Mother carrying her child  staring to camera in Ethiopia

Analysing coronavirus: an expert's opinion

An epidemiologist’s view on Covid-19 and the risks of the virus spreading in developing countries.

By Action Against Hunger

Mar 30 2020

The coronavirus (Covid-19) is spreading rapidly with 190 countries currently affected around the world. With 45 confirmed cases of the virus so far in the countries where we work, we spoke to Dieynaba N’Diaye, an Action Against Hunger epidemiologist, for an expert’s analysis on the impact a widespread outbreak could have on developing countries.

As an epidemiologist, studying patterns, causes and effects of diseases in humans, what is your analysis of Covid-19?

Coronavirus is a particularly contagious disease. It is highly transmittable, and can survive on surfaces, both of which make it highly infectious. The fatality rate is 2-3% for the general public, and 8% for over-70s. People with underlying health conditions such as diabetes, hypertension (high blood pressure), and cardiovascular disease are also more vulnerable to the virus.

As this is a new disease, we are unable to build immunity to it. Treatments and vaccinations are still in development, which puts vulnerable people at risk.

Latest studies carried out in China have also revealed that 85% of the people affected by the virus were undetected. It’s likely that they showed no or moderate symptoms of the disease, but they’re still infectious and can continue to spread the virus. Currently these figures are estimates, but suggest that we are only at the tip of the iceberg.

Is Covid-19 similar to any other diseases, such as Ebola or cholera? Has Action Against Hunger ever faced a pandemic of this kind?

An epidemic is a spread of a disease among communities in a limited area. However, a pandemic means the disease has spread globally, affecting several countries. Pandemics are rare and more difficult to combat given the geographical scale of them. 

Ebola and cholera are epidemics, confined to certain regions of the world. People who have Ebola experience severe and debilitating symptoms, and are often hospitalised or forced to stay in bed. Identifying Ebola symptoms is easy, meaning those infected can be quickly isolated. These measures stop the spread of the disease.

The coronavirus is different because it shows few or no symptoms in most people. These people do not isolate themselves and continue with their normal routines, with lots of social interaction. As a result, the virus rapidly spreads across the globe.

Action Against Hunger has supported countries with epidemics such as Ebola and cholera. However, every disease is unique and the response to an epidemic is not necessarily the right approach when tackling a pandemic like coronavirus.

We have strong expertise in crisis management, with a strong presence internationally. Our water, sanitation and hygiene (WASH) programmes teach handwashing and other hygiene practices that are crucial for preventing the spread of diseases.

Should we be concerned about the spread of Covid-19 in developing countries? What challenges would these countries face when managing the crisis?

There is a strong risk that the virus will spread. In Africa, for example, commercial links with China and Europe risk a spread of the disease through ‘imported cases’. The virus is also beginning to spread locally.

According to the World Health Organisation (WHO), the most affected countries in Africa today are South Africa, Algeria, Senegal and Burkina Faso, although few deaths have been recorded so far. Although the death toll is low, the risk of the virus spreading would put these countries under huge pressure to test and treat patients. 

We’re unsure how the virus will spread in Africa. Many factors can determine the spread including genetics, climate and demographics as Africa’s population is generally very young.

What we do know is that some countries have relatively weak health systems which are not equipped to deal with this type of outbreak. Additional factors such as political instability could also disrupt the response to the crisis.

African countries will face some of the same challenges as Western countries have done in their fight to tackle the spread of the disease, including capacity to test for coronavirus, hospital conditions, awareness raising among communities, and protection of health workers.

However, they have extra challenges that make a pandemic of this scale even more difficult to combat. Poor access to water, and low hygiene and sanitation, create barriers when implementing practices to stop the spread of a disease, for example washing hands with soap and water.

Quarantining and isolating people at risk will be hard as many families are integrated into one household. Often, grandparents or the elderly live with the rest of the family.

Does undernutrition make people more vulnerable to catching coronavirus?

It’s too early to say if people fighting undernutrition are worse affected by the coronavirus, especially as we lack data on this new disease. However, undernutrition weakens the immune system, making those affected by it more susceptible to infectious diseases.

People suffering from hunger are also those living in difficult socio-economic conditions with limited access to healthcare.

What measures have Action Against Hunger put in place to prepare for the virus spreading in the countries where we work?

Action Against Hunger is coordinating across our organisational network both on a managerial and technical level. We’re carrying out regular scientific and epidemiological monitoring in the countries where we work. 

We’re also meeting the needs of our missions, and making operational recommendations depending on the area of work. For example, we’re teaching staff in our health centres to stop the spread of the virus by:

  • Raising awareness with flyers and posters
  • Making sure we have the necessary equipment, including masks, hand sanitiser and tissues
  • Managing how people enter, exit and walk around our treatment centres, with different waiting rooms for those who are ill
  • Changing the way we collect waste

 

We’re closely monitoring the developments of the pandemic in the countries where we work. Following guidance from our experts, we’re putting in place measures to help these countries reduce the spread of the virus.

 

Children washing hands to fight disease
Children washing hands to fight disease

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Photos: Sanjida Tawhid, Khadija Farah/Action Against Hunger