Novel Coronavirus (2019-nCoV) Global Epidemic – 17 March 2020

17 March 2020

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Outbreak Update: Since the last brief, 57,936 new novel coronavirus (COVID-19) cases[1] and 2,796 new deaths have been reported globally.  Forty-two countries, including 19 new African countries, are reporting cases[2], and 26 new countries, including three African countries, are reporting deaths[3] for the first time. To date,  167,511 total COVID-19 confirmed cases, and 6,606  related deaths have been reported. The total number of confirmed cases (81,077; 48%) and deaths (3,218; 49%) reported from mainland China have now been surpassed by those reported from other countries. One hundred and fifty-one different countries or territories outside of China have reported 86,434 cases. To date 3,388 total deaths have been reported outside China from 44 countries. The case fatality rate for COVID-19 has remained between 2-4% throughout the outbreak. WHO now considers Europe the epicenter of the pandemic. For more detailed information on cases and deaths being reported outside of Africa, refer to the WHO daily situation reports.[4]

As of 17 March 2020, 443 total COVID-19 cases have been reported in 30 African countries. A total of 10 deaths have been reported from four African countries.  Africa CDC is working with all affected countries and is mobilizing laboratory, surveillance, and other response support where requested. See Table 1 for the full list of countries in Africa reporting cases and deaths. 

Table 1. Confirmed COVID-19 Cases Reported in Africa[5]

Country No. of cases (new) No. of deaths (new) Linked country[6] Transmission Type[7]
Algeria 55 (31) 3 (0) France (2), Italy (1) Local transmission
Benin 1 (1) Belgium and Burkina Faso (1) Imported cases only
Burkina Faso 15 (13) France (1) Local transmission
Cameroon 10 (7) France (1), Italy(1) Local transmission
Central African Republic 1 (1) Italy (1) Imported cases only
Congo 1 (1) France (1) Imported cases only
Côte d’Ivoire 4 (3) France and Italy (2) Local transmission
DRC 3 (1) France (2), Switzerland (1) Imported cases only
Egypt 166 (86) 4 (3) China (1) Local transmission
Equatorial Guinea 1 (1) Spain (1) Imported cases only
Eswatini 1 (1) US (1) Imported cases only
Ethiopia 5 (5) Japan (1) Local transmission
Gabon 1 (1) France (1) Imported cases only
Ghana 6 (2) Germany (1), Norway (1), Switzerland (1), Turkey (2), UK (1), USA (1) Imported cases only
Guinea 1 (1) Belgium (1), France(1) Imported cases only
Kenya 3 (3) US (1), UK (1) Local transmission
Liberia 1 (1) Switzerland (1) Imported cases only
Mauritania 1 (1) Europe Imported cases only
Morocco 38 (32) 2 (2) France (1) Local transmission
Namibia 2 (2) South Africa (2), Spain (2) Imported cases only
Nigeria 3 (1) Italy (1) Imported cases only
Rwanda 7 (6) India (1), Italy (1), Qatar and US (1), and UK (1) Local transmission
Senegal 27 (6) Italy (1), France (1) Local transmission
Seychelles 4 (4) Holland (1), Italy (2) Imported cases only
Somalia 1 (1) China (1) Imported cases only
South Africa 62 (55) Brazil (1), France (3), Germany (2), Iran (), Italy (2), Netherland(2) Switzerland (1), UAE (1), UK (5), USA (4) Local transmission
Sudan 1 (1) 1 (1) UAE (1) Imported cases only
Tanzania 1 (1) Belgium, Denmark, and Sweden (1) Imported cases only
Togo 1 (1) Germany, France,  and Turkey (1) Imported cases only
Tunisia 20 (16) Egypt (2), France (6), Italy (3) Local transmission
Total 443 (286) 10 (6)    

Africa CDC Response:

