Many African countries have fragile or almost non-existent healthcare systems, which can be easily overwhelmed by the coronavirus pandemic. A new assessment by the U.N. Economic Commission for Africa paints a bleak picture, estimating as many as 1.2 billion coronavirus infections and 3.3 million deaths if no interventions are put in place to defend the virus.

Even under the best-case scenario, which involves very strict social distancing, the African continent could see around 122 million infections and 300,000 deaths.

A ticking time bomb

At the moment, there are around 18,000 confirmed cases of coronavirus in Sub-Saharan Africa. Of course, the real number of COVID-19 cases is much higher and might explode soon, seeing how the continent is a few weeks behind Europe.

Crowded urban conditions, poverty, and a widespread incidence of chronic conditions are some of the factors that make Africa particularly vulnerable to the worst COVID-19 outcomes.

Many have watched with horror as the death toll rose day by day in countries like Italy and Spain. If things are so dramatic in rich countries with very advanced healthcare systems, it’s easy to imagine that the crisis will play out much worse in Africa.

The only good thing is the fact that many African countries have a younger demographic and COVID-19 appears to cause more fatalities in the elderly. 

According to a recent report compiled by the World Health Organization (WHO) that assessed the readiness of 34 African countries, only 50% of the nations had undertaken any COVID-19 staff training for case management and just over half the countries had personal protection equipment (PPE) available and accessible to healthcare workers.

A 2015 study found that many African countries had less than two dozen ICU beds to cover their entire population. Kenya claims it has 500 ICU beds while Nigeria has 120 critical care beds. These two countries, along with South Africa, are positive outliers, but even their capacity pales in comparison with what is found in other regions around the world.

Angola, Burkina Faso, Burundi, Central African Republic, Cote d’Ivoire, Congo Brazzaville, Guinea Bissau, Lesotho, Malawi, Mali, Mozambique, Niger, Sao Tome and Principe, Seychelles, South Sudan, and Zimbabwe have zero ICU beds available to treat COVID-19 patients.

What’s more, many African countries not only have to struggle with insufficient ICU beds and medical supplies, but they also face human resources deficiencies. For instance, Kenya has hundreds ICU beds but does not have enough anesthesiologists to man them.

Considering about 5% of COVID-19 patients require critical care, the situation in Africa could be dramatic.

To make matters worse, lockdowns may not be effective in many African countries. For one, they’re unlikely to be respected by the local population. Secondly, shutting down an already fragile economy could push 27 million people into extreme poverty, the new U.N. report warns. The authors cite a World Bank assessment that found sub-Saharan Africa will experience its first recession in a quarter-century, estimating a 2.6% contraction in GDP.

In order to have a glimmer of hope that the coronavirus situation in Africa won’t turn into a humanitarian disaster, the U.N. experts estimate at least $44 billion in aid would be required to pay for testing, personal protective equipment, and medicine. In a worst-case scenario that would involve over a billion infected individuals, at least $446 billion would be required.

The U.N. authors are urging financial institutions and governments from wealthy countries to immediately postpone debt repayments for two years for all African countries.