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How Senegal is confronting the challenge of COVID-19

A woman wears a mask as a protective measure against the COVID-19 coronavirus, as she walks in the popular Madina neighbourhood in Dakar. Photo by John Wessels/AFP via Getty Images)

Senegal is one of dozens of countries in Africa that’s been hit by COVID-19.

The question is: does it have the capacity to take the appropriate steps to stem the spread of the virus?

So far, according to the World Health Organisation, Senegal has confirmed 31 cases of COVID-19. All have been detected following appointments made with health facilities by the patients themselves. This is called passive, as opposed to active, detection.

Under normal circumstances, infected people should be detected by the monitoring system set up by Senegalese health authorities. In our view, these need to be bolstered.

For the moment there are no answers to why few cases of COVID-19 are being recorded in Africa.

Read more: COVID-19 in Africa: fewer cases so far, and more preparation needed

But experts are nevertheless alarmed, given Africa’s fragile health systems. Some countries – and regions – don’t have the necessary resources to implement diagnostic systems.

In theory, the Centre des Opérations d’Urgence Sanitaire (COUS), an organisation charged with coordinating health emergencies, has all the skills required to reinforce health systems by organising the deployment of high quality medical teams in case of emergency. But in 2014 the Ebola epidemic took health structures and services by surprise.

Since then, an entire system has been set up to preempt epidemics: by detecting them earlier via health monitoring, and by responding earlier and in a more coordinated fashion.

This system now needs to be strongly reinforced.

The handling of cases

Senegal has put in a comprehensive system to assist anybody reporting in with the illness. For example, monitoring teams from the health ministry are in action and arrive immediately to take samples when someone reports in ill.

In addition, clinics have been prepared to receive patients. One is the infectious diseases clinic of the Centre Hospitalier National et Universitaire de Fann. It is one of the only health facilities in Senegal with the capacity to quarantine patients suspected of being infected.

At Fann Hospital, the health-care team is prepared to fight the epidemic with 12 single-bed rooms. This can be extended to 36 beds by adjusting the installation.

The Centre Hospitalier Universitaire National de Fann in Dakar, on 2 March 2020. Seyllou/AFP

But there are concerns about gaps in Senegal’s ability to detect cases early. For example, the fact that the first patients who tested positive came from abroad, mainly by plane, has raised questions about the checking and prevention systems in place at points of entry into the country.

At the Blaise-Diagne International Airport, security has been reinforced, with the deployment of infrared cameras that can detect passengers whose body temperature is unusually high. One of the signs of COVID-19 is fever. The infrared technology is used to detect people with a temperature of 38°C or more.

What needs to be done

Senegal’s health systems must face up to new challenges. To treat people effectively, they must be first diagnosed early and isolated.

The infrared detection system should be set up in all airports and all frontier bus terminals. It should be bolstered by a quick and simple questionnaire to identify passengers without a temperature but who show symptoms of COVID-19. These include a slight cough, nasal congestion, a runny nose, a sore throat, or diarrhoea.

Detecting carriers early is vital because COVID-19 is highly contagious. Contagiousness is quantified by an estimation of the average number of people who contract a specific virus from an infected individual (what specialists call the basic reproduction rate or “R0”). This rate would be around 1.3% for the flu and 2.2% for SARS-CoV-2, which therefore would spread more easily from a single case.

The country should also be preparing to ramp up facilities if more cases are reported. If the country suffers many more cases, resources must be found so that other health centres can receive the sick. The higher the number of patients, the more effort is required from the health system to rise to the challenge.

Microscopic image of the coronavirus SARS-CoV-2 using negative staining by the hospital research lab Méditerranée Infection. Author provided

A wide variety of departments must be mobilised while developing outpatient care – that is, care outside hospitals – so that people do not all rush to the one location and contaminate one another.

In addition, respiratory specialists, including those working in the private system, must be deployed to take care of diagnosed patients. Peripheral health facilities – health outposts, clinics and centres – must be also mobilised, and communities, scientists and the media need to be closely involved.

Concerning communities, we must work with the nurses in charge of health outposts and community health officers, “badianou gokh” (neighbourhood godmothers in Wolof), who should be employed to relay all announcements and information concerning virus prevention and care.

As for scientists, they must help public health decision-makers understand the virus, and conduct operational research on preventative measures and treatments.

Minimising the risk

Above all, we need to:

  • wash our hands regularly with hand sanitiser, or soap and water;

  • keep a distance of one metre (three to four feet) from infected persons;

  • cover our mouth and nose with the crook of our elbow if we sneeze or cough;

  • throw tissues away immediately in a closed bin;

  • avoid popular gatherings since these increase the risk of contamination;

  • avoid touching our eyes, nose and mouth, and

  • avoid eating raw or undercooked animal products.

The illness is relatively benign in 80% of cases. And of those who become ill 5% will require intensive care.

This is why the population must be prepared and informed by science-based sources.

Translated from the French by Alice Heathwood for Fast ForWord

This article was originally published in French

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