How might Africa experience a large scale outbreak of COVID-19?

Updated: Apr 8, 2020

Although a widespread major outbreak has yet to hit the continent, it is important to acknowledge the economic, social and medical implications that Africa might face as its healthcare systems and societies attempt to absorb the virus.

The fear of COVID-19 that is taking hold is not unique to any one group, but is felt by all people across the globe. We are experiencing a collective loss of safety that is unprecedented in recent history. A loss of safety that ignores geographical boundaries. To use the United Kingdom as an example, the government has introduced both strict social isolation measures and a scheme for furloughing workers which entitles eligible employees to eighty per cent of their wage up to £2,500 a month. The United States, Australia, and various countries throughout Europe have also introduced similar schemes.

What these countries have in common is their socioeconomic status as a developed country. If and when the virus gets a stronghold in Africa, it will not be feasible to implement the same measures. Just by looking at BBC News, South Africa has the highest confirmed cases, Algeria has the highest deaths and Egypt is not far behind either of these statistics. These countries are starting to see a steady increase in confirmed cases, and it is probable that other regions will follow a similar trajectory. According to medical journal the Lancet, there is no strong evidence that African countries might face smaller epidemics as a result of their more temperate climates. Although this is a widespread theory, there appears to be no concrete evidence that Africa will be less affected than its European counterparts.

"Hand washing is an unaffordable luxury."

Major problems that countries in Africa will face in tackling a sizeable outbreak of the virus may have common themes. In major cities, issues concerning smaller and more crowded living conditions will make both isolation and social distancing much harder to implement for those dwelling in overcrowded informal settlements on the outskirts of metropolitan areas. There is a near impossibility of isolation for oneself or ones family when home is a single room with no running water, and all bathrooms and toilets are shared. The deeply communal roots of African society also make social distancing hard when extended families often share housing and food.

Water is expensive and hard to obtain, and that is without the added concerns of water sanitation; hand washing is an unaffordable luxury. The BBC have created a video on the disparities in rural areas with regards to access to safe water, and how communities and families must prioritise their water use. On top of these pragmatic issues, underlying health problems like HIV and malaria will make a large percentage of persons much more susceptible to SARS-CoV-2 as a result of their already immunocompromised status. Access to basic medical services is often the exception rather than the norm - a high prevalence of endemic disease increases the potential burden of the pandemic.

I am no doctor, but it is not hard to imagine the chaos that will overwhelm already inundated healthcare infrastructures throughout Africa. This is not to say that every country will have the same experience of the virus. Just as in Europe, each nation will encounter the virus in its own unique way. For example, coming out of a six year civil war, South Sudan is responsible for well over one million displaced persons. As with all refugee health crises this will bring with it its own unprecedented issues in management and treatment of COVID-19. The continent’s population demographic and healthcare systems make it unique from areas that have experienced outbreaks to date, and will therefore require different measures to absorb the pandemic.

"The African context is unique."

(Why Sub-Saharan Africa needs a unique response to COVID-19, World Economic Forum.)

Even in developed countries with well-funded established healthcare systems and proper housing we have been collectively overwhelmed and unable to cope - physically or mentally - with the disease. In Africa, dense populations, poor sanitation and congested communities make the quick spread of the virus probable if not inevitable. The global fear and apprehension that is escalating about coronavirus is exacerbated when a high percentage of communities have inadequate understanding of disease transmission and often a distrust of Western medicine.

COVID-19 has highlighted the inter-connectedness of humanity and how our similarities outweigh any and all differences. The virus does not recognise any socially constructed disparities; not the colour of our skin, not our gender, not our political affiliations. It is a truly global disease. It does not discriminate. The Prime Minister of Ethiopia wrote for the Financial Times:

“Only a global victory can beat this pandemic, not a temporary rich countries’ win”

He highlighted how African economies are fragile at the best of times, and would lack the same financial resources to make such meaningful interventions as the West.

'The virus does not recognise any socially constructed differences; not the colour of our skin, not our gender, not our political affiliations.'

The pandemic is going to leave a legacy of years and potentially even decades. There is categorically no way that humanity will be able to resume as if nothing happened. We are being forced to re-evaluate the way our societies are constructed, the way our healthcare systems operate and the way our economies function.

Socioeconomically developed countries are not immune to epidemics. However, as is often the case, the hardest battles will be fought in some of the poorest and most underprivileged communities. Change will require humility and perseverance. Empathy and global solidarity are going to be crucial to fight this pathogenic invader.

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