There is a need for the AAS to support the research agenda for countries on the continent to have local data for policymaking. Below are some pressing questions that need to be discussed or addressed. They by no means form a concise list of questions, but provide a good starting point for discussions:
From an epidemiological point of view, what is the anticipated model for the spread of the disease? There is a need to build disease outbreak models for African countries to determine potential peaks of the disease and infuse this knowledge to the control efforts.
How long should the intensive social distancing or partial or full lockdown of countries be? There is a need to build models that can advise on the periods needed for the intensive transmission of the disease to pass. This will help countries to avoid double or triple peaks for the disease. Is there a case for a controlled infection model that provides robust herd immunity?
What is the best way of identifying potentially infectious asymptomatic subjects on the continent? Is there a case for identifying asymptomatic subjects considering the testing capabilities that countries have?
What type of virus will be circulating in Africa during the outbreak? Will the virus be genetically the same as that in other geographical areas and will we be able to catch a genetic mutation of the virus in good time? What will be the clinical significance of possible mutations?
Are there adequately qualified groups on the continent capable of delivering clinical trials on new or repurposed drugs (e.g. Remdezivir, Chloroquine, Tocilizumab) on severely ill patients? Or testing of vaccines (e.g. CEPI funded Moderna/NIH candidate COVID vaccine) on healthy volunteers?
How do we best protect our vulnerable groups from the intense periods of SARS-CoV-2 transmission? The vulnerable groups could include those with advanced age, those with concomitant non-communicable chronic diseases including those on immunosuppressive medications and those with infections like HIV & m-TB.
What groups can contribute or need to be supported towards the global effort of developing diagnostics or vaccines or pharmacotherapeutics for this disease? What capacities can we leverage to scale up the production of supplies against the outbreak?
What opportunities can be harnessed to develop a fund for supporting some of the above-mentioned efforts? How can institutions/non-profits remain connected to their constituents and raise the revenue their programs require in these days of social distancing? What can we recommend using digital engagement to maintain resource mobilization momentum for Covid-19 initiatives?
How do we propose to deliver social distancing, self-quarantine, and isolation in high-density urban areas like slums? Lower economic communities relying on income received daily to survive? How will we deliver social distancing in congested public transport in Africa? Are there viable alternatives? How do we curb the misinformation and myths about this virus? How do we improve public health messaging and social marketing to bring the whole population to take the outbreak seriously without causing panic?
From basic science ACE2 has now been defined as the receptor-binding domain for SARS-COV2, it will be interesting to understand the expression levels, and any related prevalent mutations and their possible clinical relevance (could we use existing H3Africa data for this analysis?). This is key if we are to develop genetic/African specific tools to block transmission.
Urgency is required to develop innovations that can address the needs of healthcare workers and care facilities, given the global lack of sufficient PPEs, ventilators, etc that could be developed/scaled/produced on the continent?
There is a need to have accelerated ethical review with protocols reviewed and approved on much shorter timelines while retaining the rigorous protection needed from African ERC’s. Is there a place for using delegated opinion from global ERC’s for multicentre studies in this critical period of the disease? Is there a role for the AAS to institute a credible emergency review committee that is ratified by African countries?