Women wear face masks at Dutse Alhaji market, as authorities race to contain the coronavirus disease (COVID-19) in Abuja, Nigeria May 2, 2020. Picture: REUTERS/AFOLABI SOTUNDE
Women wear face masks at Dutse Alhaji market, as authorities race to contain the coronavirus disease (COVID-19) in Abuja, Nigeria May 2, 2020. Picture: REUTERS/AFOLABI SOTUNDE

Africa is now edging towards one-million cases of coronavirus, but experts warn far worse lies ahead in a continent struggling with fragile health systems and slender economic resources.

Countries across Africa have recorded more than 850,000 infections and at least 18,000 deaths, according to an AFP tally as of Tuesday.

The toll took a while to move into higher gear thanks to early restrictions on contact and movement, Dr Mary Stephens, an expert at the World Health Organisation (WHO) Africa office, said.

“We haven't seen the peak yet,” she warned. “All countries in Africa are at risk because our health systems are relatively weak.”

Here is an overview of key countries:

SA: The continent's most industrialised economy has notched up more than 450,000 infections — the highest number in Africa and the fifth biggest in the world. It has recorded more than 7,000 deaths, although there is concern that fatalities are being under-reported.

Last week, the respected Medical Research Council noted a nearly 60% jump in “natural” deaths for this time of the year compared with the historical trend.

“The peak will come in July, August and September,” health minister Zweli Mkhize predicted on Sunday.

SA imposed one of the world's toughest lockdowns in March. Measures included the closure of schools, factories, non-essential shops and a ban on sale of alcohol and cigarettes. The restrictions were lifted in June, but some were reinstituted this month. Schools shut again and the alcohol ban returned.

The country also has more than 13,000 infected health workers, a record.

Nigeria: Africa's most populous nation has registered 41,000 cases, the second highest tally south of the Sahara, with numbers rising by between 500-700 each day.

But prevalence could be far higher, given the lack of testing.

About 3,000 tests are carried per day on average in a country of about 200-million people — just a tenth of the number conducted in SA, which has about a quarter of the population.

“For every one case, there are a handful of cases that we are missing because we are not able to test everybody,” Sani Aliyu, the head of Nigeria's virus task force, admitted.

The epicentre is Lagos, the densely-populated commercial hub, which is also Africa's largest city with a population of 20-million.

Health officials in the crowded city are worried by the availability of space to isolate those found positive.

“Through our modelling, we know we are going to exceed our isolation capacity sooner than later,” Lagos state health commissioner Akin Abayomi said.

Despite the swelling numbers, Nigeria is having a hard time convincing sceptics that the threat is for real.

“We should not wait for such a time when we start picking bodies on the streets before we do what is necessary,” Nigerian Medical Association's Innocent Ujah said.

Kenya: The country has seen cases triple to 17,975 in the past month. However, as a percentage of its population of 47 million, the numbers remain low.

Earlier in July, the government lifted restrictions that had cordoned off Nairobi and other hard-hit cities, while announcing that international flights would resume on August 1.

But on Monday, President Uhuru Kenyatta banned the sale of alcohol in restaurants after noting an “aggressive surge” among young people who were socialising “particularly in environments serving alcohol”.

The country has declared the 2020 school year lost.

Cameroon: The country is central Africa's most affected country with 16,708 cases. Only about 145,000 tests have been carried out among the 25-million population.

Cameroon is past its first peak, which “occurred between the end of June and early July,” according to Prof Yap Boum of Epicenter Africa, the epidemiology branch of Medecins Sans Frontieres (MSF).

But “this does not mean that the pandemic is over,” he warned.

Cameroon did not impose strict lockdown measures as other countries have done. Although the wearing of masks is compulsory in public places, very few people bother to do so.

Djibouti: Tiny Djibouti, with a population of about one-million, has the second highest case rate in East Africa, with more than 5,000 infections.

Government attributes this to aggressive contact tracing and the highest testing rate in Africa with more than 5% of the population having been tested.

“I think we have passed the peak,” Dr Bouh Abdi Khareih, co-ordinator of Djibouti's Covid-19, told AFP.

Madagascar: President Andry Rajoelina has been vigorously touting an infusion derived from artemisia — a plant with proven antimalarial properties — as a home-grown cure for Covid-19.

But Madagascar has seen a surge in infections in recent weeks to more than 9,600 cases and nearly 100 deaths, and hospitals in the capital Antananarivo have said they are running out of beds.

Last week, health minister Ahmad Ahmad made an “urgent appeal” to development agencies — his ministry is seeking oxygen bottles, face masks, gloves and medical blouses.

Ahmad was reprimanded by the government for taking what it called a “personal initiative” without consultation.

Tanzania: The country has downplayed any threat from Covid-19 and stopped releasing official figures. The last tally — issued in April — stood at 509. By comparison, neighbours such as Kenya and Democratic Republic of Congo have recorded nearly 18,000 and 9,000 cases respectively.

“That's why we are all not wearing face masks here. You think we don't fear dying? It's because there is no Covid-19,” President John Magufuli declared on Monday.

Least-affected countries

Figures from a number of African countries suggest they have so far escaped the full wrath of the coronavirus.

Least-affected countries include the island nations of the Seychelles (114 cases) and Mauritius, with 344.

Eritrea has 263 cases and Lesotho 505.