Learn on how Africa is better managing the spread of Covid- 19

This special webinar on 'Africa Confronting Covid- 19' held on April 22nd 2020 at 3:00 pm GMT was co- hosted by ICAP at Columbia University and Columbia Global Centers| Nairobi together with Columbia Global Centers| Tunis

April 29, 2020

The highly anticipated webinar on ‘Africa Confronting Covid – 19’ gave a very brief presentation on the global update of Covid- 19  as well as the Covid situation in East Africa, South Africa, North Africa ( Tunis to be specific), and West Africa (Côte d'Ivoire to be specific).

Dr. Murugi Ndirangu, Director of Columbia Global Centers Nairobi started off the meeting by giving her welcoming remarks. Dr. Murugi pointed out on the 9 global centers around which connect their various regions to Columbia University. These global centers are used to facilitate research and scholarships globally. (Time frame from minute 00:22- 00:40)

Youssef Cherif, the Director to Columbia Global Centers Tunis also gave his welcoming remarks and stated that the center in Tunis works with the center in Nairobi as they try to work on African issues and also pointed out that he was glad to partner with ICAP and the Tunisian Center for Public Health. (Time frame from minute 00:50- 01:10)

Prof. Waafa El- Sadr (University Professor of Epidemiology and Medicine; Matilde Krim-amfAR Professor of Global Health; Director, ICAP at Columbia University Mailman School of Public Health) started off the presentations on ‘Africa Confronting Covid- 19’ by giving a brief presentation on the global update of the Covid- 19 situation. Prof. Waafa pointed out that:

  • As of April 21st, there were more than 2.5 million cases confirmed globally, these only stands for confirmed cases but there are many more cases than this because confirmed cases are those cases that have been tested, and in terms of numbers cases could be double this of more than 5 times of numbers of confirmed cases. There have been more than 171, 000 deaths as well as 659, 000 recoveries. (Time frame from minute 02:45- 03:35)
  • The impact of this pandemic varies by region whereby 50% of the cases have been reported from European countries, whereas a third of the global cases have been reported from the U.S, 3% of the global cases in China, and less than 1% confirmed cases in Africa. (Time frame from minute 03:38- 04:00)
  • The current snapshot in the U.S and New York city is that 788, 000 more cases have been reported as of April 22nd whereas 17% of these cases have been reported in New York City of which is the new epicenter of the epidemic with more than 132, 000 confirmed cases which is about half of the numbers in New York State. (Time frame from minute 05:40- 06:15)
  • The reason for this webinar is that there is great concern in terms of the potential impact of the transmission of this virus in African countries. The majority of these African cases have been reported from North Africa and a substantial number of cases from Egypt, Algeria Morocco, and South Africa. (Time frame from minute 07:10- 07:37)
  • Epidemics go through phases, from; Introduction or emergence to localized transmission followed by amplification and then reduced transmission. The response interventions and what should be done include; Anticipation (it is important to anticipate and be prepared for potential outbreaks of infections). Early detection (It is also important so that as soon as the virus pathogen is detected, measures can be taken and prevent transmission). Containment (identifying the cases rapidly and isolating the cases as well as identifying their contacts and making sure they are quarantined). Control and mitigation (stringent measures, limitation of travels, the lockdown of schools, and social distancing rules). Finally, there is the phase of elimination and eradication. (Time frame from minute 09:22- 11:44)
  • It is critically important to carefully monitor the epidemic in African countries as well as put in place vigorous containment and mitigation measures. (Time frame from minute 13:04- 13:15)

Dr. Mark Hawken, the country Director ICAP Kenya kicked off the regional perspectives presentations by making a presentation on the Covid situation in East Africa. Dr. Mark Hawken pointed out that, his perspective would be limited to Kenya, Tanzania, Ethiopia, Uganda, and South Sudan. Dr. Mark Hawken noted that:

