How poorer countries are scrambling to prevent a coronavirus disaster

Amy Maxmen, Nature News, 1 April 2020

https://www.nature.com/articles/d41586-020-00983-9

The threat of a COVID-19 explosion across developing countries continues to grow. While the first dozen cases in Africa were detected in March, the virus likely arrived weeks or months before. Despite the rising incidence of test positive cases, limited testing and contact tracing capacity, political leadership and resource mobilization from donor nations has been lacking, despite calls from the WHO and the UN Secretary General. Many countries face underfunded healthcare systems, unreliable stocks of essential medicines, precarious access to health facilities, and frequent power outages. The Ebola outbreaks also showed that when health systems are overwhelmed by one infectious disease, many often die from a lack of care for malaria, pneumonia and other preventable diseases, as well as care during pregnancy and childbirth. At the same time, case reports from the peak of the epidemic in Wuhan, China suggest that an estimated 2.6 ICU beds were required per 10,000 adults. Italy has less than half that capacity and is overwhelmed. Many low-income countries, including those in sub-Saharan Africa, have less than one ICU bed per million people. Given the lack of well-funded health systems, countries in Africa are focusing on mitigation strategies to prevent COVID-19 from spreading as soon as they confirm their first cases. This includes shutting down most activities with the threat of arrest, rolling out tests to detect genetic sequences from the virus and a willingness to deploy rapid, easy-to-use tests(even if they are not as accurate as PCR tests that require lab capacity), and sequencing the genome of SARS-Cov-2 sampled from Nigeria.