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African Countries on the Front Lines of COVID-19

The first confirmed case was in Egypt, and the first confirmed case in sub-Saharan Africa was in Nigeria. Most of the identified imported cases have arrived from Europe and the United States rather than from China. The worst affected countries have all taken various measures to contain the spread of the virus.

A member of a medical team sprays disinfectant as a precautionary move amid concerns over the coronavirus in Cairo, Egypt on March 22, 2020. (Reuters)

Some cities have become the centre of the COVID-19 outbreak hot spots. other major African cities with little or no social safety net to protect the poor from the economic fallout of the COVID-19 pandemic. The economic impact of COVID-19 of African cities likely to be acute through a sharp decline in productivity, jobs and revenues.Coronavirus can wreak havoc in Africa in the absence of quick and adequate measures.

South Africa

A South African National Defence Force (SANDF) soldier stands in front of a house as he patrols the streets in Alexandra, Johannesburg, on Friday, March 27, 2020 during a joint operation with the South African Police Service (SAPS) in order prevent the spread of the COVID-19 coronavirus outbreak. (AFP Photo)

South Africa, along with many other African governments, is moving early on its outbreak to introduce measures in line with policies on the tougher, more restrictive end of the spectrum.

During rush-hour at the crowded central bus station in Alexandra, many commuters did not appear too confident as they waited in line before squeezing on board cramped mini-buses for the journey home.

“I’m frightened. Truly. I don’t know who is infected and who is not,” said one woman.

“If I had any alternative transport I would definitely [use it] but unfortunately, I have no choice. I have to work to feed my family so I can’t afford to stay at home.”

“I am going back home because of corona,” said Amina Barasa, her yellow headscarf standing out in the dark bus. The electronics shop where she worked had shut, she said, and she was going to stay with her family away from the city crowds.

“There you just stay in your compound where your movements are very limited. Here in the city you brush shoulders with so many people,” she said.

According to report, worrying officials say this helped spread diseases like Ebola in other outbreaks.

Traveling makes it harder to trace contacts a sick person has had and risks increasing transmission through overcrowding, said James Ayodele, spokesman for the Africa Centers for Disease Control and Prevention.

Cape Town in South Africa which is a popular tourist destination had more than 12,000 confirmed cases as of 21st of May, 2020; representing 63% of South Africa’s 19,000 cases and about 10% of Africa’s 95,000 cases.

Gauteng province containing Johannesburg, South Africa’s largest city, and the capital, Pretoria, had been expected to be the country’s epicenter with its population density and poverty levels, but Cape Town defied predictions with high levels of community transmission, according to AP News Agency.


People stand on social distancing markers at an automation teller machine (ATM) at a bank in Abuja, Nigeria, May 6. (Reuters)

Nigeria has more than 6,000 confirmed cases of coronavirus, the third-highest in Africa. Lagos, a city of 20 million people, has been the main hotspot.

But lockdown imposed at the end of March has been partially eased, raising fears that the virus could spread. Measures introduced in place of the total lockdown include a night-time curfew and the mandatory wearing of masks in public.

There have been reports of more people falling ill and dying in Nigeria’s most populous state, Kano, since the outbreak of coronavirus nearly three months ago.

So, it is not surprising that President Muhammadu Buhari has extended the lockdown in the northern state to the end of the month.

A grave digger at the Abattoir Graveyard in the main city, also known as Kano, told the BBC:

“We have never seen this, since the major cholera outbreak that our parents tell us about. That was about 60 years ago.”

Prof Musa Baba-Shani, the head of the department of medicines at Aminu Kano Teaching Hospital, the main hospital in the state, told the BBC that they have been treating more patients with illnesses such as asthma, pneumonia, and tuberculosis, as well as chest pains and sore throats.

The professor, who works with the respiratory diseases unit of the hospital, said there had been an increase of between 40% and 45% in the number of respiratory cases in about the last three months.

He attributed the rise to the closure of many hospitals in the state, especially private clinics, because of a lack of protective gear for medics. This has forced more patients to seek treatment at the Aminu Kano Teaching Hospital.

Prof Baba-Shani said some of those with respiratory illnesses were diagnosed with coronavirus, and referred to the treatment centres set up for Covid-19 patients.

He decried the slow testing for coronavirus in Africa’s most-populous country, which has a population of around 200 million. It would be better for both patients and hospitals if testing was speeded up, he said.


A graffiti depicting the importance of face masks, part of a COVID-19 awareness-raising campaign, is pictured with the arabic hashtag “Stay aware” on a wall in the Sudanese capital Khartoum on April 8, 2020

The first COVID-19 case in Sudan was confirmed on 13 March. Sudan has 3628 confirmed cases of COVID-19 within its borders as of 22 May 2020.

