Understanding pandemics and coronavirus outbreak potential risks in Africa

Category: Opinion | Posted date: 2020-04-20 10:56:32 | Posted by: Mark Patrick

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Unfortunately, myths on the side of the masses and unpreparedness on the side of government are giving much increase to the predictions of possible massive death toll hitting African continent soon

Understanding pandemics and coronavirus outbreak potential risks in Africa

Since December 2019, the outbreak of coronavirus with its code name, Covid-19 which originated from its epicenter in Wuhan city, China has assumed a full-fledged pandemic. The global spread and events occasioned by the outbreak of the virus necessitated its official declaration as pandemic by World Health Organization (WHO) in March 2020.


According to WHO, coronavirus (Covid-19) disease is an infectious disease caused by a newly discovered coronavirus. The virus is such a unique strain of virus that has not been previously identified in humans.


Presently over 2.3million people have been infected globally and about 160,000 fatalities recorded as at today. Infection and death rates are still growing speedily as the respiratory virus continues to spread indiscriminately. As a matter of global concern, 5000 – 10,000 people die daily globally from Covid-19.


Notable symptoms of the virus include fever, cough, shortness of breath, and breathing difficulties. And in severe cases, symptoms range from pneumonia, severe acute respiratory syndrome, kidney failure and other complications leading to death.

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Presently, the United States of America, United Kingdom, Italy, France, Spain and Turkey have been the hardest hit countries recording between 500 - 2000 deaths each per day. Speculations are now growing higher over the potentiality of Africa becoming the next mass causality continent of Covid-19.


Covid-19 in Africa

Unfortunately, myths on the side of the masses and unpreparedness on the side of government are giving much increase to the predictions of possible massive death toll hitting African continent soon. Politicization of the pandemic; lockdown without adequate palliative measures; lack of transparency and poor management of public fund for combating the virus are other pressing factors putting Africa at risk.


African continent with a population of 1.216 billion people (Worldometer, 2020), only just over 100,000 people have been tested for the virulent virus. Over 16,200 cases have been recorded, with 873 deaths as at last Wednesday. Subsequent increase or decrease of infected people and fatality depend on measures put in place to contain the virus.


Like the rest of the world, as at this moment, there are no vaccines for the virus and curing of infected patients of Covid-19 has been a subject of different trials in Africa.


Amid the spread of Covid-19, social behaviours of people and orientation of reality of the disease outbreak are adversely unequal in Africa. This tends to explain or suggest that there is poor understanding of inherent risks of pandemic virus like this in the land, while myths and suspicious fraudulent activities of stakeholders may put the continent at risk of poor containment of the deadly virus.


Pandemic, endemic and epidemic pestilences among other grave disasters are of global concern as they are threats to human security collectively. This is why their containment often remain prioritised goal of the international communities.

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Pandemic diseases outbreak remains the world most dreadful nightmare—it is often a global headache. Learning hot lessons from the outbreak of 1918 Spanish flu and world war II (holocaust) between 1941 and 1945, in which people died massively with their decomposing bodies littering the streets without burial, or buried  en masse  without the presence of families and friends. The reasons the devastating mortality implication of pandemic pestilence and  enormous challenge of its containment measures attract utmost global concern in the 21st century.


Views and beliefs of different schools

However, different explanations and interpretations have been accorded  outbreaks of pandemic pestilence. Within the society of human security experts, it has been hypothetically postulated as biological terrorism unleashed against humanity. From the natural scientists’ interpretations, pandemic pestilence is genetically addressed as virulent contagious diseases that emanates from animals infected with notable pathogens, uniquely identified with stages of transmission and wide spread causing death among humans. But the astrologers argued that pandemic plagues emerge from planetary changes and repositioning of the planets, while religious interpretations affirm that pandemic pestilences are apocalyptic fulfillment as foretold in the eschatology.


An academic explanation by Miquel, 2008 posits that pandemic is an epidemic occurring on a scale that crosses international boundaries, usually affecting people on a worldwide scale. Similarly, Dr. Keji Fukuda (2009), the Assistant Director-General for Health and Environment Security, WHIO defined pandemic as global outbreak. Ideally, what makes a disease pandemic is the propensity of the disease to be virulently contagious and infectious crossing international boundaries.


In a more insightful definition, Madhav et al. (2018) defined pandemics as large scale outbreaks of infectious disease that can greatly increase morbidity and mortality over a wide geographical area and cause significant economic, social, and political disruption. According to Porta (2014), a pandemic is an epidemic occurring over a very wide area, crossing international boundaries, and usually affecting a large number of people. These definitions vividly capture the early stage of a pestilence as an epidemic migrating to its maturity stage as a pandemic.


