Ethiopia has fewer confirmed Coronavirus cases, but fears grow about what happens if the country starts to experience a broader outbreak and how the health system would cope with it.

Almaz Shiferaw, 45, wins her livelihood as a retailer of clarified butter and dry spices at Mercato, the largest market center in Ethiopia. Like most people these days, she is overly concerned about the new coronavirus (COVID-19 virus) and she is taking preventive measures not to be infected with the highly infectious virus, she says. She has a particular reason to worry: she has chronic asthma and difficulty breathing. “I am following all the instructions. I am cleaning my hands regularly with water and soap, especially after handling produces and money”, she says.

Many Ethiopians have dreaded the pandemic’s arrival, ever since it was first diagnosed in China and spread across the world. Because of the close commercial ties and the regular air liaisons between Ethiopia and China, many felt, it was a matter of time before the virus arrives. To the surprise and relief of many, it has taken time before it did. But a week ago, a Japanese national who had shown symptom tested positive for coronavirus: the first case in Ethiopia. Eight other people have contracted the virus since. Some say those numbers are an underestimate as testing is hard to access unless a patient is hospitalized.

On March 17, Prime Minister Abiy Ahmed has announced the closure of all schools in the country, the banning of all public gatherings and sports events for fifteen days, amid intensifying concerns over the spreading of the COVID-19 virus. However, at Mercato on a Thursday afternoon, the scene was usual market-day chaos. Shoppers pushed each other out of the way to buy goods. “If there is anything different, most people are buying food items, there is less demand for other articles,” an electronic shop owner said. “The topic of the corona is here and it is all over the radio and TV,” one trader said. “It’s important that we follow the health instructions and get our hands washed as often as possible and stay away from people who are coughing or sneezing. It may not be easy here,” he added. One clay pot seller says he squeezes a lemon into his hands. “It works, doesn’t it?” he looks up inquiringly. Another man sitting nearby says, “Why not? It is an acidic substance. Is it really sufficient? that should be the question.”

Price gouging

Some shoppers and traders approached at Mercato have an idea of how the virus spreads, but fewer know what measures to take to stay safe. Even those who do say, they could not find vital ingredients such as alcohol-based hand sanitizers, gels and disinfectant wipes at the market. Alarm over coronavirus has meant that the ingredients have become exceedingly hard to come by. Vendors are charging outrageously inflated prices or hoarding them in some cases.

There have been large price hikes on basic supplies such as in the staple grain Teff,  lemon, garlic, tomatoes and the condiment called Berbere. Lemon and garlic have been suggested by some as a cure for coronavirus, which explains the increasing demand for both items, even though doctors say there’s currently no known cure for the illness and there is no evidence that these foods can help to destroy the virus.  Authorities have started to clamp down « unscrupulous elements » who are engaged in hiking prices as well as hoarding products and medical supplies. According to the Reporter newspaper, some 1,607 business entities, and drugstores have been shut-down in Addis Ababa, Amhara, Oromia, and Southern regional states in the past week.    

The government has also started to provide locally produced sanitizers at moderate prices, rationing them at public Kenema pharmacies found Addis Ababa. In addition, the Addis Ababa City administration is trying to find a way to stabilize food prices by working closely with consumers union’s shops that distribute items for citizens with fair prices, according to the state media.

In the different parts of the city, volunteers are offering hand washing services to passersby but there are concerns about people not taking distance from each other. Despite bans on gatherings, the situation has remained generally unchanged, images of political meetings coming from the different parts of the country showing halls packed with people. Public transport in the city remains the most at risk as buses and taxis still operate crowded. People have to typically spend hours in queues when they wait for public transports, complicating social distancing.

Anti-foreign sentiments

The growing rate of the COVID-19 increase has unleashed widespread fear and, in some instances, outright xenophobia and anti-foreign sentiments among the public. Europeans, Americans, and Asians in the major cities of Addis Ababa and major other towns reported verbal harassment, stone-throwing, and hate-fuelled incidents. There are also reports of businesses and restaurants banning foreigners. Ethiopia Observer has learned about the case of a group of five Belgian and two French tourists, who came to Ethiopia through a tour package organized by TDS, a travel association specializing in solidarity tourism, who had to cut their stay short and leave the town of Debre Tabor, a town along the Wereta Woldia road, for Lalibela after having faced constant harassment. The U.S. embassy in Ethiopia issued a security alert, prompting the prime minister’s office to announce that COVID-19 “is not related to any country or nationality.

Undetected spread

Even though the number of confirmed coronavirus cases is surprisingly low, the country is viewed as fertile ground for an explosion of the disease. Observers say Ethiopia’s health care system offers limited comfort – noting the overcrowded hospitals, lack of beds, basic items such as gloves, protective gear, testing kits, and clinical care, among other problems – should coronavirus pandemic take hold in a population of 110 million.

So far all of Ethiopia’s coronavirus cases have been”imported” – linked to foreign travel or direct contact with someone who caught the disease abroad.  Dr. Dawd Siraj, a professor of Medicine in the Division of Infectious Diseases at the University of Wisconsin, says the real challenge for the country would come when community transmission takes off especially in densely populated areas with problems of poor sanitation and deteriorating housing conditions. “When a carrier mingles normally with people, the potential for the virus spreading rapidly remains high. That would be the start of the second stage which might necessitate placing more draconian measures other than those announced by Prime Minister Abiy,” he said.

Dr. Dawd who also advises the Ethiopian Ministry of Health stressed that « If you find one infected person, you have look for about thirty persons who might have come in contact with him. »

The World Health Organization (WHO) warns that countries like Ethiopia should learn from how the spread of the virus has sped up elsewhere. While Africa’s confirmed cases were currently low, WHO says there was no reason for complacency, recommending avoiding mass gatherings. The Ethiopian government has since then moved to impose more sweeping measures, including mandatory quarantine starting Monday. Anyone arriving in Ethiopia will be subject to 14 quarantine at designated locations.

There are concerns about the effectiveness of containment measures and the personal behavior and discipline of the public to abide by the rules. An Ethiopian, suspected of being infected with coronavirus, escaped on his way from the airport to the isolation center a few days ago. He has been found in his native village, around 400kms from Addis Ababa, after traveling in public transport and returned to quarantine. He has since tested negative for the virus.  

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