As of Feb 23, the novel coronavirus (COVID-19) registered 78,966 cases, 76,940 in China and spread to 31 countries that reported a total of 2,026 cases. Local cycles of transmission have already occurred outside China after case importation, <a href="https:\/\/see.news\/?s=Dr.+Magdy+Badran" target="_blank" rel="noopener noreferrer">Dr. Magdy Badran<\/a> said.\r\n\r\nIn Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity.\r\n\r\nOn Jan 30, the World Health Organization (WHO) declared the COVID-19 epidemic a Public Health Emergency of International Concern.\r\n<h4><span style="color: #ff00ff;"><strong>Spread of COVID-19<\/strong><\/span><\/h4>\r\nAll continents reported confirmed cases of COVID-19. Africa confirmed its first case in Egypt on Feb 14. China is Africa's leading commercial partner; thus, there are large travel volumes through which COVID-19 could reach the continent.\r\n\r\nSeveral measures have already been implemented to prevent and control possible case spread of the virus from China; however, the ability to limit and control local transmission after the spread depends on the application and execution of strict measures of detection, prevention, and control.\r\n\r\nThese measures include heightened surveillance and rapid identification of suspected cases, followed by patient transfer and isolation, rapid diagnosis, tracing, and follow-up of potential contacts.\r\n\r\nThe African continent was spared for a long time until the first case was recently reported in Egypt. Researchers evaluated the risk of the virus importation according to the number of cases declared by each Chinese province and according to air traffic between the three main airports of each of these provinces (except Hubei due to flight suspension) and each African country.\r\n\r\nIndicators for evaluation of the risk of the virus importation are legislation, adherence to WHO standards, laboratory skills, medical staff, emergency organization, food safety, level of equipment in healthcare centers and public communication.\r\n\r\nFactors not directly linked to the health system which can influence the response to an epidemic are the size of the population, the socio-economic level or even political stability.\r\n\r\nPeople in Algeria and South Africa are the most at risk of contracting the virus to Africa due to high trade exchanges with China.\r\n\r\nPeople in other countries such as Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya, are at a lower risk contracting the virus, but they maybe not be able to detect possible infection cases and may face national spread.\r\n\r\nAfrican countries at risk can be clustered into three groups according to the influence of the Chinese provinces in these countries.\r\n\r\nThus, the first group including 18 countries will be more vulnerable in the event of a major epidemic in the province of Beijing, a second comprising 7 countries will be more exposed in the event of a strong growth of the epidemic in the province of Guangdong and the third group of two countries is risking virus spread only from Fujian province.\r\n\r\nFor several poorly equipped African countries, the risks are significant of not having sufficient organization and infrastructure for detection, containment, and urgent care, raising fears of a risk of the epidemic on the continent.\r\n\r\nIt remains difficult to predict how broadly this virus will spread, or if it can be controlled and eliminated like SARS. WHO warned that African health systems would be ill-equipped to respond to the deadly coronavirus outbreak should cases start to proliferate on the continent.\r\n\r\nWHO chief Tedros Adhanom Ghebreyesus called on African Union member states \u201cto come together and be more aggressive in attacking\u201d the virus, known as COVID-19.\r\n\r\n\u201cOur biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems,\u201d Tedros, speaking by video link from Geneva, said during a meeting of African health ministers at the African Union headquarters in Addis Ababa.\r\n\r\nThere have been more than 200 suspected cases in the WHO\u2019s AFRO region, which includes most African countries, though nearly all have been confirmed negative.\r\n\r\nBut if COVID-19 starts to spread on the continent, African health systems will struggle to treat patients suffering from symptoms such as respiratory failure, septic shock, and multi-organ failure.\r\n\r\nThese patients require intensive care using equipment such as respiratory support machines that are in short supply in many African countries.\r\n\r\nAfrican countries have been scrambling to develop the capacity to test for COVID-19. In three weeks, the number of African countries capable of conducting their tests has jumped from two to 26.\r\n\r\nSeveral African airlines including Kenya Airways have suspended flights to China, although the continent\u2019s biggest carrier Ethiopian Airlines has kept its China routes open.\r\n\r\nEarly detection of COVID-19 importation and prevention of onward transmission are crucial challenges to all countries at risk of importation from areas with active transmission in China.\r\n\r\nNearly 12 countries in Asia, Europe, and North America have already reported secondary spread following from China. Onward transmission potentially occurring in countries with weaker health systems is a major public health concern.\r\n\r\nFlight bans implemented by some African airline companies serving China might alter future risk through a different repartition of the flow of travel; however, these bans are not expected to prevent the virus proliferation.\r\n\r\nNot all connections between Africa and China have been cut\u2014the main transporters continue to fly between the two (eg, Ethiopian Airlines, the largest carrier in Africa, operating almost half of the flights from Africa to China, together with all Chinese airline companies, and others).\r\n\r\nPrevious and current evidence indicates that realistic travel restrictions would have a limited effect in containing the epidemic and would delay the risk that the outbreak extends to new countries by only a few weeks.\r\n\r\nTravel or trade restrictions are not currently recommended by WHO.\r\n<h4><strong><span style="color: #ff00ff;">Animal Reservoir<\/span><\/strong><\/h4>\r\nThe virus may have an animal reservoir. In other words, it may be permanently found in a host species of animals, where it does not normally cause disease.\r\n\r\nViruses can spill over from the host to other animals and humans. Evidence points to a possible initial spillover of the virus into humans and other animals in an animal market in Wuhan in China.\r\n\r\nBats are prone to act as a reservoir for viruses. Chinese populations of the horseshoe bat genus have already been found to host viruses similar to the new coronavirus. This suggests that it\u2019s important to watch out for related viruses in this genus of bats elsewhere, including African countries.\r\n\r\nThe horseshoe bat genus is found around the world and there are 40 species in Africa. But so far no viruses related to the cause of COVID-19 disease have been reported from African bat species.\r\n<h4><span style="color: #ff00ff;"><strong>The Lesson from SARS<\/strong><\/span><\/h4>\r\nGlobal surveillance for the coronavirus diversity in bats has expanded rapidly in the past two decades because of a previous novel coronavirus disease outbreak, severe acute respiratory syndrome (SARS), in China in 2002.\r\n\r\nThis virus resulted in significant illness and death (10%) among human populations. It also spread globally due to travel. The virus appeared to have originated in animals and \u201cjumped\u201d to humans for the first time.\r\n\r\nThese viruses in bats weren\u2019t directly linked to the human outbreak. But it did indicate that spillover of these viruses circulating in bat populations was possible when opportunities for contact occurred.\r\n\r\nNo new cases of SARS have been reported since 2004 but the continued presence of various SARS-related strains in horseshoe bat populations makes re-emergence possible.\r\n\r\nViral sequences distantly related to SARS were identified in horseshoe bats collected in Rwanda and Uganda and the free-tailed bat genus in Kenya. The sequences found in Rwanda, Uganda, and Kenya are not SARS, though they have some genetic relatedness.\r\n\r\nThey do not pose a direct spillover risk and aren't able to infect human cells. There have not been any human outbreaks of SARS or other coronaviruses linked to bats on the continent.\r\n\r\nCoronavirus is known to have a high mutation rate and can recombine with other coronaviruses, creating new virus variants with the potential to emerge as outbreak viruses in humans.\r\n\r\nMost countries in Africa do not have active programs in place to watch for corona -and other bat-borne viruses in bats and to understand their epidemiology and ecology.\r\n\r\nNo outbreaks of coronavirus with a link to bats have been reported in Africa. But we still need to be vigilant.