key: cord-0730545-27domp9w
authors: Dramé, Moustapha; Godaert, Lidvine; Callixte, Kuate Tegueu; Ecarnot, Fiona; Simo-Tabue, Nadine; Tabue Teguo, Maturin
title: Coping with the COVID-19 crisis in Sub-Saharan Africa: let us not leave older people behind!
date: 2020-04-22
journal: Eur Geriatr Med
DOI: 10.1007/s41999-020-00324-z
sha: 4106b6ae10935b5c2a37c47ac984df01a379fd9a
doc_id: 730545
cord_uid: 27domp9w

nan

At present, certain colleagues affirm that Africa is more prepared than ever to face the COVID-19 pandemic, thanks to the lessons they have learned from epidemics such as Ebola [4] . While we are fully confident that this is the case, it is nonetheless clear that in previous epidemics, as well as in the ongoing COVID-19 pandemic, older persons are, once again, paying the heaviest toll. Indeed, in the case of the current COVID-19 crisis, in Sub-Saharan Africa, no specific measures have been taken to protect elders, as there have been in high-income countries. In African countries, the main measures taken to stem the spread of the disease include closing borders, grounding commercial flights from severely affected countries, and postponing or cancelling major cultural or sporting events. These measures, while necessary and effective (on condition that they are properly implemented and respected), actually barely affect older people, who travel less than their younger counterparts and less frequently participate in large cultural or sports-related gatherings. Conversely, older people have a leading role in collective activities of daily life, which continue unimpeded, such as prayer groups, weddings, christenings and funerals. Older people also continue to stand in for parents, minding children with whom they are naturally in very close contact. All these circumstances combine to put older people at risk of contracting a range of communicable diseases, not least COVID-19.

If the epidemic continues along current trajectories, African countries are or will be among the last to be affected by the COVID-19 pandemic. Yet they are likely to draw but little benefit from the experience acquired in western countries, notably because the measures applied in high-income countries are not appropriate solutions for Sub-Saharan Africa. At present, total lockdown is the only measure that is unanimously considered to be efficacious. It has been widely implemented in western countries. Currently, the focal point of the epidemic, while we await, is either an efficacious treatment or a vaccine, either (or both) of which may take several months to emerge. The social, economic and cultural context in Sub-Saharan Africa renders total confinement virtually impossible. We also must not ignore the deleterious effect that lockdown has on social terms, isolating frail individuals and leaving them without support or resources.

In a context of poor medical infrastructures and weakened health systems, the governments of Sub-Saharan Africa do not appear to be fully cognizant of the risk that the older population is incurring. We are aware that in today's world, where social intermingling and movement is highly prevalent, it is difficult to implement targeted measures. However, giving the issue sufficient thought is a prerequisite to finding acceptable and efficacious solutions. Nkengasong and Mankoula [5] exhort us to act collectively and fast. We say hear, hear-but let us not leave the older population behind when we move forward! The COVID-19 crisis is afflicting the whole world and so the search for solutions should also include the whole world, taking account of local context. Similarly, provision of resources to fight the epidemic should also occur on a worldwide scale. Indeed, the crisis will only come to an end when every country in the world has vanquished COVID-19. In this regard, and to avoid any ageism, we applaud and adhere to the suggestion of Lloyd-Sherlock et al. [3] to take age explicitly into account in the development of national and global planning for COVID-19, and to convene a global expert group for older people to provide guidance and inform our response to this urgent global health threat.

Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan

Novel coronavirus (COVID-19) epidemic: what are the risks for older patients?

Bearing the brunt of COVID-19: older people in low and middle income countries

Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future

Looming threat of COVID-19 infection in Africa: act collectively, and fast

We would like to thank Professor Emeritus Jean-Pierre Michel for his very pertinent and sound advice.

Author contributions MD: literature search, study design, data collection, analysis and/or interpretation and manuscript writing; LG: study design, analysis and/or interpretation and manuscript revision; KTC: study design, analysis and/or interpretation and manuscript revision; FE: study design, analysis and/or interpretation and manuscript revision; NST: study design, analysis and/or interpretation and manuscript revision; MT: study design, analysis and/or interpretation and manuscript writing.Funding There are no funding sources for this work.

Conflict of interest There are no conflicts of interest to declare. Indeed, authors do not declare any financial interests or connections, direct or indirect, or other situations that might raise the question of bias in the work reported or the conclusions, implications, or opinions stated-including pertinent commercial or other sources of funding for the individual author(s) or for the associated department(s) or organization(s), personal relationships, or direct academic competition.Ethical approval Not applicable.Informed consent Not applicable.