  • There is a rising number of cases throughout Africa and the figures as of 21st April show that 53 out of 55 countries in Africa have reported confirmed cases 23, 517 cases have been confirmed throughout Africa and the deaths stand at 1,160. (Time frame from minute 16:20- 16:40)
  • At the moment, in terms of confirmed cases, Egypt leads, followed by South Africa, Kenya is ranked 17th while Tanzania ranked at 18th. (Time frame from minute 16:55- 17:15)
  • In Kenya, the ‘National Emergency Response Committee’ was activated earlier in the year, on top of that Isolation centers have been established in Nairobi at Kenyatta National Hospital and Mbagathi Hospitals and more recently the Kenyatta University Hospital. The first case in Kenya was identified on 13th March from a 27-year-old female who had traveled from the USA via London, the first death was identified on 26th March. (Time frame from minute 17:30- 18:25)
  • The figures as of April 21st, Kenya had tested over 13,000 people and confirmed 281 cases with 14 deaths. (Time frame from minute 18:30- 18:45)
  • Over the past month, Kenya has been receiving an increasing nature of the epidemic and most of the cases have been around urban areas. (Time frame from minute 19:00- 19:10)
  • The Kenyan government’s response has been strong, both from the ministry of health and the president. Some of the mitigation measures that have happened in Kenya include; school closure and public gathering ban, aggressive contract tracing and quarantine of incoming passengers, air borders closed to non- citizens, religious gatherings ban, prisoner visitation ban, bars and restaurants closed, National curfew (7 pm- 5 am), masks in public places order, travel restriction orders to and from Nairobi, Kwale and Mombasa counties. (Time frame from minute 20:00- 22:10)
  • Some of the mitigations put in place by the ministry of health include: activation of the emergency response team which is inclusive of contact tracing teams, the development of 6 laboratories that have the good testing capacity, multiple quarantine centers have been established in each county as well as isolation centers, personal protective equipment has been made available through the government and through donations, sensitization training modules have been developed and are delivered to healthcare workers via video conferencing, tax reliefs have been announced and a reduction in pay as you earn tax. (Time frame from minute 22:30- 24:30)
  • South Sudan already has 4 cases as of 21st April, all introduced from outside and no recorded deaths so far. Ethiopia has 111 confirmed cases with 3 deaths, the government of Ethiopia introduced a 5-month national state of emergency and in a surprising move pardoned hundreds of prisoners in an attempt to reduce transmission within the prisons. Uganda has 55 reported cases and no deaths so far, the government response in Uganda have taken serious measures including suspending public and private transport as well as closing down malls and only allowing food shops to operate. Tanzania has 255 cases and 10 deaths, the cases have increased within a one-week time frame for cases in the previous week were at 50. (Time frame from minute 24:55- 27:00)
  • Kenya and the neighboring countries are at an early stage of the pandemic, however, community transmission is occurring. (Time frame from minute 30:42- 30:52)

Dr. Blanche Pitt, the Country Director, ICAP South Africa presented her regional perspective on the Southern Africa countries in reference to; Angola, Zambia, Malawi, Zimbabwe, Namibia, Botswana, Mozambique, South Africa and, Lesotho. Dr. Blanche Pitt pointed out that;

  • There has been an upward trajectory in South Africa, over a period of  4 weeks, the virus has infected almost 4, 000 people in South Africa and the cases might be higher for these cases account to only reported cases for the actual number could be much higher. (Time frame from minute 32:30- 33:00)
  • There is a concern over the high prevalence of suppressed immune conditions including HIV patients. South Africa remains the epicenter of the Covid pandemic in Southern Africa as well as the country with the largest Aids epidemic globally. When intensifying mitigation measures for Covid, South Africa needs to ensure HIV and TB patients have access to and remain on treatment to prevent an increase of these pandemics. (Time frame from minute 33:35- 34:20)
  • It is critical for countries to prioritize this pandemic and discover those affected early and put in place good systems for mitigation measures. From the South African experience, it’s evident that internal transmission spreads rapidly and silently. (Time frame from minute 35:35- 36:00)
  • In terms of data recording the Covid cases, South Africa was the first followed by Eswatini. All the South African countries went into lockdown after the first confirmed case.  Countries in Southern Africa have implemented a range of additional measures to slow down the spread of Covid. (Time frame from minute 37:00- 37:57)
  • The first internal transmission cases in South Africa happened on the 13th of March. From this date, there has been a gradual increase in infected cases. The highest number of cases being on 27th March whereby there were 243 cases. (Time frame from minute 40:33- 41:05)
  • The more South Africa expanded its testing and improvement in contact tracing, the more Covid cases found. (Time frame from minute 42:40- 42:50)
  • As of April 19th the total number of confirmed cases in South Africa was at 3,158, the tests conducted were 114, 711, the deaths stood at 54 whereas 42 are unknown. These cases have not only occurred in the elderly but also the young. (Time frame from minute 43:08- 44:02)
  • There is an impact in livelihoods as having to stay indoors deprives the vulnerable communities of what they regard as essential in order to put food on the table. (Time frame from minute 50:55- 51:20)
  • In summary, every country in Southern Africa with reported Covid cases have taken restrictive measures to curb the spread of the pandemic. (Time frame from minute 52:10- 52:20)

