After being head of the infectious diseases department at the Saint-Antoine hospital in Paris, Professor Pierre-Marie Girard is now the Director of International Affairs at the Pasteur Institute in the capital and head of the International Network Instituts Pasteur, 10 of which are located in Africa.
The great fear around this new epidemic was that it would reach Africa. However, there is only one known case, in Egypt. Is this good news?
Today, no one understands why the epidemic has not yet developed on the African continent. Many experts doubt the reality of the figures displayed. The most optimistic are surprised but they bet that the epidemic will end before the African continent is hit. For pessimists, there are two possibilities: either cases have not yet been identified and it is only a matter of time, or the ever-increasing evolution of the epidemic in China, the inevitable flaws in the measures isolation and the extent of their constraints will necessarily lead to an extension of the epidemic to Africa.
Why is there such a strong doubt?
A simple observation: in Africa, there are more than a million Chinese nationals who go back and forth to their country, and there was, in addition, a strong movement around the Chinese New Year. Everything contributes to the virus circulating. Moreover, on Wednesday, there was a remarkable modeling done by an Inserm team around the Italian researcher Vittoria Colizza showing that Egypt, Algeria and South Africa would be the gateways to the most likely of the coronavirus on the African continent. To do this, they worked on the importance of air traffic with the contaminated Chinese provinces, pointing to the large air hubs through which many travelers pass. These three countries are also among the best equipped on the continent to quickly detect and deal with new cases. In other African countries, according to this research, the risk of importation is lower but the sanitary deficiencies can raise fears of a rapid diffusion.
In this case, what explains the absence or almost no case?
It is possible that there are hidden cases, infected people who did not have access to the tests or, above all, people infected during the incubation period, therefore not detectable. The most likely assumption is that the coronavirus is circulating at least quietly.
Maybe the climate is not suitable for this virus?
No. The tropical climate is not a powerful brake on the replication of coronaviruses although a partial seasonality is likely as for most respiratory viruses. To bet on climate protection in Africa or spontaneous control of the epidemic at the end of winter would be absurd.
What should be done, however, for Africa?
Prepare, and, as is the case in many African countries, with the support of international aid. With our 10 institutes, we were able to make molecular tests available as soon as they were developed. Reference centers were equipped and biologists trained from mid-January. Fortunately, infected people are mainly contagious during the first symptoms, which makes it possible to identify the people most at risk, those who can even be severely affected and transmit the virus to those around them. This allows you to act more efficiently and quickly limit the transmission.
Still, in your eyes, there will be an epidemic in Africa anyway …
In any case, nothing is finished. The epidemic is not currently under control in China, it is not known how long people will remain contagious, and as in any epidemic, there can be rebounds after phases of relative lull. It will last for months. Perhaps the worst is ahead of us. But if the worst is never certain, it would be collectively unacceptable not to prepare for it and thus ignore the risks run by the poorest countries.