Nigeria responds to first coronavirus case in Sub-Saharan Africa

An Italian contractor who flew into Nigeria from Milan became sub-Saharan Africa’s first confirmed coronavirus patient on Friday, stoking concern that an outbreak on the continent could overwhelm already strained health care systems.

The patient, a young man, had no symptoms when he landed this week in Lagos, travelled 60 miles north to the cement factory where he works and developed a fever there, a Nigerian health commissioner said to reporters.

Nigeria records first coronavirus case amidst fears of unpreparedness

The appearance of the first case in Lagos — a city of 20 million people and the economic capital of Africa’s most populous nation — set off fear, rumours and panicked buying of hand sanitizer and face masks. It also posed a test for the Nigerian medical system, which like others in Africa, has been preparing for the virus to arrive for weeks.

“I feel scared,” said Karo Otitifore, an elementary schoolteacher waiting at a bus stop in Yaba, the Lagos suburb where the Italian patient was being treated. “I try to sit tight, squeeze my whole body so that I won’t have to have too much body contact with people.”

Public health officials have been warning that the coronavirus could be devastating in Africa, a continent with relatively weak health care and disease surveillance systems. So the Nigerian health system — which had gained a reputation for efficiently containing cases during the Ebola epidemic in 2014 — responded quickly to the appearance of a suspected case of coronavirus.

The young Italian was sent back to Lagos, where he is being treated in a hospital facility that had been set aside to handle coronavirus, while a team of epidemiologists traces his contacts.

Dr Ngozi Erondu, an associate fellow in the Global Health Program at Chatham House, an international research group in London, said Nigeria’s confirmation of the coronavirus case in just two days was “a very positive reflection of the disease surveillance and laboratory capacity in Nigeria.”

But it will be key, she said, for all African countries to enhance scrutiny of travellers, especially those coming from countries with documented outbreaks.

The coronavirus, which emerged in central China late last year, has spread to almost 50 countries, sickening about 84,000 people and killing nearly 3,000 — mostly in mainland China. But in recent weeks, the virus has spread across the globe with outbreaks in Iran, Japan, South Korea and Italy, especially in Milan.

To date, 26 African countries have reported suspected coronavirus cases, according to the Africa Centers for Disease Control and Prevention. Only three countries on the continent — Algeria and Egypt in North Africa — and now Nigeria in the sub-Saharan region, have announced confirmed cases. The case in Algeria was an Italian who arrived in the country on Feb. 17, according to the World Health Organization.

Global health experts had anticipated that the virus would most likely spread to Africa from China, which has increased its ties with Africa enormously over the past two decades.

To combat the potential spread of the deadly outbreak, airlines including Egypt Air, Kenya Airways and South African Airways have suspended their flights to China.

Ethiopian Airlines, which operates the largest number of flights between China and Africa, has refused to follow suit despite widespread criticism from political and business leaders across the continent.

The Kenyan government faced criticism this week for allowing China Southern Airlines to resume flights from Guangzhou Province in China to Nairobi, the Kenyan capital. The government said that all 239 passengers on the first plane after the service restarted had been screened onboard, cleared and advised to self-quarantine for 14 days. But on social media, many expressed outrage about the flights, calling officials negligent.

On Friday, after numerous lawsuits were filed against the government, Kenya’s high court temporarily suspended flights from China for ten days.

The Ebola outbreak that ravaged Liberia, Sierra Leone and Guinea five years ago is still fresh in the minds of West Africans. Many are fearful that their governments are not much better prepared to detect, respond to and contain outbreaks than they were then.

A continentwide Center for Disease Control has since been established and has been coordinating efforts across the continent. The Africa C.D.C., in collaboration with the W.H.O., has worked with countries to improve their surveillance and testing processes.

Currently, 26 laboratories can test for the coronavirus on the continent, up from just two in early February, according to the W.H.O. The Africa C.D.C. has shipped one thousand test kits to Nigeria.

Nigerians expressed some confidence in their government’s ability to contain coronavirus on Friday, stemming from their experience with the Ebola epidemic, which experts say appears to be far more deadly than the coronavirus.

A Liberian-American who brought Ebola to Lagos in 2014 was prevented from leaving a clinic, his contacts were traced and 900 people were monitored. He and a doctor and six other people died — a number many epidemiologists considered mercifully low given that more than 11,000 people died in the West African outbreak, which lasted from 2014 to 2016.

However, Lagos is a city that contains both extreme wealth and poverty, and if the virus gets into its poorest areas, the lack of adequate housing and sanitation among people living in cramped conditions could cause it to spread at breakneck speed, a public health expert said.

In Lagos on Friday, people across the city were hurriedly buying hand sanitizer, face masks and in the shaky hope, it would make a difference, vitamin C supplements.

“Somebody came in and just bought all our vitamin C. People have been constantly asking for it,” said Eniola Okunnuga, a pharmacist at one of the biggest pharmacies in Lagos.

Unfounded rumours spread rapidly that bathing in water laced with ginger and garlic would protect against the virus, particularly on the messaging service WhatsApp. But sound advice also circulated, about washing hands and keeping away from people with coughs.

Mr Otitifore, the schoolteacher, scoffed at old wives’ tales about ginger and garlic, but also repeated some rumours he had given credence to. Drinking a lot of water would wash the virus down so that stomach acid could attack it, he said.

He waited at a crowded bus stop for a bus crammed with passengers. A recent ban — unrelated to coronavirus — on the city’s fleet of motorcycle taxis and auto-rickshaws meant that many Lagosians are in even closer contact than usual, raising the risk of exposure should the virus spread.