Experts call for accelerated testing in Africa as WHO predicts up to 190,000 COVID-19 deaths

By John Agaba

June 1, 2020

Experts have called on African countries to accelerate testing, contact tracing, isolation and treatment of COVID-19 positive persons after a World Health Organization study predicted up to 190,000 persons on the continent could die in the first year of the pandemic.

Dr. John Nkengasong, director of the Africa Centers for Disease Control and Prevention (CDC), said it was “very vital” for African countries to accelerate the 3Ts — testing, tracing and treatment — to manage the spread and effects of the viral infection that’s killed over 300,000 globally. The WHO report estimated nearly one in four Africans was at risk of contracting the novel coronavirus this year.

The goal of Africa CDC is to test at least one percent of Africa’s 1.3 billion population, Nkengasong said.  “That is about 13 million people,” he said. “But then we have to trace contacts, isolate those who are positive and treat them. With this virus, we have to emphasize contact tracing. There is no other way.”

The study by the WHO regional office for Africa predicted a lower rate of exposure and viral spread for the continent than elsewhere in the world. But it indicated the associated rise in hospital admissions, health needs and huge impact on other morbidities, including HIV and tuberculosis, could disproportionately strain resources and worsen impact of the virus here.

“While COVID-19 likely won’t spread as exponentially in Africa as it has elsewhere in the world, it likely will smolder in transmission hotspots,” Dr. Matshidiso Moeti, the WHO Regional Director for Africa was quoted as saying. “COVID-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region.”

The WHO study estimated there could be 3.6 to 5.5 million COVID-19 hospitalizations, of which 82,000 to 167,000 would be severe cases requiring oxygen and 52,000 to 107,000 would be critical cases requiring breathing support.

Such numbers would severely strain health resources, which are already lacking. 

African countries have to aggressively address the component of testing and treatment of COVID-19 positive cases to “not allow these estimates to happen,” said Dr. Monica Musenero, consultant epidemiologist and senior presidential advisor on epidemics in Uganda.

“The estimates give us a standard we can look at to improve. It is our duty [as Africans] to encourage interventions which we already know work, such as social distancing and proper hygiene,” Musenero said. “We have to test and quickly identify persons who are positive and treat them.

“We should make sure that we contribute as few cases [to the global burden] as we can,” she added.

As of May 31, Africa CDC was reporting 147,099 confirmed cases of coronavirus, with 4,228 deaths and 61,808 recoveries.

The continent has made significant gains in testing, with around 1.5 million COVID-19 tests conducted so far. However, testing rates remain low and a number of countries continue to require support to scale-up testing.

The WHO study said “containment measures” were critical for the region, as health systems in Africa were not designed to mitigate against implications of widespread community transmission of SARS-COV-2.

The study researchers called on countries of the WHO African Region to expand capacity of their primary hospitals, in particular, to mitigate implications of widespread community spread of SARS-CoV-2. They said basic emergency care needed to be included in primary care systems.

But Nkengasong said testing as many people as possible and protecting health workers who come into contact with suspected and confirmed cases are crucial aspects of this response.

“There is need to accelerate the testing capacity in all the African countries,” said Nkengasong, revealing that the Africa CDC was working with its partners to procure and deliver test kits and personal protective equipment to the rest of the continent, especially those with the most vulnerable populations.

“It is important that we prioritize these containment measures. We have to collaborate, speak to each other and with one voice implement these interventions which science has shown work,” he said.

Nkengasong said the slow progression of the virus on the continent was perhaps because a number of African countries “locked down early” and other “unique environmental factors.” Nonetheless, he called on the countries to be vigilant and proactive to defeat the virus.

“We have to go with an assumption that we have not seen all the cases because of the limited testing, but at the same time we are encouraged that we are not seeing lots of community cases and deaths happening,” Nkengasong said. “Also, we have not seen massive flooding of our hospitals because of COVID-19 infected patients.”

But African countries must work together to rid the continent of the virus.

“We can never really say Africa is free of COVID-19 when some individual countries still have cases,” Nkengasong said.

Image: Flying Doctors Nigeria