Spread and adverse effect of pandemics

Histories of the world most ravaging pandemics have proven that the outbreak of a pestilence is a very grievous global health and human security issues, with underlined devastating implications that last for decades. Pandemic outbreaks are often accompanied with permanent or long term national, regional and (or) international socioeconomic and political structural change. For example, during the 1346 Yersinia Pestilence, several feudal socioeconomic structures in Europe were overthrown; while the 1918 Spanish Influenza was believed to have ended World War 1.


Notably, pestilences are acute contagious or infectious diseases occurring most times to attack human immune system within 2-14days of initial infection. More also, the diseases have ravaging capacity to spread fast through mathematical method known as multiplier effect in a matrix form. The implication of this is that, contagious diseases often spread wide through human to human contacts with make it difficult to contain quickly.


Without exaggerating mortality rates resulting from global pandemics, nothing less than hundreds of thousands to millions of people die globally from a single pandemic outbreak. Outbreaks of pandemic are challenging and most worrisome period to the world as it places heavy pressure on every sector of the globe. During pandemic outbreak, nations and states usually go on total or partial lockdown, international trades are halted, food insecurity and malnutrition increase, global recession occur rapidly, poverty soars higher, regional and international population drastically reduces, unemployment increases while millions of jobs are lost globally.


Severity of adverse effects of pandemics makes restoring affected regional and international system to its normal position a daunting challenge. Basically, easing ravaged global socioeconomic and political systems from the impacts of global pandemic often takes longer period that could last for decades. As global structures and system change, recovery initiatives often take gradual process to achieve.


For proper understanding of what global pandemic constitutes, it is very germane for this article to provide historical overviews of global pandemics. This is purposed to critically deconstruct what pandemics really mean, and as well as reviewing their devastating implications on the world.


Justinian Plague

The world has witnessed several devastating pandemics in the past crumbling its socioeconomic life and political spheres. The foremost was the Plague of Justinian which occurred in Eastern Europe (541-542AD). The plague was a pandemic that attacked the Sasanian Empire, Byzantine Empire an ancient Greek speaking empire of the Eastern Roman and its capital Constantinople and as well as the entire port cities around the Mediterranean sea. As a strong disease, it lasted for two centuries with record of reoccurrence that lasted till 750AD.


Epidemiology research on the pestilence suggested that, the monstrous Justinian plague originated from Kyrgyzstan, Kazakhstan, and China. Recent genetic and clinical studies on the Justinian pestilence have proven to be Yersinia pestis, the same bacterium responsible for the second plague (Maria, 2014; Bockemuh, 1994). Clinical and genetic studies on the pestilence was scientifically achieved through the collection of skeletons of Justinian plague victims in Germany and the sample of a skeleton identified as an early Hun (180AD) found in Tian Shan Mountain (Eroshenko et al., 2017).


Further epidemiology study revealed that Justinian plague spread sporadically to West Eurasia through the Xiongnu and the Huns Nordics who migrated across the grassland of Eastern Europe and Asia (Damgaard et al., 2018). Other DNA evidences provided that trade networks was suspected as the likely avenue through which the virus spread indiscriminately rather than migrations of populations (Rasmussen, 2015).


Notable symptoms of Yersinia pestis bacterium includes pneumonic, bubonic and septicemic sickness on infected person. Horribly, the death toll from the pandemic was estimated to be around 25 to 100 million people.


The certainty of the pestilence mortality rate has been contended by various historians. At the peak of the plague, Procopius (542AD) a Byzantine historian recorded that the disease killed 10,000 people daily in Constantinople while Mordechai et al (2019) believed that the plague killed as much as 5,000 people per day in Constantinople. Justinian plague had a huge long term effect on agriculture and the history of Christian in Europe.


Black Death pandemic

Another devastating pandemic worth considering is the Black Death pandemic (1346-1353). It is also known as the Pestilence and the Great Bubonic Plague. The pandemic was the second and the most devastating pandemic experience recorded in human history. As the world most horrible experience, researchers averred that the Black Death was the first major European outbreak of plague with the highest fatality rate. Medical geneticists and epidemiologists scientifically traced and documented that the disease originated from ground rodents infected with Yersinia Pestis bacterium. Yersinia pestis is a coccobacillus bacterium that infects humans through oriental flea bites.


