As the spread of the novel coronavirus accelerates around the world, sub-Saharan Africa has largely been spared — until now.Recent days saw more African countries reporting cases and deaths from the virus, including in Nigeria and Zimbabwe. And the head of the World Health Organization has issued a stark warning: “Africa should wake up.” (What Africa can teach the world about beating the coronavirus)
The rise of Covid-19 comes as an outbreak of another deadly virus, Ebola, appears to be ending in Central Africa’s Democratic Republic of Congo. Those of us who have been responding to Ebola are now turning our attention, resources and expertise to Covid-19.Our experience dealing with multiple outbreaks of Ebola offers some lessons that could be helpful in addressing Covid-19. Some of these are more specific to the African context, but most apply anywhere.
Protect health care workers. This is emerging as a major priority, as the coronavirus begins to overwhelm the health care system in the United States. Unfortunately, we saw too many cases of heroic doctors, nurses and others become infected with Ebola from the patients whose lives they were trying to save. Health care workers were 21 to 32 times more likely to contract Ebola than the general population during the West Africa Ebola outbreak in Guinea, Liberia and Sierra Leone.
With this novel coronavirus, health care workers will face similar risks at work, and will likely be required in many cases to continue treating patients even without the most rudimentary protective measures. Many sub-Saharan African health systems are already severely constrained because there are not enough doctors and nurses to meet basic health care needs of the population.
We must protect this workforce in order to keep health systems from collapse. Health care facilities need to be equipped and supplied, and the health workers must be trained in how to prevent the spread of infection within facilities, both from patient to patient and from patient to health care worker.
Aggressively push back against rumor and disinformation with frequent, fact-based communication. In responding to Ebola, bad information spread quickly and was a major hindrance to getting communities to cooperate with efforts to detect and slow the spread of the disease. For example, in the DRC outbreak, rumors led to violence against health care workers and attacks that destroyed clinics.
Home care will be an important part of this response and providing good information to families and communities on how to care for the sick — and when to seek care — will be an important component of this response. We need to quickly disseminate as much information as possible to the public about the nature of the virus and the response.
Engage the local community. Some of our best and most effective outreach during the Ebola outbreak in the DRC was done through trusted members of the community. By training and equipping them to keep their neighbors informed and reassured, community cooperation will increase and will facilitate efforts to detect the virus and encourage individual and family responses that will slow its spread.
Use faith-based networks. Faith leaders are often among the most trusted members of a community and enlisting them in providing accurate information and encouraging cooperation among members of their congregations is extremely effective. In chronically under-resourced African nations, faith-based institutions provide services, including health care, where governments sometimes can’t reach.
For example, the organizations I represent, Lutheran World Relief and IMA World Health, are working in partnership with Christian health associations in several countries to provide information on the virus, technical assistance and equipment and supplies to implement infection prevention and control in health facilities.
In the recent Ebola outbreak in the DRC, we worked with church networks to provide technical assistance, equipment and supplies to help prevent the spread of infections, as well as to help the global health community track where cases of the virus were spreading.
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Test, test, test. As we are finding in the United States, you can’t treat it if you can’t see it. When Covid-19 was first detected outside of Asia, only two laboratories in all of sub-Saharan Africa were equipped to process tests. That capacity has since ramped up considerably, but it is still short of the mark, as shortages of testing kits and laboratory supplies are common. We must expand the capacity to test to every national and regional reference lab on the continent as soon as possible and provide the supplies needed to test in accordance with WHO guidelines.
Covid-19 poses a particularly dire threat to sub-Saharan Africa, given its generally weak health systems — and too many people already suffering the effects of living in extreme poverty. And in urban slums in cities like Lagos, Nigeria, where people are crowded into cramped housing and pack into minibus taxis to travel to work they can’t afford to miss, social distancing is all but impossible.
But the African continent can draw from significant experience dealing with epidemics. The continent is currently waging battles against epidemics of measles and cholera, just to name a few. And the lessons learned in controlling and containing viruses such as Ebola can inform the fight against this novel coronavirus.