Africa’s number of confirmed coronavirus infections has more than doubled in two weeks, despite a relative lack of testing caused by a shortage of test kits and logistical constraints. The continent had by Monday recorded more than 32,000 cases, twice that of a fortnight earlier, with 1,428 deaths. But with the totals dwarfed by the world’s more than 3 million confirmed cases and 211,032 deaths, there are fears that people carrying Covid-19, the disease caused by the coronavirus, may be going undetected. Some experts have disputed the Economic Commission for Africa’s prediction that more than 300,000 Africans could die from Covid-19. However, difficulties in stepping up testing has left authorities in the dark as to the illness’ true spread. Nigeria, the continent’s most populous country with about 200 million people, has admitted that its coronavirus testing has been inadequate, after reports of mysterious deaths in Kano State, in the country’s northwest. The West African country had reported 1,273 coronavirus cases and 40 deaths as of Monday, having conducted about 10,000 coronavirus tests. “I am gravely concerned about the unfortunate developments in Kano in recent days,” President Muhammadu Buhari said on Monday as he ordered a total lockdown on Kano for two weeks, effective immediately. Dr Chikwe Ihekweazu, director general of the Nigeria Centre for Disease Control, said at a briefing last week that the country faced difficulties . “We have to work with what we have,” he said. “We wish we had more laboratories … care facilities and ventilators, but we simply don’t, and the supply chains for these are fragmented at the moment.” Nigeria typifies a large number of African countries that lack the capacity to test a large number of people, including South Sudan, Burundi, Somalia, Gambia, Zimbabwe, Libya, Mali, Zambia, Algeria and Mozambique. Ethiopia , whose population is more than 100 million, had by Monday tested a little more than 14,000 people. It had reported only 124 infections, with three deaths. Researchers in Senegal have been trialling a Covid-19 diagnostic test kit that can produce results in 10 minutes at a cost of about US$1 each. If cleared for use, it could be a game-changer for African countries that need to raise their testing rates. US still falling short on coronavirus testing, FDA chief says Meanwhile, the Africa Centres for Disease Control and Prevention (CDC) said last week that, to help scale up testing, it would start distributing more than 1 million test kits to African countries in four weeks, rising to 10 million tests in 24 weeks. However, analysts at the Atlantic Council, a US think tank, have published a paper saying that beyond concerns over the supply of tests, efforts to push for mass testing were compromised by logistical constraints on access to rural and densely populated urban areas, shortages of health care staff and facilities, distrust of health workers, and a stigma associated with the virus itself. “If African nations hope to stay ahead of the virus, testing capacity needs to be dramatically expanded, and fast – before rampant community spread negates the value of contact tracing,” the paper said. In contrast with Nigeria’s 10,000 tests, Ghana – with a population about a seventh of Nigeria’s – has conducted more than 100,000, and reported 1,550 cases with 11 deaths as of Monday. South Africa , which has the continent’s most advanced health care system, had conducted its highest number of tests, with 178,470. It had reported 4,793 infections and 90 deaths as of Monday. Egypt had done more than 90,000 tests, and recorded 4,782 cases and 337 deaths, while Algeria had the highest number of deaths , at 432, and 3,517 confirmed cases, having done 6,500 tests. Dr Madina Hussein, a Kenyan working at the Sierra Leone Ministry of Health, said it was believed that most carriers of the virus in Africa had mild or no symptoms, making it more difficult to detect. West Africa hopes Ebola experience will help fight coronavirus She said the mass testing that could help address that issue was unaffordable for many African countries, and tightening social distancing measures such as curfews and travel restrictions may be easier to implement. But Dr Hussein said that, as with West Africa’s 2014-15 Ebola outbreak – when she worked on the front line – families needed to adapt their behaviour to guard against transmission within households. “Restrictions on travel can slow the spread of the disease, but it also helps if individuals and families understand the infection pathways and implement domestic precautions,” she said. “Covid-19 will require similar changes at the family level, especially in terms of how the elderly are protected and cared for.”