A case of the novel coronavirus was found in Nigeria on Friday, stoking concerns about the African continent's ability to deal with a major outbreak.
Algeria, Egypt, and Nigeria, have reported one case each, leaving experts fearing that many more cases could be going unreported.
The World Health Organization and Bill Gates have been warning that the coronavirus could overwhelm Africa's health systems.
China and Africa have deep ties, with many direct flights between the two and hundreds of thousands of Chinese laborers working across the African continent.
Nigeria reported its first case of the novel coronavirus on Friday — becoming the first such infection in sub-Saharan Africa — igniting experts' fears that Africa's "fragile healthcare systems" will struggle to cope with the outbreak.
The victim, an Italian national who arrived in Lagos on Tuesday, is "clinically stable, with no serious symptoms," Nigerian health minister Osagie Ehanire said Friday, according to The Guardian.
It is only the third confirmed case of COVID-19 on the African continent. Egypt reported the first on February 14 and Algeria reported the second on Tuesday, identifying its victim as a visiting Italian national.
A total of 738 million people live on the African continent. Given its size and connections to China, scientists and global health campaigners fear there are many more infections that are not being reported.
They also fear that Africa is not equipped to deal with a major health emergency. Nigeria's senate said on Thursday — hours before the first confirmed case — that the country was not prepared to deal with the coronavirus outbreak.
The World Health Organization (WHO) has also described Africa's health systems as "fragile."
Dr Matshidiso Moeti, Africa director at the WHO, said on Tuesday that the "window of opportunity the continent has had to prepare for coronavirus disease is closing."
In a report published by The Lancet earlier this month, Michel Yao, the WHO's Africa program manager for emergency operations, also said: "We all know how fragile health systems [are] in the African continent, they are already overwhelmed by many outbreaks."
"For us, it is critical to detect coronavirus earlier [so] that we can prevent spreading within communities that can trigger a number of cases that can overwhelm the treatment capacity."
Bill Gates, the Microsoft founder and global health campaigner, also warned on Monday that the coronavirus could overwhelm health systems on the African continent.
"This disease, if it's in Africa ... it's more dramatic than if it's in China," Gates told the American Association for the Advancement of Science in Seattle.
Specifically, the impact in sub-Saharan Africa could be "very, very dramatic," said Gates, who in 2018 had warned of a global pandemic.
The US' Rand Corporation found in 2016 that 22 out of the 25 countries most prone to infectious disease outbreaks were in Africa.
The WHO is now deploying help and experts to 13 African countries that it thinks are the most vulnerable, based on their transport links to China, including Algeria.
As of Sunday, 26 African countries had the capacity to test people for the coronavirus, according to Agence France-Presse. That number is expected to rise to 40.
Another paper published The Lancet last week found that Egypt, Algeria, and South Africa were most at risk of importing the virus from China, followed by Nigeria and Ethiopia.
Given its response to the 2014 Ebola outbreak, Liberia could also struggle, Emily Ricotta, a research fellow at the National Institute of Allergy and Infectious Diseases, told Business Insider's Sarah Al-Arshani earlier this month.
One reason why Africa could suffer most from an outbreak is due to low levels of trust in healthcare systems.
According to The Washington Post, several studies in the continent show that many "place greater confidence in traditional or religious leaders than government officials," meaning some people could chose not to seek medical help.
Salvatore Laporta/KONTROLAB/LightRocket via Getty Images
China, which has reported the most cases and deaths from coronavirus, has deep ties to Africa.
The flow of people between China and Africa has risen sharply in the last decade, according to Quartz, with direct flights rising 600%.
As of 2017, more than 200,000 Chinese laborers were working in construction and other projects on the African continent, according to research from Johns Hopkins University.
Algeria and Nigeria are in the top five African nations with the most Chinese laborers.
Some African airlines have canceled all flights to and from China, including Kenya Airways. But Ethiopian Airlines, the continent's largest operator to China, remains open, according to Chinese state media Xinhua.
The death toll of the coronavirus outbreak has reached 2,858, with more than 83,000 people affected. Most of these have taken place in China, but more than 40 countries have also reported cases.