US COVID Experts Call for Help in India and Africa

Damian McNamara

May 13, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Officials and health care providers in the U.S. watching the COVID-19 crisis unfold in India and certain African countries can help make a difference, experts said.

People are interconnected through global travel and commerce, so major COVID-19 outbreaks in other countries and regions – especially those linked to new variants of concern – could affect us all, they said.

Although an initial shipment of materials from the U.S. to make vaccines was appreciated, more help is needed to avoid further COVID-19 tragedies, two physician experts noted during a media briefing this week sponsored by the Infectious Diseases Society of America.

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Sending much needed oxygen helps, but also figuring out the logistics of transporting oxygen within India would be "markedly helpful," said Krutika Kuppalli, MD, vice chair of the society's Global Health Committee.

"We are hearing horrible, horrible stories of people who need oxygen who don't have the money to pay for [it] because of price gouging. So they disconnect the oxygen and die," she said.

Also, "people don't have money to pay for cremations and they are disposing of bodies in the river."

"It's heart-breaking," she said. These reports describe things "that should not be happening in this day and age," added Kuppalli, an IDSA Fellow and assistant professor at the Medical University of South Carolina in Charleston.

What's Needed Now

Now that supply is outpacing demand for COVID-19 vaccines in the U.S., Kuppalli suggested redirecting surplus supplies to countries in need.

"Some of these high-income countries … we really urge them to really strongly consider releasing some of that surplus of vaccines to not just India, but other countries that have a high number of cases right now," she said. "We really need to get these infections under control."

In addition, help setting up field hospitals would be appreciated, as would assistance on telemedicine capabilities.

"There is a limited number of in-country personnel that can help man these telemedicine support centers," Kuppalli said. "The health care system is vastly stretched thin." Beyond helping patients, telemedicine could also mentor medical students who will now be on the frontline.

Public-private partnerships could boost rapid diagnostic saliva testing. The same strategy could foster more expertise and resources related to genomic sequencing to identify and track variants. "We need to know what's happening and where it's happening," she added.

"The India situation is really an unprecedented public health emergency," Kuppalli said. She said India currently has about 23 million cases related to COVID-19 and more than 250,000 deaths. "It's likely that these are underestimates."

Current predictions are that they'll be over 1.5 million deaths by Sept. 1st unless drastic measures are taken, said Kuppalli, who is also team lead for COVID INDIA SOS, a volunteer group of scientists, officials and others worldwide trying to address the many pandemic challenges in India.

 

Africa Also in Crisis

Underreporting of cases and deaths related to COVID-19 is also likely throughout much of Africa.

The reported numbers have trended lower in the last 2 weeks compared to December and January, for example, said Dawd Siraj, MD, member of the IDSA Global Health Committee and professor in the Division of Infectious Diseases at the University of Wisconsin-Madison.

Despite that, he said, hospitals are desperate for oxygen in, many countries, Siraj added.

Also, the rate of positive tests in some African countries, such as Ethiopia and South Africa, is higher than the 5% the World Health Organization said is required to help control infection transmission.

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Data from CDC Africa shows 4.6 million COVID-19 cases have been reported from 55 countries within Africa. Also, B.1.167, the variant of concern first identified in India, is now being reported in a few African countries as well.

"We're really worried that those variants are already there. As we know they are highly transmittable, more transmittable than the wild one, so the pandemics is yet to unfold [fully] in the continent of Africa," Siraj said.

A future crisis in Africa on the scale of what India is now experiencing is possible, he said. "I sincerely hope that this is not the case."

One reason for concern is Africa has a relatively low COVID-19 vaccination rate. About 1% of the population has received one vaccine dose, and only slightly more have received two doses.

"So it's clear that Africa has a long way to go in terms of vaccination," Siraj said. For the same reason, he added, "herd immunity might not be a realistic, achievable goal in Africa."

"Looking at this it is very clear that the world needs to do more to help Africa to increase their vaccine rate very, very quickly," Siraj said.

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