There have been over 64,400 confirmed cases of COVID-19, the new and rapidly spreading coronavirus, along with at least 1,384 deaths.

Yet, there is only one case in Africa — which was confirmed earlier today by the World Health Organization — and none in South America, according to Johns Hopkins University researchers who are sourcing data from WHO, Centers for Disease Control, and other international health organizations.

The lack of cases across these continents are notable due to their extensive economic ties to China.

China is Africa’s “most important economic partner,” according to a McKinsey report, which documents economic ties encompassing $200 billion in trade during 2018 and a $60 billion pledge of aid from China that same year.

In Latin America, trade with China topped $305 billion in 2018.

In Africa, WHO officials believe the 2014-2016 Ebola outbreak and ongoing Ebola outbreak in the Democratic Republic of the Congo have helped prepare countries on the continent to respond to COVID-19.

“People learned a lot from the Ebola outbreak,” said Dr. Michel Yao, WHO program manager for emergency response in Africa.

He pointed to detection mechanisms at countries’ entry points, isolation areas, and Ebola treatment capacity centers that can be upgraded for COVID-19.

“When we did an analysis, many countries have measures in place already from the Ebola disease,” Yao said.

As a result of these measures, Yao said countries have mostly been able to respond quickly and implement WHO recommendations, such as early detection protocols at airports and seaports, as well as monitoring individuals who have traveled to impacted areas in China and other countries with confirmed cases. Some countries are able to isolate people and others are monitoring them from their residences, he said, adding that this was something WHO had to focus on, since the isolation components in many countries were initially “not adequate.”

Currently, WHO is aware of 43 previously suspected cases in Africa, all of which came back negative after testing.

There are 19 cases currently under review, Yao said, but 8 of those have already been confirmed as negative as well.

Throughout Africa, 17 labs exist which can test for the virus. However, none of the reagents are manufactured in Africa, which has led to some delays in getting results, Yao said.

Yao said he feels confident in the efficacy of testing and reporting procedures in Africa, owing to the multi-layer process many countries started implementing weeks ago as well as the ease with which he believes, symptomatic individuals would be identified.

“With this kind of communicable disease, it will be very difficult to hide, especially in these communities,” he said.

In line with other outbreaks, neither WHO nor CDC are recommending that China or other countries with cases close their borders.

Yao said that this step, while often clamored for among segments of the public, is rarely enforceable, and always comes with substantial negative economic consequences.

“Closing borders can have a huge economic impact but not stop the epidemic,” he said. “Africa’s borders are porous, people find ways to pass through.”

Though the practice of quarantine goes back to at least the 14th century, Andrew Schroeder, VP of Research and Analysis for Direct Relief, raised concerns about their effects on large populations.

He gave the example of how Sierra Leone quarantined a significant section of the country during the Ebola outbreak in 2014, which prevented people in the countryside from getting to the capital, Freetown, but also obstructed many other functions, including food transport. Since they did this around harvest time, the net impact was to block people with the disease and those with goods, services, and food from entering as well, which resulted in secondary increases in food insecurity.

“Quarantines are, in general, considered by the public health expert community to be last-resort measures, which have high risks of not working,” Schroeder said.

“In large part, this is because whatever gains may be secured from isolating infected individuals tend to be lost due to declining trust on the part of the quarantined population. There is also a diminishment in the ability to conduct certain basic social or logistical functions.”

“Don’t make the cure worse than the disease,” he said.

Instead of sidelining people via a widespread quarantine, Yao said his goal, and that of WHO, is to deputize them.

“The idea is to educate people to get them to fight against the virus,” Yao said.