A map has been created to illustrate the continent’s most at-risk countries for the coronavirus and those best equipped to fend off the epidemic.
People hoped the coronavirus – or COVID-19, as it has been officially renamed by the World Health Organization (WHO) – was contained, stabilised or even on the decline. However, once Chinese authorities adopted a broader definition of coronavirus cases, at the flip of a switch the number of persons infected dramatically increased from an estimated 44,000 on 12 February to more than 60,000 on 13 February, with the vast majority of cases reported in China and, for the time being, no cases reported in Africa.
However, WHO and the African branch of the United States’ Centers for Disease Control and Prevention (CDC) prefer to be cautious: statistically speaking, it is highly unlikely that Africa will be the only continent unaffected by COVID-19, and it is possible that there are people in Africa who have the virus but have simply not yet been detected.
At this time, the various suspected cases in countries like Côte d’Ivoire and Burkina Faso have proved to be false alarms.
In an effort to go beyond basic probabilities and platitudes, scientists from Europe, Africa and the United States teamed up to map, as precisely as possible, the virus’s importation risk in Africa. Which countries are the most at risk and where does the illness have the greatest chance of being appropriately stamped out?
From the most vulnerable countries…
To answer these questions, doctors, epidemiologists, demographers and public health experts compared data, created a methodology and drew up maps.
The results of their work, which was conducted under the supervision of experts from INSERM at Sorbonne Université, were published online at medrxiv and provide a list – accompanied by various maps and charts – of the African countries most vulnerable to the arrival of COVID-19.
Part of what makes the study so original is that it takes into account the volume of air traffic connections between each African country and Chinese regions heavily impacted by the virus (see map 1).
Based on this criterion, Egypt, Algeria and South Africa stand out the most and, since the first infected individuals are highly likely to arrive in Africa via air travel, are the most at risk.
The silver lining is that these three countries, especially South Africa, rank among those with the soundest health system and are probably the most capable of containing the epidemic.
Next in line in the high-risk category are Nigeria and Ethiopia due to their close ties with China. They are followed by Morocco, Sudan, Angola, Tanzania, Ghana and Kenya.
… to the countries best equipped to fend off COVID-19
The study also takes into account two indicators known as SPAR (State Party Self-Assessment Annual Reporting) and IDVI (Infectious Disease Vulnerability Index). SPAR, which is intended to assess the capacity level of each country’s health system, can be unreliable since it is based solely on information reported by local authorities.
IDVI (see map 2) appears to be sounder since it is produced by international experts and takes into account a broad range of factors, such as the state of health systems, economic development, how previous epidemics were spread, and, a particularly crucial point in the case of the coronavirus, demographics and population density.
Based on these factors, countries best equipped to fend off COVID-19 include South Africa, Egypt, Tunisia and Morocco, while the most vulnerable include Somalia, Chad, the Central African Republic and Mauritania. But here again, there’s a silver lining: although vulnerable, these countries are not, so it seems, the most likely to have infected individuals arrive in their respective countries.
In the US, researchers at Johns Hopkins University in Baltimore have developed a COVID-19 global cases daily tracker that is updated on a very regular basis. According to their calculations, the Johannesburg airport is most likely to be the first place to ‘import’ the virus on the continent.
That said, their prediction is entirely based on statistics and has accordingly been met with sharp criticism by the Chinese government.
During a press conference on 5 February, Chinese Ambassador to France Lu Shaye had harsh words to say about the various scenarios devised by Western researchers and which, in his opinion, are pure speculation and only serve to spread panic.