General activities

  1. Africa CDC activated its Emergency Operations Center and its Incident Management System (IMS) for the COVID-19 outbreak on 27 January 2020. Africa CDC has developed its third Incident Action Plan that covers the period between 16 March to 15 April 2020.
  2. The Africa Union Ministers of Health gathered in Addis Ababa, Ethiopia, on 22 February for an emergency COVID-19 meeting where they agreed upon a joint continental strategy and guidance for assessment, movement restrictions, and monitoring of people at risk for COVID-19, including people being repatriated from China.
  3. Africa CDC is holding weekly updates with national public health institutes in Member States and has formed working groups for high priority areas of coronavirus control, including: surveillance; laboratory diagnosis; infection prevention and control; clinical care; and risk communication.
  4. Three experts each have been deployed to Cameroon and Nigeria and to support COVID-19 outbreak response efforts.
  5. Response simulation exercises (i.e., ‘table top’ exercises for high-level coordination) are being initiated, including an initial simulation conducted with a group of ~10 West African Countries in partnership with WAHO.
  6. Africa CDC is working to procure emergency medical equipment stockpiles including diagnostics (over 6,000 test kits), PPE, thermal scanners and other critical equipment that can be used to rapidly equip countries in the event of rapid onset of cases.
  7. Twenty-four volunteers have been recruited to support various response activities with more in-process of recruitment.
  8. Africa CDC gave an orientation to the African Union Commission staff on the epidemiological situation, Africa CDC efforts, and the precautions that staff members should take to prevent themselves and others from getting infected by COVID-19. A social distancing police was issued by AUC to avoid big gatherings and meetings in the AUC facilities.

Surveillance

  1. Africa CDC collaborated with the World Health Organization on 22 February 2020 to train in-coming analysts in event-based surveillance using the Epidemic Intelligence from Open Sources platform. These headquarters will be working closely with the Regional Collaborating Centres and Member States to track and verify COVID-19 related events, providing critical information to inform Member States’ response and control efforts.
  2. Africa CDC in collaboration with WHO provided two Training of Trainers events for participants from 18 countries: Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Egypt, Ethiopia, Ghana, Kenya, Mauritius, Mauritania, Nigeria, Niger, Zambia, Rwanda, Sao Tome and Principe, South Africa, Tunisia and Zambia to enhance surveillance at points of entry for COVID-19. Additional training is planned for March and April targeting the remaining countries in Africa.
  3. Africa CDC in collaboration with the U.S Centers for Disease Control and Prevention will be training 20 countries in event-based surveillance for COVID-19 starting in March 2020. The first training for 7 countries was held in Kampala, Uganda on 2-4 March 2020.

Laboratory

  1. Total of 40 countries were trained on laboratory confirmation of SARS –CoV-2 in collaboration with partners. Except very few laboratories, all have verified the testing protocol and are doing testing of suspected cases.
  2. Start-up kits were provided to all laboratories after training. Additional kits were provided to countries that have registered confirmed cases (Egypt, Nigeria, Cameroon, Kenya, Ghana, Central Africa Republic, and Rwanda)
  3. Africa CDC is coordinating with partners to establish sequencing capacity in 12 African  reference laboratories, as well as external quality assessment and proficiency testing for all laboratories with COVID-19 testing capacity. 
  4. Member States can use WHO’s existing specimen referral network for influenza to ship their specimens to laboratories with capacity to test for COVID-19. For a full list of laboratories in Africa and how to submit specimens, Member States should contact the WHO country office and Africa CDC at yenewk@africa-union.org.

