Nairobi — ‘We are constantly expecting something to happen.’

As the coronavirus continues to spread beyond mainland China, the medical journal The Lancet has released a study ranking the vulnerability of African countries to the highly contagious respiratory disease.

The study models the risk of Covid-19 exposure based on air travel from areas in China with active transmissions, and the capacity of individual African countries to manage an outbreak.

Air travel data alone suggests – in order of decreasing likelihood – that Egypt, Algeria, South Africa, Nigeria, and Ethiopia have the highest “importation risk”, with Cairo International Airport receiving the most travellers from areas with active transmission in China – excluding Hubei province, the epicentre of the disease, from where flights are banned.

That risk was underlined when Egypt became the first African country to register a confirmed case of coronavirus on 14 February.

Sudan, Angola, Tanzania, Ghana, and Kenya were identified as having a moderate importation risk, but with varying levels of health system preparedness to handle an outbreak.

Many of these countries are among the 13 African nations with a high volume of travel to and from China, which the World Health Organisation (WHO) has prioritised to receive support for added measures like improved airport screening.

The vast majority of the more than 79,000 confirmed coronavirus cases to date still remain in China’s Hubei province, but more than 2,000 cases have now been reported in over 30 additional countries. Of growing concern is the “secondary spread”, the number of cases with no clear epidemiological link to China.

Although all flights from Hubei were suspended on 23 January, there have still been direct connections between African countries and other major hubs in China, like Beijing, where a recent cluster of cases has emerged.