Coronavirus case counts are rising exponentially in Africa. Since the continent saw its first case, in Egypt in mid-February, some 10,000 cases and 500 deaths have been confirmed.
Public health officials think this is just the beginning, and they worry that the situation in the coming weeks will get much worse. "COVID-19 has the potential not only to cause thousands of deaths, but to also unleash economic and social devastation," Dr. Matshidiso Moeti, WHO regional director for Africa, said in a statement Wednesday.
There are several reasons why health officials are especially concerned about the impact of COVID-19 in African countries.
First, countries in sub-Saharan Africa carry some of the world's heaviest burdens of serious underlying conditions such as HIV, which limits immune function, and tuberculosis, which often scars the lungs. Malnutrition compromises the health of more than 50 million children in the region.
Then there's the limited access to quality care. Numbers vary by country, but on average across the region, there's about one doctor and five nurses for every 5,000 people. A consult with a doctor could be far away and prohibitively expensive.
And when it comes to specialized equipment like ventilators that can help severely ill patients breathe, there just aren't enough of them. "We talk about surging to 75,000 ventilators in New York City, and yet we have whole countries that only have one or two ventilators," says Joia Mukherjee, chief medical officer for the global health nonprofit Partners in Health.
"I fully expect that when [COVID-19] hits, if it hits in a big way in impoverished countries, it could have a four to five times higher mortality" than in other countries so far, Mukherjee says.
In Nigeria, public health officials are working to get local manufacturers to produce various types of ventilators, putting up prefabricated isolation centers and turning hotels and convention centers into hospital beds. Some 20,000 hospital beds will be added to Nigeria's capacity by week's end, says Dr. Adaeze Oreh, a senior official with the Nigerian Ministry of Health.
The primary strategy, though, is to try and prevent as many infections as possible. "We've seen the increase in the rates of spread across Africa," Oreah says, "We are trying to be proactive in trying to stop that kind of massive spread in the communities."
Last week, Nigeria locked down the cities of Lagos and Abuja, telling more than 20 million residents to stay at home.
That's especially hard in a country where half the population is below the poverty line, and many people work every day to earn their daily bread.
But Nigeria is betting that the unchecked spread of COVID-19 would be worse.