Coronavirus in Africa: Contained or unrecorded?

Medical staff at Chandaria Health Center experiment with facial shields in Nairobi, Kenya – May 14, 2020

The World Health Organization (WHO) has warned that almost a quarter of a billion Africans can contract coronavirus in the first year of the pandemic, with between 150,000 and 190,000 of them dying.

So far, Africa has had less than 100,000 cases, but WHO experts believe the continent will have a prolonged outbreak over a few years – and the strong focus on containing the virus has led to other health problems.

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Here, five BBC reporters show what is happening in their countries:

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Congolese & # 39; probably had viruses without knowing it & # 39;

By Emery Makumeno, Kinshasa

DR Congo is battling coronavirus and ebola
DR Congo is battling coronavirus and ebola

The Democratic Republic of Congo confirmed its first case of Covid-19 in early March, but a doctor in the capital, Kinshasa, believes the disease has arrived earlier.

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"During December and January, I don't remember how many patients sought medical treatment, cough and fever and headaches," he said, referring to the WHO-listed symptoms of Covid-19.

"I am convinced that we, the medical team, have already been exposed to coronavirus, without knowing it, and have created a kind of immunity," he added.

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But the Democratic Republic of Congo carried out few tests to check people's Covid-19 status, due to a lack of medical equipment.

Countries with successful testing strategies, like South Korea and Germany, quickly reached at least 1% of their population, points out the British medical journal The Lancet.

If equipment is available, many African states will be able to speed up testing – they did more HIV testing between October 1 and December 31 than the 1% target for Covid-19 testing, says The Lancet.

  • Number of Covid-19 tests carried out in the Democratic Republic of Congo until May 18: 4,493

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  • Tests needed to form 1% of the population: 895,614

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  • HIV tests performed from October 1 to December 31, 2019: 203,859

Sources: Africa CDC; The Lancet

So far, the Democratic Republic of Congo has registered more than 1,600 cases of the virus – the ninth highest number in Africa, according to the WHO.

The first Covid-19 case was detected in La Gombe, Kinshasa's main business district. The government acted quickly to introduce a blockade, but the virus has spread to seven of the country's 26 provinces – including the Lubumbashi mining center.

The outbreak comes at a time when DR Congo – which has poor health services and has been hit by decades of conflict in the east – is also facing an ebola outbreak. It has killed more than 2,000 people since 2018.

The UN children's agency, Unicef, has also raised concerns about a reduction in vaccination rates, saying the gains made with immunization in the past two years can be erased.

Hundreds of thousands of children have not been vaccinated
Hundreds of thousands of children have not been vaccinated

Unicef ​​said that vaccines were already in decline earlier this year and that the effects of the coronavirus will worsen.

Hundreds of thousands of children have not received polio, measles, yellow fever and other vaccines.

The Democratic Republic of Congo may lose its polio-free status and there may be a resurgence in other deadly diseases.

Health workers did not have equipment to protect themselves or children in Covid-19, and parents were afraid to take them to vaccination centers.

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Kenya Hospital has "fewer patients, but more corpses"

By Mercy Juma, Nairobi

To cover your face, become the norm in Kenya
To cover your face, become the norm in Kenya

A large public hospital in the Kenyan capital, Nairobi, recorded an increase of almost 40% in respiratory diseases, such as tuberculosis, pneumonia and asthma, between December and early March, a doctor who works there told the BBC.

However, the hospital has seen a sharp decline in these cases since mid-March, said the doctor, who spoke to the BBC on condition of anonymity because he was not authorized to speak to the media.

One reason was that the government imposed a curfew across the country to curb the spread of the coronavirus.

This resulted in a drop in overnight admissions, but an increase in the number of deaths being taken to the hospital's morgue, the doctor said.

Some people were desperate to get out of quarantine
Some people were desperate to get out of quarantine

People also appeared to be avoiding the hospital for fear of being diagnosed with Covid-19 and being sent to quarantine centers, he said.

This is because the quarantine has been controversial in Kenya, with the government forcing suspected Covid-19 patients to pay for their own confinement.

The price ranges from $ 20 ($ 16) to $ 100 a night, depending on the center, although the government has now promised to cover costs at public quarantine centers.

  • Number of Covid-19 tests carried out in Kenya until May 18: 44,851

  • Tests required for 1% of the population: 537,713

  • HIV tests performed from October 1 to December 31, 2019: 2, 177,170

Sources: Africa CDC; The Lancet

Hostels at schools and universities, as well as private hotels, were used as quarantine centers.

A video clip went viral last month, showing several people climbing a wall to escape a center in Nairobi.

Those quarantined complained that some centers are not much better than prisons, with poor hygiene and overcrowding, making social detachment impossible.

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& # 39; More patients and more corpses & # 39; in northern Nigeria

By Ishaq Khalid, Abuja

Very few tests for Covid-19 have been carried out in Nigeria
Very few tests for Covid-19 have been carried out in Nigeria

There are reports of more people falling ill and dying in Nigeria's most populous state, Kano, since the coronavirus outbreak almost three months ago.

It is therefore not surprising that President Muhammadu Buhari extended the blockade in the northern state until the end of the month.

A grave digger at the Abattoir cemetery in the main city, also known as Kano, told the BBC: "We have never seen this since the great outbreak of cholera that our parents tell us. That was about 60 years ago."

Musa Baba-Shani – head of the medicine department at Aminu Kano Teaching Hospital, the state's main hospital – told the BBC that they are treating more patients with conditions such as asthma, pneumonia and tuberculosis, in addition to the chest. pain and sore throats.

