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Arrival of Covid-19 in Africa only a matter of time, warns epidemiologist
Author: Media & Communication, Faculty of Science
Published: 14/02/2020

We can expect to know within the next month whether the novel corona virus has found its way to Africa. In the meantime, all efforts to halt or slow the spread of the virus are still our best line of defense.

So says Prof Juliet Pulliam, an expert in the modeling of infectious diseases in resource-limited countries. She is also director of the South African Centre of Excellence for Epidemiological Modelling and Analysis, hosted at Stellenbosch University (SU).

During a public lecture at the Wallenberg Research Centre in Stellenbosch last night (13 February 2010), she gave an overview of how epidemiological models are being used to understand the scope and spread of the novel 2019 coronavirus outbreak, and particularly why no cases have so far been confirmed in Africa.

She says recent studies show that while fever screenings at airports are unlikely to be sufficient to prevent the spread to new locations, it will help to slow the spread of the virus outside of China.

Once a case of infection is confirmed, it is paramount that measures such as isolation of sick patients and tracing their contacts be put in place immediately, in order to prevent further infections. This is, however, going to be a challenge in countries with insufficient screening and testing facilities, combined with weak health systems. The World Health Organisation (WHO) is currently in the process of establishing testing facilities in 29 African countries.

She says there are three possible scenarios for why the virus have not yet been detected in Africa. The first scenario, that the virus has not yet arrived on our shores, she believes to be unlikely. The second scenario is slightly more plausible, namely that there have been a low number of imported cases, but there is a low level of spread due to local environmental conditions. Here she referred to a 1985-study that showed that coronavirus degrades quickly at high temperatures, such as found in tropical Africa and during the summer.

But this is an unlikely scenario, she believes, as cases have been confirmed for other sub-tropical countries such as Thailand. Scientists also do not as yet have sufficient information about the virus to be able to make these kinds of predictions.

The third scenario, while it is the most likely is also the most alarming, namely that the virus is spreading undetected, comparable to how it is behaving elsewhere. In a number of articles published in February on the medical platform medrxiv, researchers warn that the virus is probably spreading undetected in several African countries.

 “I am particularly concerned about people with compromised immune systems, and those countries with weak health systems," Prof Pulliam warns.

On 31 January, the South African Department of Health activated an emergency operations center to deal with the outbreak. In the meantime, anyone who experiences flu-like symptoms with a travel history or contact with someone who has travelled, particularly to China, should call their nearest clinic, GP or hospital to seek guidance, or the National Institute for Communicable Diseases' public hotline at 0800 029 999.

Photo: Anton Jordaan