On 16 March 2020, Sudan’s Transitional Government closed all airports, ports and land crossings and declared a public health emergency over fears of further spread of coronavirus. Only scheduled flights of goods and humanitarian supplies are permitted.

Similarly, in March, Sudanese authorities ordered the release of thousands of prisoners to prevent the novel coronavirus from spreading in the country’s jails, according to a state media report.

Sudan imposed a lockdown on the capital Khartoum for three weeks in April, after 10 more cases of the new coronavirus were discovered.

Meanwhile, authorities have moved to increase measures to enforce social distancing within the country, implementing a nationwide lockdown and deploying members of the Sudanese army and the Rapid Support Forces in Khartoum, which has been under a lockdown since mid-April after the country saw a large uptick in cases early May.

Limited exceptions apply for the public to go to grocery stores or pharmacies in close proximity to their residences.

For many Sudanese affected by or suspected of having the disease, the imposed measures have been deemed arbitrary and inadequate – as health experts warn that the country should brace itself should Covid-19 spread.

Medical sources and eyewitnesses have told Middle East Eye that hundreds of individuals – both believed to be sick with Covid-19 or under observation after recently travelling abroad – had fled hospitals and isolation centres in late March.

A doctor working with teams on the ground in Khartoum – who asked not to be named – told MEE that suspected cases had escaped from the Universal Hospital and Ibrahim Malik Hospital in the Sudanese capital.

“We are witnessing many cases where people reject the (coronavirus) tests or being put in isolation,” the doctor stated. “Some of them even escaped the isolation centres. This is serious and authorities, as they had warned, have had to use force to prevent people from escaping.”

One of those who escaped from the isolation centre in Bahri, Ahmed Abdul Azim, told MEE that he had been screened at the Argeen border crossing, where he was told he was at risk. However, Abdul Azim said he decided to flee the centre as it was not adequately prepared to receive patients citing shortages of medical personnel, food and protective gear.

“You can’t ask the people to stay when you didn’t prepare the places well,” he told MEE over the phone.

The situation is further compounded by the state of emergency in Darfur, according to Salih Osman, vice president of the Darfuri Bar Association, a human rights law organisation.

“This state of emergency is a tool that was used by the previous regime to suppress people in Darfur, with regular government forces and the Janjaweed using this to ‘implement the law’,” says Osman, referring to soldiers and armed militias who hunted down Darfuris on behalf of Omar al-Bashir’s government.

The state of emergency enabled the authorities to carry out human rights violations, stop people from gathering, communicating and having their voice heard, according to Osman.

Osman went to Darfuri internally displaced camps late last year to speak to people there. Even after the installation of the transitional government, they told him violations continue to occur.

Nearly 2 million of Sudan’s 42 million population remain internally displaced as a result of conflicts in Darfur, South Kordofan, and Blue Nile state, according to the UN.

“Most face dire conditions, living in camps or settlements, unable to meet their basic needs,” according to UN’s Bachelet.

In South Darfur, internally displaced people at Kalma camp, which houses 90,000, are not allowed to even go to Nyala city, the capital of the state, which is on the outskirts of the camp, according to Osman.

Many people, especially the elderly, have been dying of various illnesses in the capital, Khartoum, because dozens of health centres including hospitals shut after the outbreak of coronavirus in March. Many doctors refused to work, complaining about a lack of protective equipment.


The testing by health-care workers at the border is the only real indication that the world has of the extent of the coronavirus outbreak in Tanzania, which has stopped reporting its case numbers.

Tanzania first case, a female, had travelled from the country to Belgium on 3rd March and returned on the 15th March. She took a taxi to Arusha town where she locked herself in a room to self-quarantine but later called government officials who took her for treatment.

After the first case, people rushed to the shops to stock up on food items, drinks and other essentials in Dar-Es-Salaam and other major cities.

In pharmacies, the depletion of masks and hand sanitizers was drastic. Entrepreneurs took advantage of the situation and in one night these products, which were not popularly known in the country before, hit skyrocket prices. The price of hand sanitizers, for example, rose from US$1 for a 100ml bottle to $7. A box of gloves was going for up to $20 while masks were completely out of stock.

Zambia’s government shuts the border with Tanzania in early May after almost half of the nation’s 446 cases were identified at the Nakonde border crossing. Many of those infected are truck drivers, according to Health Minister Chitalu Chilufya.

The last coronavirus report to come from the Prime Minister’s office on April 29 had the confirmed case toll at 480. According to the World Health Organization, Tanzania has recorded 509 cases and 21 people have died.

Tanzania has faced criticism from international health authorities including the World Health Organization (WHO) for being slow in imposing social distancing measures and lacking transparency in its approach to the pandemic.

