Dr Bertha Ayi, experte CDC Africa-DR
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Tribune “We will be able to eradicate the Covid 19 pandemic within the next six months if we continue to impose behavioral changes”

The Center for Disease Control (CDC Africa) has been coordinating actions to contain and eradicate the pandemic since the beginning of the COVID 19 crisis. Objective of CDC, Overview of the evolution of the pandemic, evaluation of experimental treatments in progress, with Dr Bertha AYI, expert within CDC Africa.

 

The African Union’s Centre for Disease Control (CDC) was established four years ago. In January 2017, it was inaugurated as a specialized technical institution of the African Union to support the public health initiatives of Member States and strengthen the capacity of their public health institutions to detect, prevent, control and respond quickly and effectively to disease threats. It is headed by Dr. John Nkengasong, who oversees the Emergency Preparedness and Response, Disease Surveillance, Risk Communication, Case Management and Infection Control sections.

 

My mission, as a member of the Technical Working Group on Case Management, is to provide expertise to the group in formulating treatment guidelines for Member States, but also to rapidly review new clinical research information as soon as it becomes available and assess how it can be applied to the clinical situation in Member States.

 

The Centre for Disease Control plays a very important role in the fight against COVID-19 in Africa by building capacity for testing, education and mobilization of physical resources. The Case Management Technical Working Group evaluates all new therapies and issues guidelines for physicians. The most recent guideline is the guideline that emphasizes the use of the supine position in patients with respiratory insufficiency.

 

“The CDC recently launched a pact for an Accelerated COVID-19 Testing Strategy (PACT) aimed at providing 10 million COVID-19 tests in four months”

 

For COVID testing, the CDC recently launched a pact for an Accelerated COVID-19 Testing Strategy (PACT) aimed at providing 10 million COVID-19 tests in four months. We have already passed the 4 million mark.

 

In the area of infection control, the CDC’s Infection Control Wing is involved. It fulfills this role by providing ongoing training to health care personnel on infection control. In this sense, the third session of the CDC Infection Control Webinar Series focused on “Infection Control and Prevention (IPC) in the Community” and Kenya’s COVID-19 experience. This webinar was held in English and French on 17 June 2020. It was attended by 621 people.

 

In terms of laboratory and testing activities, CDC performed a total of 4.2 million PCR tests for COVID-19 with an overall positivity rate of 7.3%. This is a 22% increase over last weekThe African Union Centre for Disease Control has distributed 625 000 tests to 51 Member States and will distribute another 315 000 in the coming weeks. The Centre will continue to support Member States to ensure an uninterrupted supply of test kits, reagents and other essential supplies for testing.

 

As part of its pandemic surveillance role, CDC Africa is working with the World Health Organization (WHO) and health departments to monitor the progression of the disease across Africa. The Technical Working Group on Surveillance is working with various stakeholders, including WHO, the International Civil Aviation Organization (ICAO), Regional Economic Communities (RECs) such as the East African Community (EAC), the Economic Community of West African States (ECOWAS) and the private sector, to jointly develop a comprehensive public health recommendation to support the resumption of travel on the continent using land, sea and air transport. This recommendation will address four key issues. The first step is the establishment of harmonized minimum criteria for pre-trip authorization for travelers, the maintenance of a safe public health corridor in the different modes of transport, followed by the establishment of a technological protocol to guide the minimum functions and data security for any electronic platform used to process traveler information in order to ensure its reliability. The paper will also discuss the establishment of a framework for cross-border data sharing to enable the exchange of traveler information between African Union member states.

 

With regard to the educational role, CDC Africa has a workforce development institute that organizes weekly webinars for the Community of Clinical Practitioners, primarily to provide state-of-the-art information to physicians and other health professionals. Bi-weekly meetings are also held on Wednesdays and Saturdays at 12:00 p.m. (East African time) to allow physicians to discuss clinical problems and how best to manage them.

 

As for risk communication, CDC Africa shares real-time information on its Facebook page every week, reaching 131,563 social network users in Africa.  Every Thursday, the Director of CDC Africa holds a press briefing with journalists at 11:00 a.m. to inform them of the disease situation. CDC Africa, in collaboration with the Jack Ma Foundation, distributed 300 ventilators to Member States.

 

As of July 3, 2020, the total number of patients affected was 414,011 and 10,260 deaths, with a case-fatality rate of 2.7%. African cases account for 3.6 per cent of global cases. More than 20 per cent of them were diagnosed within one week (63,544). This suggests that we are entering a phase of increasing Community spread. 45% of these cases come from the southern part of Africa. Ten countries account for 86% of the new COVID-19 cases reported since the last briefing note: South Africa (44%), Egypt (17%), Nigeria (7%), Côte d’Ivoire (4%), Ghana (3%), Cameroon (3%), Ethiopia (2%), Kenya (2%), Morocco (2%) and Sudan (2%). Djibouti (465), Sao Tome and Principe (320), Gabon (213), South Africa (171) and Cape Verde (170) are the African countries reporting the highest number of cumulative COVID19 cases per 100,000 inhabitants. Seven countries report case-fatality rates comparable to or higher than the global case-fatality rate of 5.3%. These are the following countries: Chad (8.6%), Algeria (7.1%), Niger (6.4%), Sudan (6.1%), Burkina Faso (5.8%), Mali (5.7%) and Angola (5.4%).

 

The virus was imported late due to less international traffic. As a result, African cases account for less than 4 per cent of the global disease burden. In addition, I suspect that there is a form of cross-immunity to another unidentified pathogen that results in a high rate of asymptomatic patients. Last week, data from Spain and Italy also suggested that differences in the ABO blood group system may dictate the severity of disease with the OB blood group. But, most of the countries that lifted travel restrictions too early, including Ghana, have seen an increase in the number of cases.

 

“Africa is exploring ways to produce its own vaccines”

 

On 24 and 25 June, the African Union Centre for Disease Control organized a virtual conference on vaccines under the theme “Africa’s leadership role in the development of the COVID-19 vaccine and its accessibility”. The conference was chaired by the Chairperson of the African Union, His Excellency President Cyril Ramaphosa, President of the Republic of South Africa. Other participants included the Director of WHO, Dr Tedros Ghebreyesus, and Dr John Nkengasong, CDC Director for Africa. Africa is exploring ways to produce its own vaccines.

This is partly because scientists have not discovered an effective agent that actually attacks the virus and prevents it from multiplying.

 

We will be able to eradicate in the next six months if we continue to impose behavioral changes such as social distancing and the wearing of masks. Vaccines are promising, but it will still be at least eight months to a year before they are commercialized and ready for use. I advocated a very simple plan, which I have yet to see executed. World leaders should have met and agreed to a coordinated lockdown of six to twelve weeks of no travel, intensive case tracking, contact tracing and management of confirmed cases. This would have shortened the duration of the pandemic and avoided the peaks of contamination currently occurring in China, South Korea and the United States. As actions are uncoordinated and mainly country-focused, there will be a risk of local resurgence as several European countries open their borders.

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