Rationalizing Fear – Global Response for Pandemics

Epidemics are hardly a novelty. They have been shaping, mapping, and fundamentally altering human history across the world for millennia. Infectious diseases have consistently threatened humans, their governments, and social security. African countries are highly vulnerable to outbreaks that are perpetuated by poverty, poor healthcare infrastructure, and unstable governance at national, state, and local levels.

Unpredictable pandemics constitute black swan events with immense potential to severely erode market confidence and countries’ economic capacities, thus triggering crises of political faith from which it is often difficult to recover. It is therefore not surprising to witness the surge of alarmism and panic in the wake of the novel coronavirus outbreak that causes the disease COVID-19 which has now been elevated to pandemic level status and has infected about 680,000 individuals worldwide, officially exceeding the threshold of 32,000 deaths.  Just when the World Health Organization was looking forward to announcing the world is Ebola-free on the 12th of April, 2020, this milestone was eclipsed by the novel coronavirus outbreak that began mid-December in Hubei Province, Wuhan, China. 

COVID-19

Infectious diseases of the lower respiratory tract, tuberculosis, HIV/AIDS, malaria, and diarrheal diseases still represent the top causes of morbidity and mortality in African countries.

The threat of COVID-19 is an undeniable source of political and social anxiety for African countries particularly due to the severity of the disease in individuals with underlying health conditions. Several African countries have healthcare systems that are already overwhelmed by the double burden of both communicable and non-communicable diseases and obstructed by gradual privatization. These systems would be strongly challenged by the quarantine of even hundreds or more suspected COVID-19 cases. Currently, there are no approved vaccines or treatments. Although several drugs are being investigated for their efficacy in treating COVID-19 infection including, an investigational drug that was originally intended to treat Ebola called remdemisvir, several protease inhibitors that are normally used to treat HIV, the anti-malarial drugs hydroxychloroquine and chloroquine, and the macrolide antibiotic azithromycin, and results have been encouraging, more studies and randomized clinical trials will be needed in order to determine which treatment or treatments are most effective.

Hantavirus

In addition to COVID-19, the recent report of the death of a man from hantavirus while riding on a crowded bus in China ignited more fear that yet another outbreak was lurking around the corner for humanity. However, it is important to note that the hantavirus is not a novel disease and has been thoroughly studied, and is primarily limited to the Eurasian geographic region. The disease is transmitted to humans by mice, specifically the deer mouse, whose habitat is mainly limited to rural woodlands. Hantavirus is carried by the deer mice and the virus is passed into the environment through their saliva, urine, and feces. People usually come in contact with the virus through inhalation of contaminated dirt and dust particles while cleaning. Although an African hantavirus, also known as the Sangassou virus, was identified in the rodent species Hylomyscus simus in Guinea of 2006, there have been no known outbreaks in Africa to date. It is not known how widespread the presence of hantavirus is in Africa, and researchers screening for the presence of hantavirus in South Africa also found no evidence of infection out of over 2000 rodent samples tested. Infection with hantavirus is greatly feared as it may lead to the development of two serious types of diseases in humans: Hemorrhagic fever with renal syndrome (HFRS) and cardiopulmonary syndrome. Fortunately, hantavirus cannot be transmitted from human-to-human, therefore the risk of such an outbreak in Africa causing widespread morbidity and mortality like COVID-19 is incredibly low and the public should not be alarmed

Situational Analysis in Africa

Despite the high prevalence of both infectious and non-infectious diseases throughout Africa and the recent Ebola outbreaks in West Africa and the Democratic Republic of Congo, the overall average healthy life expectancy in Africa is on an upward trend, increasing from 50.9 to 53.8 years between 2012 and 2015. However, there are strong inequalities that exist between and within countries in the African region. Access to health services is often determined by other socio-economic or political factors, with poverty and insecurity being some of the greatest obstacles. These challenges will need to be addressed in order to keep this upward life expectancy trend.

Because of these strong inequalities that exist between countries, poor healthcare infra-structure, and unstable political climates, Africa is poised to be the weakest chain in global containment efforts. Yet, the narrative about Africa’s vulnerability and weakness once again fails to grasp that the continent is exactly that, a continent with different political, economic, and healthcare systems, each endowed with different levels of resilience. Africa’s fragile states are torn by conflict, political instability, or grave poverty and are less resilient and more vulnerable to shocks. Other African countries have undergone dramatic improvements in the development of more robust disease surveillance and monitoring apparatus mainly because of the mobilization of resources and capacities during the Ebola outbreak. Several governments already possess enhanced screenings and trained health workers at airports which definitely contributes to strong COVID-19 response capabilities. More importantly, previous epidemic experiences characterized by strong multilateral coordination have also helped Africa develop greater responsiveness to impeding threats which offers hope in the face of this pandemic.

In summary, this draws attention to the prime importance of developing the overall resilience of African health systems. Multilateral efforts need to be sustained year-long for their sheer intrinsic value, and not just in the face of rogue epidemics that are unlikely to cause as much morbidity and mortality as other more prevalent diseases in the region. And although there is still much to be learned about the virus that causes COVID-19, experts evaluate it is less likely to survive in the hostile warm environments of Africa than in colder regions because heat is more likely to environmentally inactivate the virus making it less likely to spread as quickly as it has in colder climates where the virus can survive outside the body longer.