Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study

Abstract

Background The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. MethodsWe used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk.Findings Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively.Interpretation Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission.

Stochastic discrete epidemic modeling of COVID-19 transmission in the Province of Shaanxi incorporating public health intervention and case importation

“…To estimate the effective reproduction number we let the distribution of serial interval be chosen as gamma distribution with mean of 7.5 days and standard deviation of 3.4 days [4,11].…”

“…Since January 23 rd 2020, the Chinese authorities have been implementing unprecedented and increasingly stringent public health interventions, including a complete lock-down of Wuhan and neighboring cities, strict contact tracing and travel restrictions in the epicenter and across the country [13]. Incorporating these interventions into the classical epidemic models has resulted in reliable estimates of epidemiological characteristics of COVID-19 transmission in the epicenter and accurate near-casting the epidemic trend and peak time [18][19][20], in comparison with other earlier modeling studies focusing on analyzing the transmission risk based on data at the early outbreak stage [1,3,4,17]. One important lesson gained from our recent experience suggests the need of updating the model parameters and model setting to reflect the rapid improvement of screening, diagnosing and testing techniques/procedures, accompanied by intensive contact tracing, quarantine and isolation.…”

COVID-19 in Latin America: The implications of the first confirmed case in Brazil

“…Are Latin American healthcare systems sufficiently prepared? Probably not, but in general, this is the same in other regions of the world, such as in many parts of Asia and Africa [10]. Although most countries in Latin America are trying to step up their preparedness to detect and cope with COVID-19 outbreaks, it will be essential to intensify inter-continental and intra-continental, communication and health workforce training.…”

Can Nigeria contain the COVID-19 outbreak using lessons from recent epidemics?

“…Moreover, Gilbert and colleagues' modelling rated Nigeria as vulnerable to exposing huge populations to COVID-19 (potentially 200 million citizens), with a moderate capacity to control the outbreak. 3 This assessment questions Nigeria's capacity to provide sufficient bed space and associated clinical care to support those who could need isolation and quarantine if local cycles of transmission of COVID-19 occur in the country.…”