The professor, who works with the hospital's respiratory disease unit, said there has been a 40% to 45% increase in the number of respiratory cases in recent months.

He attributed the increase to the closure of many hospitals in the state, especially private clinics, due to the lack of protective equipment for doctors. This forced more patients to seek treatment at the Aminu Kano Teaching Hospital.

Baba-Shani said that some people with respiratory diseases were diagnosed with coronavirus and referred to treatment centers set up for Covid-19 patients.

He criticized the slow test for coronavirus in the most populous country in Africa, with a population of around 200 million. It would be better for patients and hospitals if tests were speeded up, he said.

  • Number of Covid-19 tests carried out in Nigeria until May 18: 33,970

  • Tests required for 1% of the population: 2,061,396

  • HIV tests performed from October 1 to December 31, 2019: 1,160,920

Sources: Africa CDC; The Lancet

Another doctor at the hospital, who asked not to be named because he was not authorized to speak to the media, said some people were avoiding seeking treatment because they feared contracting Covid-19 in hospitals.

In northeastern Yobe state, an extraordinarily high number of people – 471 people – have died in the past five weeks.

It is not clear whether the deaths are related to the coronavirus, but state health commissioner Muhammad Lawan Ghana told the BBC that a preliminary investigation found that the majority of the dead were elderly people with pre-existing health conditions such as hypertension and diabetes .

Nigeria has more than 6,000 confirmed cases of coronavirus, the third highest in Africa.

The commercial capital, Lagos, is at the epicenter of the outbreak, but a blockade imposed at the end of March was partly eased, increasing the fear that the virus could spread.

"It is a difficult decision, but I think it was the wrong decision," said Andrew Iroemeh, who works at a Covid-19 isolation center in the city,

"It is recommended [that] for a blockade to be relaxed, we must have a consistent reduction in the infection rate for at least 14 days. We didn't see that, "he added.

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& # 39; Few signs of viruses & # 39; in ethiopia

By Kalkidan Yibelta, Addis Ababa

Ethiopia has banned meetings of more than four
Ethiopia has banned meetings of more than four

Respiratory infections are common in Ethiopia, the second most populous state in Africa, with a population of over 100 million. Research shows that they are the third leading cause of death each year, after neonatal disorders and diarrheal diseases.

The coronavirus outbreak does not appear to have led to more patients with respiratory infections being admitted to hospitals in recent weeks.

A doctor in the capital, Addis Ababa, told the BBC he was looking for signs of unreported cases of Covid-19, but he found nothing unusual.

  • Number of Covid-19 tests carried out in Ethiopia until May 18: 59,029

  • Tests required for 1% of the population: 1,149,636

  • HIV tests performed from October 1 to December 31, 2019: 136,307

Sources: Africa CDC; The Lancet

There was no increase, for example, in the number of patients with pneumonia, a serious complication caused by the virus.

Similar reports were given by a doctor and a nurse with whom the BBC spoke in eastern and southern Ethiopia, respectively.

In the past few days, the number of cases detected daily has increased from one to two digits. This raised some concerns, but the overall number is still low – less than 400.

This is despite the fact that Ethiopia, unlike many other states, has not adopted a blockade, adopting limited measures, such as banning sporting events and meetings of more than four people, to contain the spread of the virus.

The Addis Ababa doctor said that Ethiopians may have been spared the worst of the virus because of fewer trips abroad, or there may be other unknown factors at play.

He said people should take precautions to prevent the virus from spreading, as the possibility of an increase cannot be ruled out.

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Uganda will focus on & # 39; verbal autopsies & # 39;

By Catherine Byaruhanga, Kampala

Traders were ordered to sleep in the markets to reduce the risk of bringing the virus home
Traders were ordered to sleep in the markets to reduce the risk of bringing the virus home

Uganda has imposed one of the strictest blockades in East Africa and, to date, has one of the lowest number of Covid-19 cases in the region – around 260 – and no deaths.

Most of the tests carried out in Uganda were on truck drivers arriving from neighboring states. Last week, Health Minister Ruth Aceng said that of the 139 confirmed cases at the time, 79 were truck drivers.

The chairman of the Uganda Medical Association, Dr. Richard Idro, said doctors across the country did not report seeing more patients with respiratory illnesses, although the blockade – which includes a travel ban – may have prevented them from going to the hospital.

People with mild symptoms of coronavirus may also have stayed at home, resulting in some cases without registration.

  • Number of Covid-19 tests performed in Uganda as of May 18: 87,832

  • Tests required to constitute 1% of the population: 457,410

  • HIV tests performed from October 1 to December 31, 2019: 2,098,734

Sources: government of Uganda; The Lancet

In a recent speech, Ugandan President Museveni said the government planned to conduct "verbal autopsies" in communities to find out if people could have died from Covid-19.

The government has promised to distribute free masks to all citizens over the age of six in the next two weeks before easing blocking measures.

In general, Ugandans on social media have been skeptical about the plans, pointing to delays in providing food to 1.5 million people in the capital and around the capital, Kampala, after losing their income because of restrictions on Covid-19.

If the distribution of the masks is successful, Museveni has promised that stores will be able to open, public transport will be back on the road, but carrying half the number of passengers and food market suppliers – who sleep in their tents under the orders of the president – you will be allowed to go home at the end of each day.

Image of the banner reading & # 39; more about coronavirus & # 39;
Image of the banner reading & # 39; more about coronavirus & # 39;
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