Healthcare Preparedness

  1. Africa CDC has been working with Member States to build infection prevention and control capacity in healthcare facilities and with the airline sector to support screening of travelers. The first two IPC trainings, targeting 22 Member States took place between from 20-25 February 2020 in Abuja, Nigeria for Cameroon, Côte d’Ivoire, DRC, Ethiopia, Gabon, Ghana, Kenya, Madagascar, Malawi, Mali, Mozambique, Namibia, Senegal, Sierra Leone, South Africa, South Sudan, Sudan, Tunisia, Uganda, Zambia, and Zimbabwe.
  2. Africa CDC initiated a continent-wide network of clinicians which met for the first time on 9 March 2020, with a webinar that included ~230 clinicians from across the continent. The next webinar is scheduled for 19 March 2020.
  3. Africa CDC initiated design of an online portal with training materials via online courses, online case studies, and social media vignettes to support evidence-based care of COVID-19 patients.

Risk Communication

  1. Africa CDC conducted a training on risk communication for government officials in 26 countries across multiple sectors to manage public information flow during a potential outbreak. 

Recommendations for Member States:

  1. All Member States should enhance their surveillance for severe acute respiratory infections (SARI)[8] and to carefully review any unusual patterns of SARI or pneumonia cases. Examples of enhanced surveillance include:
    1. Adding questions about travel and testing for coronaviruses to existing influenza surveillance systems;
    2. Notifying healthcare facilities to immediately inform local public health officials about persons who meet the case definition for SARI and recently traveled to Wuhan (or other affected countries).
  2. All Member States should a) activate their Emergency Operations Centers and rapid response teams for COVID-19, b) exercise their emergency response systems for readiness.
  3. Member States that receive direct or connecting flights from affected countries should screen incoming passengers for severe respiratory illness and a history of recent travel to any country/area or territory reporting local transmission. Member States should be prepared to expand questions about recent travel to additional countries as the outbreak evolves.
  4. Notify WHO and Africa CDC immediately if suspected or confirmed cases of infection with novel coronavirus are identified. Africa CDC should be notified by emailing AfricaCDCEBS@africa-union.org.
  5. Prepare to collect specimens from patients suspected of having novel coronavirus infection. Interim guidance on specimen collection and handling is available from WHO at https://www.who.int/health-topics/coronavirus/laboratory-diagnostics-for-novel-coronavirus.
  6. Provide guidance to the general public about seeking immediate medical care and informing healthcare providers about recent travel in anyone who develops symptoms of severe respiratory illness and recently traveled to Wuhan or one of the affected areas.

Resources for more information:


Endnotes

[1] Per WHO, effective 17 February 2020, ‘confirmed’ cases include both laboratory-confirmed and clinically diagnosed (Hubei province, China only).

[2] Antigua and Barbuda, Benin, Bolivia, Brunei Darussalam, Cayman Islands, Central African Republic, Congo, Côte d’Ivoir, Cuba, Curaçao, DRC, Equatorial Guinea, Eswatini, Ethiopia, Gabon, Ghana, Guinea, Guadeloupe, Guyana,  Guernsey, Honduras, Jamaica, Jersey, Kazakhstan, Kenya, Liberia, Maldives, Mauritania, Mayotte, Mongolia, Namibia, Panama, Puerto Rico, Réunion, Rwanda, Seychelles, Somalia, Sudan, St. Vincent and the Grenadines, Tanzania, Trinidad and Tobago, Turkey, and Venezuela.

[3] Albania, Algeria, Austria, Bahrain, Belgium, Bulgaria, Canada, Cayman Islands, Denmark, Ecuador, Germany, Greece, Guyana, Hungary, India, Indonesia, Ireland, Lebanon, Luxembourg, Morocco, Norway, Panama, Poland, Sudan, Sweden, and Ukraine.

[4] WHO coronavirus disease (COVID-19) situation reports: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

[5] New numbers reported since last weekly brief (10 March 2020)

[6] Country with local transmission where cases reported recently traveling.

[7] Local transmission: indicates locations where the source of infection is within the reporting location; Imported cases: only indicates locations where all cases have been acquired outside the location of reporting.

[8] WHO SARI case definition: anyone with an acute respiratory infection with history of fever (or measured fever of ≥ 38 C°) and cough with symptom onset within the last 10 days that requires hospitalization.   https://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/

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