Studies on the bacterium provided that the Black Death pandemic broke out in Asia or East Asia the epicenter, spreading to other regions and continents of the world through infected Mongol armies and traders who travelled along the Silk Road to Europe (Hollingsworth, 2020; Bramanti et al, 2016; Wade, 2010). Further studies by epidemiologists and archeologists provided that due to severe climate change in Asia, ground rodents infected with the Yersinia bacterium fled from dried-out grassland to live in populated areas where the disease was later fast transmitted from animals to humans through oriental fleas that fed on infected rodents and later bites humans (Tignor et al, 2014).

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The Yersinia virus was an unusual virus, spreading and killing fast like a wildfire. Both decomposed animals and humans bodies covered the streets without burial, making the outbreak the world most deadly pandemic. Barney (2011) and Dean et al (2018) unanimously contended that the quick wide spread of the disease and its ravaging mortality rate transcended beyond rodents-fleas-human transmission, but through person to person contact which made the disease spread worldwide like a wildfire.


Symptoms of the bacterium in human were pneumonia, fever, headaches, joints pain, vomiting and bubonic growths on infected patients. According to Totaro (2005), about 80% of those who contacted the disease without early treatment died within eight days of the infection while Herlihy (1997) established that victims died within two to seven days after initial infection.  Most vulnerable of the killer disease were children and areas stricken by poverty.


The ravaging pandemic resulted in the global death toll of about 75 to 200 million people in the world. It was accounted that massive death rate depopulated countries in Europe (London, France, Italy), Asia, Middle East, North Africa and part of Sub-Saharan Africa. Aside the ravaging mortality rate arising from the pandemic, the outbreak triggered severe socio-political upheavals in Europe and the rest of the Muslim Empire. From 1349-1351 thousands of Jews were massacred in European communities (Gottfried, 2010; Tuchman, 1978). As Italy was badly hit by the pandemic, historians reiterated that surge in the disease mortality led to the emergence of the Italian Renaissance in the 14th century (Brotton, 2006).


Spanish flu

Another  pandemic worth considering is the 1918 Influenza, popularly known as the Spanish Flu (1918-1920). The influenza was a very unique and deadly virus that infected more than 500 million people in the world. The flu triggered cytokine storm destroying the immune system of young adult. During the first wave of the pandemic, most affected of the deadly virus were young adults and pregnant women. The second wave triggered virulent attack on adults resulting in mass casualties.


Notably, symptoms of the devastating virus includes sneezing, coughing, ear bleeding, and petechial hemorrhages in the skin. The death toll from the global pandemic was estimated to be around 17 to 50 million people globally (Rosenwald, 2020).


Epidemiologists historically traced the origin of the flu in to China (Cheng, 2019; Langford, 2005), but stating that the speculations of relatively low death rate recorded in China authenticates the affirmation of China as the flu epicenter. Crosby (2003) and Barry (1918) both historically argued that the 1918 flu originated in Kansas in the United States. In 1993, Claude Hannoun asserted that the flu originated from China and then spread to United States where it was later transmitted to Europe and the rest of the world through Allied soldiers and sailors.


Humphries (2014), through an archived evidence of respiratory illness that struck Northern China in 1917, averred in a new dimension that the mobilisation of 96,000 Chinese laborers to work behind British and French Lines may have been the source of the pandemic. In 1918, Chinese health officials identified the 1917 Chinese respiratory illness as identical with the Spanish influenza (Vergano, 2014).


Countries that recorded massive death rate from the pandemic were China 5 - 10million, India 12 - 17million, Ghana 100,000, United States 500,000 – 850,000, Britain 250,000, Japan 390,000, France 400,000, Indonesia 1.5million, Brazil 300,000, and Iran 900,000– 2million. Majority of the deaths resulted from bacterial pneumonia and damages of the lungs (Moris et al., 2017; Taubenbberger et al., 2001).


In a simple epidemic model study, school opening and closing, temperature changes and human behavioural changes in response to the outbreak were identifiable factors that trivialized the epidemic in the United States (He et al., 2013).

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Factors contributing greatly to pandemic diseases’ mortalities

Due to the globalisation of migration, trade and commerce nation states become easily vulnerable to pandemic outbreak. Escalation of pandemic pestilences in previous centuries suggests that increase in global migration, urbanisation, changes in land use, exploitation of natural resources increased the spread of pandemics (Madhav et al. 2018; Jones et al. 2008; Morse 1995). Murray et al. (2006) further explained that, severity of global pandemics reflects in part the limited health technologies in those periods and unavailability of antibiotics, antiviral, or vaccines made for reducing transmission and mortality.


