VUL­NER­A­BLE NA­TIONS: The coron­avirus is mov­ing into parts of the world that may be least pre­pared.

Latin Amer­ica and Africa lack tools to stem spread

Chicago Tribune (Sunday) - - FRONT PAGE - By Car­ley Petesch

DAKAR, Sene­gal — The West African na­tion of Mali has roughly one ven­ti­la­tor per 1 mil­lion peo­ple — 20 in all to help the crit­i­cally ill with res­pi­ra­tory fail­ure. In Peru, with more than 32 mil­lion peo­ple, about 350 beds in in­ten­sive care units ex­ist.

The coron­avirus is mov­ing into parts of the world that may be the least pre­pared. Some coun­tries in Africa and Latin Amer­ica lack the equip­ment or even trained health work­ers to re­spond.

Many of their na­tions are shut­ting bor­ders and ban­ning large gath­er­ings in the hope of avoid­ing the scenes in wealth­ier coun­tries such as Italy and the Unites States, but lo­cal trans­mis­sion of the virus has be­gun.

Con­tain­ing that spread is the new chal­lenge.

Africa has more than 1,000 con­firmed cases and Latin Amer­ica more than 2,500, but an early re­sponse is cru­cial as frag­ile health sys­tems could be quickly over­whelmed.

With such lim­ited re­sources, ex­perts say iden­ti­fy­ing cases, trac­ing and test­ing are key.

“We have seen how the virus ac­tu­ally ac­cel­er­ates that after a cer­tain tip­ping point. So the best ad­vice for Africa is to pre­pare for the worst and pre­pare to­day,” WHO Di­rec­tor-Gen­eral Te­dros Ad­hanom Ghe­breye­sus said last week.

“We have dif­fer­ent and sig­nif­i­cant bar­ri­ers to health care in Africa, which could be a real chal­lenge,” said Dr. Ngozi Erondu, a se­nior re­search fellow at the Chatham House Cen­ter for Global Health Se­cu­rity.

Many coun­tries in sub­Sa­ha­ran Africa do not have the iso­la­tion wards or large num­ber of health care work­ers to re­spond to a surge of COVID-19 pa­tients, she said.

Liberia and Burk­ina Faso only have a few ven­ti­la­tors for their mil­lions of peo­ple.

Dr. Bernard Olayo, founder of the Kenya-based Cen­ter for Pub­lic Health and De­vel­op­ment, said most coun­tries in Africa can’t af­ford ven­ti­la­tors. Even if ven­ti­la­tors were pro­vided by other coun­tries, it’s not suf­fi­cient be­cause of the lack of qual­i­fied peo­ple to use them.

“It’s com­plex, be­cause the pa­tients that end up on ven­ti­la­tors re­quire round the clock care by larger teams,” he said.

It’s not all grim. Elsie Kanza, head of Africa at the World Eco­nomic Fo­rum, said many coun­tries are de­ploy­ing lessons learned from the Ebola out­break in West Africa in 2014-2016 that killed well over 10,000 peo­ple.

The Africa Cen­ters for Dis­ease Con­trol and Pre­ven­tion was cre­ated to re­spond to that Ebola out­break. As of Thurs­day, more than 40 coun­tries can test for the coron­avirus, it said. In ad­di­tion, Chi­nese bil­lion­aire Jack Ma pledged to do­nate 1.1 mil­lion test­ing kits, 6 mil­lion masks and 60,000 pro­tec­tive suits and face shields to share among all African coun­tries.

Mean­while, Sene­gal is help­ing to de­velop a fast COVID-19 test that is ex­pected in June.

But some in­clud­ing Adama Demp­ster, a hu­man rights ad­vo­cate in Liberia, warned that support for African na­tions’ ef­forts might dry up if cases soar.

“It’s some­thing that is wor­ri­some be­cause other coun­tries that are so pow­er­ful and have the so­phis­ti­ca­tion to deal with things like this are them­selves con­cerned about their own sit­u­a­tion,” she said.

Africa isn’t the only con­ti­nent wor­ried about what’s to come.

Sev­eral coun­tries in Latin Amer­ica are among the least pre­pared in the world for a pan­demic, with health­care sys­tems al­ready stretched thin.

Peru­vian Min­is­ter of De­fense Wal­ter Mar­tos told lo­cal Amer­ica TV last week that the na­tion has less than 400 res­pi­ra­tors avail­able.

“It’s not a lot,” he said. “Re­ally, we don’t have the in­fra­struc­ture that de­vel­oped na­tions do.”

Peru and other na­tions in Latin Amer­ica are look­ing to the ex­pe­ri­ence in Europe as a cau­tion­ary tale and hop­ing to cur­tail the spread of coron­avirus cases be­fore they over­whelm hospi­tals.

Epi­demi­ol­o­gist Cris­tian Diaz Velez said those measures could po­ten­tially cre­ate a slower rise in cases that is more man­age­able for Peru’s med­i­cal sys­tem. He said the coun­try has around 300 to 350 beds in in­ten­sive care units, half of which are now in use.

“It will over­whelm our health­care sys­tem,” he said, if cases sky­rocket.

Other coun­tries in Latin Amer­ica could fare far worse.

Venezuela ranks 176th of 195 na­tions world­wide in pre­pared­ness for a health cri­sis, ac­cord­ing to the Global Health Se­cu­rity In­dex, a project of the John Hop­kins Cen­ter for Health Se­cu­rity and the Nu­clear Threat Ini­tia­tive.

The na­tion’s health care sys­tem has been crip­pled by years of eco­nomic con­trac­tion, po­lit­i­cal chaos and a hu­man­i­tar­ian cri­sis, with ris­ing in­fant mor­tal­ity rates and crit­i­cal short­ages of wa­ter and medicine.

A mi­gra­tion cri­sis in which over 4.5 mil­lion peo­ple have fled could ex­ac­er­bate the spread of the virus through­out the re­gion.

That is of par­tic­u­lar con­cern in Colom­bia, where nearly 2 mil­lion Venezue­lans now live as hospi­tals along the bor­der have seen their ca­pac­ity stretched.

“The health sys­tem ob­vi­ously has a ca­pac­ity that could be clearly surpassed, in Colom­bia and in any coun­try in Latin Amer­ica,” said Dr. Al­fonso Ro­driguezMo­rales, vice pres­i­dent of the Colom­bian As­so­ci­a­tion for In­fec­tious Dis­eases.

NATACHA PISARENKO/AP

A su­per­mar­ket cashier waits for cus­tomers be­hind a makeshift plas­tic cur­tain Mon­day in Buenos Aires, Ar­gentina.

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