries or medical care or to provide essential services. Public transport operates only during the usual rush hours, but complaints were reported of being charged double the price.
"We are putting our lives at risk," one commuting worker, Simphiwe Radebe, told The Associated Press, saying they had little choice. "Please pray for us that are still working." Minibus taxis were sprayed with disinfectant before passengers boarded, leaving spaces between them, some wiping their hands.
Some shoppers ignored calls to keep at least a meter apart, jostling, as about 200 lined up outside a center in Vosloorus, a township east of Johannesburg.
Some people were openly scared. One caller to a popular morning radio talk show dissolved into tears: "I feel there's nothing we can do," he said.
Anxiety has been especially high among low-income South Africans squeezed into crowded townships with limited water supplies, sometimes with an extended family sharing a shack of corrugated metal and little income. Fears of an increase in domestic violence and rape have been expressed by civil society groups.
Economic pain is widespread, with the country already in recession and unemployment at 29%.
In Africa's largest city, Nigeria's Lagos, traders also worried after nonessential markets were shut down and the country's cases rose to 65. "If we do not go out, we cannot eat, our government did not make any provision for us," Bolaji Tajudeen said.
Elsewhere in Africa, the United Nations mission in Somalia said a contractor had the virus, bringing cases in that fragile country to three. Somalia's health ministry said the person was in the international compound at the Mogadishu airport, where many diplomats and aid workers are based.
For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.
More lockdowns are expected. Twenty-four of Africa's 54 countries already have fully closed borders, according to the Africa Centers for Disease Control and Prevention.
"It is a literally a matter of life and death," Botswana President Mokgweetsi Masisi said Friday, urging citizens to stay home. The country is just one of eight in Africa without a confirmed case. "Our actions will determine whether we survive this pandemic or not."
Customers started behaving oddly about a week ago, visibly dejected street vendor Frank Mojapelo said. Some were wary to exchange cash. Some backed away, or refused to touch him.
Now, an unprecedented lockdown looms in South Africa over the coronavirus, with a country of 57 million people told to stay home starting Friday. Virus cases leapt again to 554 on Tuesday, the most of any country in Africa. Forty-three of the continent's 54 countries now have cases, with the total at 2,046, the Africa Centers for Disease Control and Prevention said.
The next few weeks will be tough, Mojapelo said. Though people will be allowed to leave home under "strictly controlled circumstances" to access essential items, he doubts he can continue selling boiled eggs, candy and homemade pickles out of the trunk of the car that he pulls up onto the Johannesburg sidewalks.
Small businesses expect to suffer. And that pain could grow across Africa as more countries impose tougher measures. Economies are expected to take a severe hit as borders close and trade drops.
Africa needs a $150 billion emergency financing package, Ethiopia's government said in a proposal to the G20 global forum for economic cooperation ahead of the G20 summit.
"COVID-19 poses an existential threat to the economies of African countries," the proposal said. It also proposes that all interest payments to government loans, and part of the debt of low-income countries, should be written off.
Rwanda and Tunisia also have announced lockdowns. In South Africa, determined shoppers are making their last runs for supplies as authorities try to reassure the public that food will not run out.
Nelson Pombo, who runs his own supermarket in Johannesburg, said he hoped to make more sales during the lockdown as people try to avoid bigger supermarkets, where social distancing has been difficult.
"People will be too scared to go to bigger shops to avoid the virus," he said. "I will also be spraying hands with sanitizers to make sure they are safe in the store." Mixed with his confidence, however, was worry that some suppliers would increase their prices because of the high demand.
Workers across South Africa will be required to stay home except for those in essential services including health care and security as well as the production and distribution of food, utilities and medical products.
A significant number of last-minute customers and workers wore face masks or gloves as businesses such as hair salons seized the chance to make more money before the lockdown pinched wallets.
Fanuel Mamova, who was accompanied by his two children after schools were shut down last week, said he only bought the basic goods — flour, toilet paper, cooking oil — which will last for only a week.
"Even if we wanted to buy more, we cannot because we are only getting paid our salaries at the end of the month," he said.
South Africa's economic hub of Gauteng, which includes Johannesburg and the capital, Pretoria, has the country's highest number of infections with 302, followed by the Western Cape, which includes the city of Cape Town, with 213.
Health Minister Zweli Mkhize said officials expected the number of cases to continue to rise despite the lockdown, but changes might be seen around the end of the second or third week of the lockdown.
"We must not be shocked when we see the increase," Mkhize said.
Elsewhere in Africa, the West African nation of Niger recorded its first virus-related death. Authorities said a 63-year-old man who was brought to a hospital Monday tested positive for the virus after he died Tuesday. Niger's health minister also reported three new cases, bringing the country's total to six.