Contemporarily, pandemic unpreparedness, waiting period for the production and supply of test kits and vaccines are considerable factors that can trivialize pandemics most especially in low and medium income countries (Sean, 2020).


Some helping measures

Other issues such as timely detection of disease, availability of basic care, tracing of contacts, quarantine and isolation procedures, preparedness outside the health sector, global coordination and response mobilisation are notable fundamental measures necessary to mitigate global pandemic outbreak (Madhav et al., 2018; Moon et al., 2015; Pathmanathan et al., 2014).


Studying pandemic trends…

Studying pandemic diseases trends globally over time in relation to the observed level of readiness to adequately combat coronavirus in Africa, one may conclude that there is potential possibility of the virus ravaging hard in the continent. The more advanced nations are still lamenting that the Covid-19 outbreak caught them unaware just as the EU Commissioner for Internal Market, Thierry Bretton remarked recently in a Skype interview with France24. The stakeholder claimed that coronavirus as a tsunami caught up both the Europe and United States unaware.


Presently, Europe (UK, France, Spain, Italy, Turkey and Germany) and the United States are the hardest hit of the coronavirus recording thousands of death in a day. However, there are frightening speculations already that India and Africa may be the next hard hit regions.


An epicenter and its features are contributing determinant factor for spread trends of a pandemic. For example, Wuhan the epicenter of coronavirus helped in spreading the awareness and information of the novel virus globally through its industrialization, trading, tourists and international migration features. This explains to a far degree why the 2014 Ebola epidemic could not turn out to be a pandemic irrespective of its mortality rate. Therefore, in doing risk evaluation of an epidemic, epicenter’s geographical location and its economic facilities are necessary tools to measure and monitor the trends of an epidemic.


Potential trends of global pandemics deduced from previous outbreaks suggest that, these factors are vital points Africa need to put into risk evaluations and developmental policies consideration.

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Essentially, there are two notable stages that have been captured in this article that best explains the transition periods of an epidemic.

1. The Production Stage: the production stage is the initial and foremost stage genealogist genetically tries to study the DNA and the likely source of deadly micro organisms. Notably, pandemic diseases are largely produced by domestic and wild animals infected with infectious pathogens. These pathogens are thereafter transmitted from animals to humans through vectors (flea bites) or human-animal contacts either by hunting, trading of wildlife and consumption of wild species (Madhav et al. 2018; Pike et al., 2010). This stage can also be called the primary stage of infection. At this particular stage, pathogens are produced in animals awaiting human contacts to activate its pathogenic functions in human.

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2.  The Consumption Stage: also known as the secondary stage. This stage represents the period when the virulent pathogens are successfully transmitted and activated in the human system for a wide scale infection through human to human contacts. At this particular point, the disease has successfully consumed the human immune system making humans the host of the disease. Person to person contacts becomes the avenue through which viruses spread very fast.


According to Sherman (2007), when a person infected with influenza sneezes or coughs, more than half a million virus particles can spread to those nearby. This characteristic is noticeable in the coronavirus culture warranting the strong needs for social distancing, ban of social gathering, effective quarantine, covering of the nose with mask, and regular washing and sanitizing of hands. This to a large extent explains why the French colony of New Caledonia succeeded in preventing a single death through effective quarantines in the 1918 influenza pandemic.


During the 1918 – 1920 Spanish Flu, cities in the United States that implemented early and extensive non-medical measures such as quarantine, social distancing and lockdown suffered minimal severity from the pandemic compared to cities that did not put measures in place (WEF, 2020; Sergio et al., 2020).

Warning signal to African countries

In conclusion, pandemics are global health and security issues that traumatize the world. Histories of global pandemics offer the Africa enormous instructive signals in risk evaluation necessary to take into consideration during this coronavirus pandemic outbreak. Potential risks and threats of pandemics are predictable: this may largely depend on swift and effective measures put in place. This will also determine whether mortality rates of the pandemic will be mitigated or not.


Recently, WHO Director-General, Tedros Adhanom Ghebreyesus, lamented that COVID-19 is spreading at an alarming rate in rural areas of Africa. The reason boils down to poor pandemic management and heavy corruption in Africa. Therefore, it is instructive for African countries to take the potential risks of the pandemic into due consideration by providing extensive quarantine system, provision of effective palliatives in the time of lockdown, and as well as growing regional and international cooperation at this point.


Combating COVID-19 is a collective responsibility. Therefore, citizens should be socially responsible, cooperating with the government and abiding by health rules and regulations to halt the spread of the virus.


Mark Patrick is a Political Scientist and member of the Nigeria Youth for Peace Initiative (NYPI)


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