Interview-Covid-19: "Africa Must Adapt its Response...", Dr. Pierre Mpélé, Epidemiologist

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Extract from the article: The coronavirus Covid-19 pandemic is taking its time but progressing across the African continent. Today, 12 African countries are affected, and we are already recording the first deaths. Covid-19 and the African response seen by an...

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The coronavirus Covid-19 pandemic is taking its time but progressing across the African continent. Today, 12 African countries are affected, and we are already recording the first deaths. Covid-19 and the African response seen by an epidemiologist from the continent in this article from Health-Education. Dr. Pierre M’PELE, MD, MPH, PhD, Specialist in public health, epidemiology, and tropical diseases, Former WHO Representative, Former Regional Director of UNAIDS for Central and West Africa sheds some light on Covid-19.

"The Covid-19 infection is a global public health problem, a serious medical issue that deserves a global response to address the pandemic, now declared somewhat belatedly by the WHO, but action must be taken, both individually and collectively." Dr. Pierre M’PELE, MD, MPH, PhD, Specialist in public health, epidemiology

 

The coronavirus Covid19 is said to have both mild and more severe forms! Can you explain?

What we know today is that Covid19 infection is most often asymptomatic or simply marked by a mild flu-like syndrome, characterized most often by a cold, cough, body aches, and fever in about 75% of cases. In around 15% of cases, the infection presents as a flu-like syndrome with moderate lung involvement, and in 10%, it presents in a severe form with severe lung involvement, most often occurring in people over 70 years old and associated with comorbidities such as diabetes, cancer, immunosuppression, etc.

Can all these forms be detected?

Yes, clinical signs and patient history or interview draw the attention of the doctor or healthcare professional. A laboratory test confirms the presence of Covid19, with samples taken from the nasopharynx. Results can typically be obtained within 4 hours.

The disease spreads more slowly on the African continent. How do you explain this?

It's a noteworthy observation and a clear impression that Covid19 is not spreading rapidly in Africa. Exchanges have occurred between Africa and China, with many Chinese nationals, including those from the Wuhan region in China, entering Africa during the "silent" period of the epidemic, between November 2019 and late January 2020.

We observe that most cases reported in Africa are imported, meaning they come from countries experiencing epidemics, and tracking their African contacts has not yet shown rapid spread of the virus as seen in China or currently in Europe, where one contact case can infect up to 3 people. However, in Africa, this could lead to several contacts because "we like to touch" and "our communal living" can put us at high risk.

Epidemiologists, virologists, and infectious disease specialists in Africa need to join forces and mobilize to fight this epidemic. Targeted surveys in high-risk groups (hospitalized patients in pulmonary, hospital emergency, and infectious disease services, for example) are needed to assess the circulation of the virus in Africa.

At the end of 2019 and the beginning of 2020, West Africa experienced a wave of flu-like syndromes, perhaps related to the "Harmattan" season. What do you say? Simple seasonal flu or already the presence of coronavirus. "The current heatwave prevents us from catching colds and sneezing..."

In Africa, we need a response based on epidemiological and scientific evidence and, of course, taking into account our experiences in preparation for and response to recent epidemics such as Ebola, Zika, Lassa, and why not the HIV/AIDS pandemic, for which Africa has borne and still bears the heaviest burden.

You who coordinated the fight against HIV/AIDS in Africa, do you think Africa is ready to respond to Covid19?

Africa is not ready, but it must be ready. Health systems in the majority of African countries are fragile and would struggle to cope with a massive Covid19 epidemic. "Water and soap are sometimes scarce commodities and yet are fundamental to risk reduction."

It is therefore very useful to make the right decisions at the right times, to implement response measures without always relying on others who are themselves currently very affected, as is the case in Europe.

In your opinion, what urgent measures should African governments take to reduce the risks of contagion?

Make political decisions based on scientific evidence from current knowledge, be flexible, and adapt according to the evolution of the problem.

 · Avoid strategies that go against human rights and are counterproductive, such as stigmatization, discrimination, fear, and threats, like recent decisions by US President Donald Trump. This also means that WHO as the global health authority and the world's government leaders have a huge responsibility to prevent the world from descending into chaos with economic implications and especially concerning freedoms,

· Put African health professionals on the front lines by raising awareness, training, and equipping them so that they can assume their responsibility,

· Develop and implement coherent response plans against the epidemic in Africa according to WHO guidance, including funding, ensuring the availability of prevention amenities, and the means of diagnosis and patient care. Ensure that populations are informed so that they are not only the targets of response strategies but also the actors in responding to this pandemic.

In Africa, Covid19 can be prevented and is within our reach; we can draw from the Chinese experience and adapt our response by leveraging our values, culture, customs, and traditions. It is the responsibility of everyone here in Africa and elsewhere in the world.

Interview conducted by Raymond DZAKPATA