South Sudan closed its borders as the country struggling to rebuild from a five-year civil war tried to prevent the virus from arriving. Some senior government officials and others were not complying with orders to be checked for fever at the airport in the capital, Juba, said the undersecretary in the health ministry, Dr. Makur Matur Koriom.
Nigeria's ban on international flights began. And Zimbabwe's president said the country was closing its borders to all but returning residents.
South Africa's coronavirus cases jumped to 402 Monday, up 128 from the day before, continuing worrying exponential growth and making it the country with the most cases in Africa.
South African President Cyril Ramaphosa is expected to speak to the nation about the growing threat and many expect him to announce new restrictive measures to try to slow the spread of the disease.
More than half of South Africa's total cases are in Gauteng province, which include Johannesburg, the country's largest city with 5.7 million people, and the capital, Pretoria, with 2.4 million, according to the figures released by the government health ministry.
South Africa has overtaken Egypt to be become the African country with the highest number of cases. South Africa has not registered a death from the disease. The majority of cases are from travelers from Europe and other countries, but the number of cases that are locally transmitted is rising.
Lockdowns have begun in Africa as coronavirus cases rise above 1,000, while Nigeria on Saturday announced it is closing airports to all incoming international flights for one month in the continent's most populous country.
Rwanda said all unnecessary movements outside the home are banned for two weeks as of midnight except for essential services such as health care and shopping. The East African nation, which has 17 cases, told all public and private employees to work from home. Tunisia earlier imposed a lockdown as well.
Meanwhile, two African heads of state appeared to defy their own travel restrictions to attend another president's inauguration.
Uganda, Eritrea and Angola announced their first cases, meaning 42 of Africa's 54 countries are now affected. Congo and Ghana reported their first death; Burkina Faso reported two new ones. Uganda is closing its borders to all but cargo. Ethiopia said all arriving passengers will face mandatory quarantine as of Monday. Republic of Congo and Ghana are closing their borders. But Somalia is lifting its ban on international flights for two days so stranded citizens can come home.
Nigeria's international flight ban came a day after Africa's busiest airport, in Johannesburg, blocked foreigners from disembarking and two major airlines — Ethiopian Airlines and South African Airways — announced sweeping cancellations of international flights.
Nigeria's announcement followed its first cases in the capital, Abuja.
The Nigerian Civil Aviation Authority said "emergency and essential" flights are exempt from the ban that starts Monday. An adviser to President Muhammadu Buhari, Bashir Ahmad, said Nigeria also plans to suspend passenger rail services starting then.
While Angola closed air, land and sea borders this week, President Joao Lourenco attended Saturday's inauguration of Namibian President Hage Geingob. Also there was President Mokgweetsi Masisi of Botswana, which this week suspended international travel by all government employees. Namibia has three cases.
"My conscience tells me ... I did not give a bad example to Angolans," Lourenco told state television, saying his earlier decree left room for extraordinary circumstances, the Portuguese news agency Lusa reported.
Zimbabwean President Emmerson Mnangagwa also was there. On Saturday, his country announced the first case in the capital, Harare.
Africa now has more than 1,100 cases, the Africa Centers for Disease Control and Prevention said.
Burkina Faso now has the most virus deaths of any country in sub-Saharan Africa and the most cases in West Africa with 64.
Several government ministers there have tested positive. On Friday, President Roch Marc Christian Kabore announced the country's two international airports would close for two weeks with exceptions for military and cargo.
Burkina Faso is one of Africa's most fragile states with a growing humanitarian crisis caused by attacks linked to Islamic extremists. More than 130 health centers have closed, the government and aid groups say.
According to a government response plan seen by The Associated Press, emergency teams aren't trained for a respiratory disease outbreak and don't have appropriate protective gear.
There's also insufficient screening at borders. Of Burkina Faso's 44 high-flow entry points, only 23% have coronavirus screening devices.
Jerry-Jonas Mbasha, cluster coordinator for the World Health Organization in Burkina Faso, said he was "much worried about what might happen in the next one week, two weeks from now."
Most people only experience minor flu-like symptoms from the coronavirus and recover within a few weeks, but the virus is highly contagious and can be spread by those who appear well. It can cause severe illness, including pneumonia, in some patients, particularly those with underlying health problems.
More than 275,000 cases have been confirmed globally, including over 11,000 deaths, according to a running tally by Johns Hopkins University. At least 88,000 people have recovered.
In Nigeria, which just three weeks ago announced the first coronavirus case in sub-Saharan Africa, authorities said that first patient, a man who had traveled from Italy, was now fit to go home.
In Kenya, health officials disinfected crowded markets in the capital, Nairobi.
"It's for the sake of us, it's for the sake of the country," said Simon Kimani, public health council chairman.