Johannesburg, March 23 (RHC)-- The West African nation of Mali has roughly one ventilator per 1 million people — 20 in all to help the critically ill with respiratory failure.  In Peru, with more than 32 million people, about 350 beds in intensive care units exist.

Many of their nations are slamming shut borders and banning large gatherings in the hope of avoiding the scenes in wealthier countries such as Italy and the U.S., but local transmission of the virus has begun.  Containing that spread is the new challenge.  Africa has more than 900 confirmed cases and Latin America more than 2,500, but an early response is crucial as fragile health systems could be quickly overwhelmed.

With such limited resources, experts say identifying cases, tracing and testing are key.  “We have seen how the virus actually accelerates that after a certain ... tipping point. So the best advice for Africa is to prepare for the worst and prepare today,” WHO Director-General Tedros Adhanom Ghebreyesus said.

“We have different and significant barriers to health care in Africa, which could be a real challenge,” said Dr. Ngozi Erondu, a senior research fellow at the Chatham House Center for Global Health Security.  Many countries in sub-Saharan Africa do not have the isolation wards or large number of health care workers to respond to a surge of COVID-19 patients, she said.

Liberia and Burkina Faso only have a few ventilators for their millions of people.  Dr. Bernard Olayo, founder of the Kenya-based Center for Public Health and Development, said most countries in Africa can’t afford ventilators. Even if ventilators were provided by other countries, it’s not sufficient because of the lack of qualified people to use them.

“It’s complex, it’s very very complex because the patients that end up on ventilators require round the clock care by larger teams,” he said.  Many patients could do well with just oxygen, he said, but close to half of health facilities in African countries don’t have reliable oxygen supplies. Oxygen concentrators can be used, but given the frequent electricity cuts in many countries, oxygen generators and pressure cylinders are needed because they can function while power is out.

The WHO regional Africa director, Dr. Matshidiso Moeti, said the lack of ICU facilities and ventilators is one of the biggest challenges facing the continent.  “We have been able to identify importing a field hospital-type of facility that can be set up and equipped with some of the key items needed, such as ventilators,” she said. Training has begun in Republic of Congo and Senegal so health care workers will be ready to operate it, and World Bank funding is being made available, she said.

Several countries in Latin America are also among the least prepared in the world for a pandemic, with healthcare systems already stretched thin.

Peruvian Minister of Defense Walter Martos told local America TV on Monday that the nation has less than 400 respirators available.  “It’s not a lot,” he said. “Really, we don’t have the infrastructure that developed nations do.”

Peru and other nations in Latin America are looking to the experience in Europe as a cautionary tale and hoping to curtail the spread of coronavirus cases before they overwhelm hospitals.

Epidemiologist Cristian Díaz Vélez said those measures could potentially create a slower rise in cases that is more manageable for Peru’s medical system. He said the country has around 300 to 350 beds in intensive care units, half of which are now in use.  “It will overwhelm our healthcare system,” he said, if cases skyrocket.

Other countries in Latin America could fare far worse.