Many African countries tried to improve their abilities to detect, trace and contain epidemics after the 2014-2016 Ebola epidemic, which killed 11,000 people. Nations identified gaps in their public health systems, but few have done enough to prepare for the emergence of a threat like the coronavirus, Kenyon said.

“They’ll be playing catchup,” said Anthony Fauci, the head of the US government’s National Institute of Allergy and Infectious Diseases in a podcast last week. “You can’t transform a health care system over a couple of months.”

It does not help that US President Donald Trump slashed financial support for CDC and US Agency for International Development programmes to strengthen public health in Africa. Trump has shown little interest in helping other nations improve their health systems.

“How long have we [in the US] been saying that this was coming?” asked Kenyon. “Didn’t we say after Ebola we’d strengthen public health systems? Did we do that? No. It’s been a failure of leadership.”

Still, African public health officials are proud of their improved abilities, which include monitoring temperature of arriving air passengers and some surveillance and tracking. “We’re in a lot better place than we used to be,” said Chikwe Ihekweazu, director of the Nigeria Centre for Disease Control (NCDC). “But it does not make a lot of hard challenges go away.”

And where the coronavirus slips past public health containment measures it is likely to play havoc with hospitals and clinics, experts say. Millions of people have undiagnosed HIV, tuberculosis and diabetes – all of which are likely to complicate treating coronavirus and raise the fatality rate. Respiratory diseases can spread easily in open hospital wards, said Kenyon, who has spent 20 years fighting disease in Africa.

Health workers can easily sicken and take diseases home to their neighbourhoods or villages.

“It’s with trepidation that I think about that,” said Fauci, when asked about the virus’ likely activity in Latin America and Africa. “There are already so many confounding diseases.”

Ihekweazu began preparing his staff at the NCDC for the virus as news of an outbreak began to emerge from China on January 7. Nigerian public health workers were among those from 28 countries who received test kits for the virus at a meeting last month hosted by the Africa Centres for Disease Control and Prevention in Ethiopia.

On February 27, Nigeria diagnosed its first case – an Italian businessman who had arrived three days earlier and developed a fever. He visited a doctor familiar with the protocol for reporting suspected cases, and the NCDC – created in 2018 – used classic shoe-leather epidemiology to trace and isolate 61 potential contacts, in addition to 50 passengers on the Italian’s plane. So far, one of these people has been diagnosed with the virus.

“We’re cognisant of the fact that if we had a lot more patients showing up at the same time it would be a lot more difficult,” Ihekweazu said. His nightmare is a visitor with few symptoms travelling to a far-flung Nigerian city and spreading the disease to hundreds of others before detection. “What happened in Italy could happen in Nigeria,” he said.

It is unprecedented in recent times, Ihekweazu acknowledged, for African nations to be in the position of defending their shores from a European disease.

“If there is some good that comes out of this epidemic, it is to give us a great example of how global health really means global,” he said. “There are problems we cannot solve within our political borders.”

Many Africans are sceptical of their governments’ abilities to keep out the virus. China Southern Airlines’ decision to resume flights between Nairobi and Guangzhou the week of March 2 sparked controversy in Kenya, leading the country’s Supreme Court to order a halt to the flights.

The South African government’s foot-dragging about bringing home teachers and students trapped in Wuhan was seen as bowing to China’s wishes, said Cobus van Staden, who directs research for The China Africa Project. There are bitter recollections of the fact that Chinese authorities strictly quarantined African visitors to China during the Ebola crisis.

Chinese companies say they are taking precautions to prevent the importation of the virus into Africa.

Many of them say that workers who travelled back to China for the Lunar New Year holiday have been quarantined or kept from returning to the continent.

Sinohydro Corporation, a state-owned Chinese company with several multibillion-dollar projects in Africa, said its Chinese workers who have returned to Africa are quarantined. The company promised not to send abroad staff from hard-hit Hubei province until the epidemic was over.

In Nairobi’s Kilimani area, one of the city’s Chinatowns, those who have travelled to China recently are not allowed to open their shops until cleared by local health officials. The number of customers at Chinese restaurants and casinos has plunged since the outbreak began.

African docks have been emptied by the lack of Chinese shipments, and prices are going up for goods that Africans rely upon, said Su Zhenyua, a leader of overseas Chinese in Ghana.

“The feeling in Kenya of a ‘Chinese invasion’ has been deepened by the threat of coronavirus,” the analyst Douglas Kiereini wrote last week in Nairobi’s Business Daily . “In some quarters Kenyans view Chinese presence as a new era of colonisation through the back door.”

African public health officials are doing what they can to counter such sentiments, said Tolbert Nyenswah, who ran Liberia’s incident response team during the Ebola epidemic, and now conducts infectious-disease research at Johns Hopkins University in Baltimore.

And other infectious disease challenges are not going away. Nigeria, for example, is suffering its worst epidemic of Lassa fever, a viral haemorrhagic disease that has resulted in 500 hospitalisation and 70 deaths this year alone.

But there is no way for public health officials to avoid focusing on coronavirus, Ihekweazu said.

“We have a lot of anxiety in Nigeria particularly in the political class and economic interests,” he said.

“Whether we like it or not we have to be in a position to respond, even when the threat – at the moment – is very small.”

Arthur Allen reports for Politico from Washington, DC; Jevans Niyabiage reports for the South China Morning Post from Nairobi, Kenya, and He Huifeng reports for the South China Morning Post from Guangdong, China.