COVID-19 in Cameroon: a crucial equation to resolve

On March 6, 2020, the first case of coronavirus disease 2019 (COVID-19) was officially reported in Cameroon.¹ As of April 25, 2020, the number of cases had increased to 1569, with 53 deaths,² indicating an exponential growth in the number of cases. Although these numbers already sound shocking, the truth is that they are an underestimation because the diagnostic system for COVID-19 in Cameroon is not robust. Realistic projections in this context suggest approximately 14 000 cases of COVID-19 in the country.

A series of infection control measures have been implemented by the Government of Cameroon, including hygienic measures (eg, systematic hand washing), physical distancing, closure of all educational facilities and international borders, interministerial consultations that included the input of development partners, and financial measures allocated to implement this response. The university research community and national media outlets helped to develop and implement these measures alongside medical practitioners.³

Despite this mobilisation, the progression of the pandemic indicates the weaknesses of some of the selected approaches. For instance, in early March, the first cases were reported only in the Centre Region of Cameroon, and 10 days later a small number of cases were identified in the Littoral and West Regions.⁴ This was the time to seal off these three regions, which are the most economically active and populated parts of our nation, but no restrictions on movement were introduced. Of note, the general state of hospital infrastructure in Cameroon is similar to that of many other African countries—that is, far from the standards required internationally. Moreover, although Cameroon has many highly qualified professionals in the fields of medicine and social science, regrettably, these experts were not always consulted on meeting the challenges of the unfolding pandemic. Finally, society-wide acceptance of prescribed rules and regulations must be achieved if public health measures are to be effective, and this was not the case in this instance. Many Cameroonians are slow to acknowledge the potential danger of the pandemic.

Improving the response to COVID-19 in both Cameroon and the rest of the continent is crucial. In view of the projected number of cases, which differs so greatly from the officially known figures, a total confinement of the entire population seems inevitable. Public support for the confinement process will be imperative, and could be encouraged by conveying the message that the stronger the adherence to complete confinement, the shorter the period of that confinement and the sooner people can return to normal life. Given the economic precarity of most households in Cameroon, including vulnerable groups such as people with HIV infection, an allocation of special financial allowances to households could encourage compliance with confinement measures.⁵ Similarly, financial support should be provided to the medical personnel at the forefront of this fight and business owners for whom operations will be restricted throughout a period of confinement. Contact tracing, wearing of masks in public places, and self-isolation of individuals who have symptoms are crucial. Finally, the use of scientific developments (including newly developed rapid diagnostic tests and treatment options) and allocation of more resources to the fight against COVID-19 would lead to a greater capacity for the diagnosis, rapid isolation, treatment, and care of infected individuals. These actions will help save millions of lives and make it possible to restart the economy as quickly as possible. This is the time to show solidarity, compassion, and leadership.