Clock is ticking: 300,000 vs 3.3m Covid-19 Africa deaths?

With every time slot come advantages and disadvantages: being early means one is mostly alone with the problem: unfortunately, threat perception does not travel any faster than the virus itself.

But it also means that we are already in the future while others are still where we used to be: the early days of the pandemic.

Because of this asynchrony, we have not just enough time to pass on lessons learned, but in fact the responsibility to help those who are likely to be hit in the coming hours: the Middle East and North Africa (MENA) around 6 o'clock, and sub-Saharan Africa around 8 o'clock. We have very little time to lose.

One hour away: Middle East, North Africa

Even though MENA enacted lockdown measures at the same time as Europe and comparatively early in the pandemic (when states had between 50 and 300 cases), it was still too late for most states to contain the virus.

As it stands, only Tunisia and Morocco managed to flatten the curve, i.e. keep the number of infections even.

In all other states, the number of new infections has doubled in the last two weeks: an indication that these measures were taken too late to suppress the virus.

Why? There are now indications that lockdown measures take full effect only when they are implemented as early as at 0.2 deaths per 100,000 inhabitants per week.

Iraq, Saudi Arabia, Egypt, Algeria are therefore all expected to see the full effects of the pandemic in the coming two months – especially if they proceed with easing of restrictions as Lebanon and Jordan just did.

In the conflict states of Yemen, Syria and Libya, data scarcity will act like a broken watch: in the absence of numbers, time will appear to stand still (or lead some analysts, as is already happening, to the conclusion that the virus has spared these states).

We will simply not know the extent of the problem, but we can be sure that these states are sailing straight into a humanitarian crisis in June.

Three hours away: sub-Saharan Africa

Most of sub-Saharan Africa has even more time to prepare: it is now where MENA countries were two hours ago.

With the exception of South Africa and some parts of West Africa, the continent has been relatively untouched, including (quite surprisingly) highly-connected Ethiopia.

Namibia, Burundi, Botswana, Seychelles, Zimbabwe only count a dozen of cases, with varying levels of restrictions, and Lesotho is a virus-free country.

Make no mistake: low numbers are not an indication that societies have been spared, but that they have not been hit yet – or that, like the Middle Eastern conflict states, that the data clock is broken.

How badly sub-Saharan Africa will be affected in the end is a big question, perhaps the big question: navigating the unknown, scenarios developed by King's College show a big gap between the best (300,000 deaths) and worst case (3.3 million) scenarios.

What is done in the present to prevent further spread of the virus, boosting preparedness and early detection mechanisms, can determine which one of the two scenarios the continent ushers into.

The earlier African decision-makers act, the less likely that they will have to deal with a time bomb by the end of the summer.

What to do

Time is the main ally Europe has to assist neighbours. Slow bureaucracy is instead the biggest enemy.

Acting immediately can help mitigate the effects in the Middle East, and protect Africa from the worst. Immediately means days or weeks. Not months. How?

First, show concrete and visible solidarity. The take-off of the EU Humanitarian Air Bridge to Bangui on 8 May is a good start, more actions should follow.

Second, repair the broken data watch: testing kits are of course the first element, but it will help only so much if it is not flanked by crucial data on population size.

Without data, states will not know where exactly the virus has spread, and where they are in the pandemic life cycle.

Third, states in the region have two options available: continue with lockdown measures, or ease them while imposing others.

But the calendar is working against option number one: the end of Ramadan, and the beginning of several harvests at the end of May (not to mention social resistance) mean that policy-makers will have to resort to masks, testing, and tracing instead – all three of which they are ill-equipped to do.

Fourth, plant now the seeds of socio-economic resilience.

The earlier the moment for post-Covid-19 creative destruction is seized, sparking technological innovation and economic reforms, the likelier people in the Middle East and Africa are to recover and avoid moving down towards the poverty line.

Nothing is set in stone when it comes to how much Europe's extended neighbourhood will suffer from Covid-19. But it all depends on how fast we act now.