Dr. Stéphania Koblavi Dème, the country Director, ICAP Côte d’Ivoire made her presentation on the West Africa Covid pandemic that majorly focused on Côte d’Ivoire. Dr. Stéphania Koblavi Dème pointed out that;

  • The first case was registered on March 11th, the progression has been constant day by day.  As of 21st April, 5077 tests had been conducted, out of these tests 916 cases have been confirmed 600 on treatment 303 on recovery and 13 dead. (Time frame from minute 55:20- 55:58)
  • The high burden of Covid in the country is at Abidjan with 94% of the reported cases, the first cases came from abroad, Europe, and the Middle Eastern countries. (Time frame from minute 56:00- 56:20)
  • Looking at the sex and age group distribution of cases, there are children and adolescents infections but the distribution between men and women shows that most men are infected than women, maybe because they have more social contacts. (Time frame from minute 56:30- 56:55)
  • The government of Côte d’Ivoire has taken strong measures to control and contain the spread of the virus. In relation to public health measures, other measures taken include; containment of the spread of the infection, preventive measures in curbing infection spread, the motivation of health workers, enhanced treatment, social distancing rules enforced, security measures enforced, economic measures to cushion the Covid effect on the economy, setup referral centers, installation of quarantine sites, increased laboratory capacities, train people in this context centered voluntary screening sites, the introduction of tax reliefs, fundraising and supporting the vulnerable in the community. (Time frame from minute 57:00- 58:40)
  • Based on a study model from the ‘London School of Health’ the estimation was that of Côte d’Ivoire should reach their first 1000 cases by April 15th, of which is not the case, another estimation was that by the first week of May cases will be around 10,000, but due to the measures being taken by the government, this estimation is not likely to happen. (Time frame from minute 1:00:44- 1:01:35)
  • This Covid situation could be looked at as a blessing in disguise and act as a durable experience for the next sanitary crisis in the continent. (Time frame from minute 1:01:40- 1:01:55)

Dr. Habiba Ben Romdhane, the former Minister of Health in Tunisia gave her North Africa perspective that majorly focused on Tunisia.  Dr. Habiba Ben Romdhane pointed out that;

  • The response by the Tunisian government to large scale crises objectives during this times of the pandemic include; to ensure the real-time of health alerts, to ensure the exchange of information and coordination with other departments when managing a crisis, to provide communication tools for monitoring, to provide event-based surveillance used as a tool for exchanging information by weekly conference calls between the health regions. (Time frame from minute 1:03:58- 1:04:50)
  • The objective of these responses from the Tunisian government is to curb the spread of the epidemic within the population in order to minimize the potential health impact. (Time frame from minute 1:05:25- 1:05:40)
  • Planning principles of the Covid epidemic include; strong leadership and coordination of the response, activation of the response and resilience plan for disease with epidemic potential in Tunisia, dynamic risk assessments of potential health and other impacts, using the available scientific advice, Tunisian government working with WHO, The African Centre for Disease Prevention and Control and China ( CDC). (Time frame from minute 1:05:50- 1:0:42)
  • The most important strategy used by Tunisia is an early warning and response system. It was implemented in early March, it’s inclusive of early detection and contact tracing, isolation of patients, and early treatment. (Time frame from minute 1:06:50- 1:07:18)
  • According to the situation in Tunisia by April 19th, 17, 287 people were screened, 879 total number of cases were recovered out of these cases 95 were health workers, there were 37 deaths out of these tests the fatality rate according to Tunisia stands at 4.2. The same number of men and women get the virus so there is no disparity between the two. (Time frame from minute 1:09:48- 1:11:25)
  • There are health system challenges experienced and these challenges include; the screening strategy is not effective in terms of mass testing, strained healthcare for the general population, health providers are not getting accurate information and yet they critically need it. (Time frame from minute 1:13:32- 1:16:55)
  • There is the huge issue of economic and social challenges in Tunisia because Tunisia is facing the deepest recession since independence in 1965, Microeconomic imbalances and very high external as well as public debts, contain the spread of the virus and mitigate the human social needs amid an unprecedented vulnerability and to ensure the sustainability of the external debts. (Time frame from minute 1:17:03- 1:18:35)