There has been a rapid response to the pandemic from Africa’s public health systems well before cases were reported. On 3 February 2020, the Africa Centres for Disease Control and Prevention established the Africa Task Force for Novel Coronavirus. The task force has been working with WHO African Region on community engagement, surveillance, including screening at points of entry, infection prevention and control in health-care facilities, clinical management of people with severe 2019-nCoV infection, laboratory diagnosis, and risk communication [4]. Moreover, with the previous programs addressing Ebola of affected regions in Africa, some of the systems implemented and lessons learned may have provided the groundwork in addressing the current pandemic.
African countries have activated the Emergency Operations Centres to coordinate response and preparedness activities. Training sessions have also been set up across the African continent to equip the rapid response team with knowledge and skills. Public health programs have been ramped up by national authorities. WHO African Region has also set up a public interactive dashboard for the visualization of the 2019-nCoV situation in the region. Furthermore, in preparation for a possible increase of cases, some African countries have increased their healthcare capacity. For instance, Morocco currently has 44 hospitals with 32 specialized centres that are fully equipped in response to the pandemic [5].
Nigeria, Algeria, Senegal, South Africa and many African countries have laboratories which conduct in-country testing for 2019-nCoV. Between 2 February and 18 April 2020, in the WHO African Region, the laboratory testing capacity has increased from two to forty-four countries [2]. Efforts are currently underway to increase diagnostic capacity across the continent. Many countries have identified isolation and quarantine centres. Effort is also ongoing to ensure effective contact tracing of potential contacts with infected persons.
Work on strengthening the surveillance system in Africa have also been started prior to the pandemic. Partners have also indicated their support to countries in the implementation of early investigation studies, such as the First Few X (FFX) case and contact investigation protocol for timely estimation of transmissibility and severity of 2019-nCoV. However, as of 18 March 2020, only fourteen countries have expressed interest in the implementation of FFX [6]. As of 8 April 2020, four countries (South Sudan, Madagascar, South Africa and Cote d’Ivoire) have started the implementation of early investigation protocol. Nigeria is the first African country to publish 2019-nCoV genomic data from index patient.
Airports across the continent are testing passengers’ temperatures upon arrival. Most African airlines have temporarily suspended flights to high-risk countries. As of 18 April 2020, in the WHO African Region, 35 countries have implemented total refusal of entry into their territories, 9 countries are implementing refusal of entry of passengers from high risk countries and 3 countries allow entry with 14 days quarantine upon arrival [2]. Most governments have temporarily closed educational institutions in order to limit the spread of the virus. Gatherings have been banned with police enforcement in the Gambia, Nigeria, Rwanda, Zimbabwe, South Africa, and Senegal among others. Curfews and interstate travel ban have been implemented in some countries.
In the area of clinical case management, efforts to develop and ensure evidence-based treatment guidelines and protocols for the management of 2019-nCoV are ongoing in Senegal, Nigeria, Algeria, South Africa, Madagascar and other countries across the continent.
Even though it is too early to assess the effectiveness of the responses, countries have adopted measures worth learning from; for instance, simplified triage strategies and proactive screening (Uganda), handwashing stations at transport hubs (Rwanda), WhatsApp chatbots providing reliable information, and rapid testing diagnostics (Senegal), and volunteer-staffed call centres via toll-free telephone lines and celebrity campaigns (Nigeria) [7]. Countries like São Tomé and Principe, Zambia, Nigeria, Burkina Faso have also been using telecommunication companies to support dissemination of information regarding prevention and control practices. Togo is leveraging on medical students to raise awareness among grassroot communities while Senegal has mobilized religious leaders. With the support of donors and governments, some African countries are also making efforts to provide relief materials, food items and other supports to the poor.
