Is physiotherapy ready for the management of COVID-19 in Africa? - Snippets of anecdotal evidences in two African countries.

By the time COVID-19 was officially declared as a pandemic by the WHO on the 11th March 2020, more than 114 countries were already infected (Anjorin, 2020; Sohrabi et al., 2020. In Africa, there has been a comparatively lower number of cases of COVID-19 across the continent. However, in the first week of April 2020, the Africa Centres for Disease Control and Prevention (Africa CDC) reported that there were 10,075 cases of COVID-19 amongst the 52 member states of the African Union (Nkengason, 2020). Though still under-reported, the two countries with the highest number of cases in each region of the continent were Algeria and Egypt (Northern), Cameroon and Democratic Republic of Congo (Central), Mauritius and Kenya (Eastern) Burkina Faso and Cote d'Ivoire (Western), and South Africa and Zambia (Southern). In addition, the wide spread of non-communicable diseases in Africa, such as chronic obstructive pulmonary disease (COPD), heart disease, hypertension and diabetes are known risk factors for severe cases of COVID-19 (Guan et al., 2020). This is a major concern for Africa as there are 19 million adults aged between 20 and 79 years, with 60% of the population with undiagnosed diabetes (International Diabetes Federation, 2019). The spread of COVID-19 in the African continent is therefore of great concern (Nkengason & Mankoula, 2020). Acute respiratory distress syndrome (ARDS) is a common and often lethal clinical syndrome in CORVID-19 with a complex underlying pathophysiology (Hart & Black, 2019). Physiotherapy intervention in the Intensive Care Unit (ICU) was associated with saving lives (Chung & Mueller, 2011) and decreasing mortality (Munshi et al., 2017). The WCPT has developed guidelines for the physiotherapy management of COVID-19 in acute hospital settings (Thomas et al., 2020), and these inform the protocols developed in member countries (Lazzeri et al., 2020). There are currently no local guidelines or recommendations on the provision of physiotherapy management for patients with COVID-19 in Mauritius, South Africa and other African countries. Therefore, the aim of this commentary is to report on the preparedness of physiotherapy in the clinical management of COVID-19 in Africa, using updates from Mauritius and South Africa. This commentary also aims to advocate for the potential role of physiotherapy in the management of infected patients in Africa. 2 | COVID-19 IN MAURITIUS AND SOUTH AFRICA