The Tanzanian government closed schools, stopped international flights and banned large gatherings but much of the regular economic activity has continued and religious services have been allowed to continue unlike neighbors like Rwanda and Uganda which imposed total lockdowns.

Tanzanian President John Magufuli has said numbers are falling, but a U.S. Embassy statement Indicate that many hospitals in the former capital, Dar es Salaam, had been overwhelmed and that the likelihood of contracting the virus in that city was “extremely high.”

Tanzania has taken fewer day-to-day measures to control the virus’s spread than Kenya, which has a dusk-to-dawn curfew, mandatory mask-wearing and localized lockdowns.

DR Congo

DR Congo is grappling with coronavirus and Ebola

The DR Congo has recorded more than 1,600 cases of the virus as of May 20 – the ninth-highest number in Africa, according to WHO.

The first Covid-19 case was detected in La Gombe, the main business district in Kinshasa. The government moved swiftly to introduce a lockdown, but the virus has since spread to seven of the country’s 26 provinces including the mining hub of Lubumbashi.

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 grappling with an Ebola outbreak. It has killed more than 2,000 people since 2018. Covid-19 has so far claimed the lives of more than 60 people.


To cover your face become the norm in Kenya

A major public hospital in Kenya’s capital, Nairobi, saw an almost 40% increase in respiratory illnesses such as tuberculosis, pneumonia and asthma between December and early March, a doctor who works there told the BBC.

However, the hospital had a sharp decline in such cases since mid-March, said the doctor, who spoke to the BBC on condition of anonymity as he was not authorised to speak to the media.

One reason was that the government had imposed a nationwide dusk-to-dawn curfew to contain the spread of coronavirus.

This has resulted in a drop in night-time admissions, but an increase in the number of dead people being brought to the hospital’s mortuary, the doctor said.

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

This is because quarantining 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 centre, though the government has now promised to cover costs at public quarantine centres.


Ethiopia has banned gatherings of more than four

Respiratory infections are common in Ethiopia, Africa’s second most-populous state, with a population of more than 100 million. Research shows they are the third major cause of death each year, after neonatal disorders and diarrheal diseases.

The coronavirus outbreak does not seem to have led to more patients with respiratory infections being admitted to hospitals over the past few weeks.

A doctor in the capital, Addis Ababa, told the BBC that he was looking for signs of unreported Covid-19 cases but he did not detect anything unusual.

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

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

In recent days, the number of cases detected daily has risen from single to double digits. This has raised some concern, but the overall number is still low – less than 400.

This is despite the fact that Ethiopia, unlike many other states, has not introduced a lockdown, taking limited measures, such as a ban on sporting events and gatherings of more than four people, to curb the spread of the virus.

The doctor in Addis Ababa said Ethiopians might have been spared the worst of the virus because of less foreign travel, or there may be other unknown factors at play.


Traders have been ordered to sleep in markets to reduce the risk of them taking the virus to their homes

Many slum families also live in just one room, making it impossible to maintain a physical distance of 2 metres (6 feet) from one another to reduce the chance of infection, said Haas, who is based in the Ugandan capital of Kampala.

And with Uganda having just 55 intensive-care hospital beds for a population of 43 million, “our health system can’t afford to take on the pandemic infection rate we see across the United States and parts of Europe and Asia”, said Haas, whose organisation promotes sustainable growth in developing nations.

Uganda has imposed one of the strictest lockdowns in East Africa and so far it has one of the lowest number of Covid-19 cases in the region around 260 and no deaths.

Most of the testing in Uganda has been on truck drivers who arrive from neighbouring states. Last week, Health Minister Ruth Aceng said that of the 139 confirmed cases at the time, 79 were truck drivers.

The President of the Uganda Medical Association, Dr Richard Idro, said that doctors around the country had not reported seeing more patients with respiratory illnesses, though the lockdown which includes a ban on travel could have prevented them from going to hospital.

People with mild symptoms of coronavirus might have also stayed at home, resulting in some cases going unrecorded.

In a recent address, Uganda’s President Museveni said the government planned to carry out “verbal autopsies” in communities to find out whether people might have died from Covid-19.

The government has promised to distribute free masks to all citizens above six years old over the next two weeks before easing lockdown measures.

Ugandans on social media have generally been sceptical about the plan, pointing to the delays in giving food to 1.5 million people in and around the capital, Kampala, after they lost their income because of Covid-19 restrictions.

If the mask distribution is successful, Mr Museveni has promised that shops will be allowed to open, public transport will be back on the road but carrying half the number of passengers and food market vendors who have been sleeping at their stalls under the president’s orders will be allowed to go home at the end of each day.

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