Experts fear that a spike in coronavirus cases in West African nations will be devastating for the region.

People in countries such as Sierra Leone and Liberia are still traumatized from the Ebola pandemic, which killed 11,000 people in the region over two years.

The region is home to some of the poorest countries in the world, and are lacking doctors and vital resources such as ventilators.

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A new outbreak of Ebola has killed five people in the Democratic Republic of the Congo, according to multiple sources.

The announcement of new Ebola cases came just two days before officials were set to declare an end to the most recent outbreak of the virus in Congo.

Authorities say the outbreak is in its final stages, but it nonetheless is digging up painful memories for many people on the continent, who fought another deadly Ebola pandemic from 2014 to 2016. And now, those that survived are bracing for spikes in another pandemic: the coronavirus.

In West Africa, countries being hit by the coronavirus have barely recovered from Ebola.

West Africa is home to some of the poorest countries in the world. With coronavirus cases beginning to surge in the region, nations with already dire health systems are facing the almost unthinkable prospect of another widespread pandemic.

Although coronavirus outbreaks have been relatively small in the region so far — with Sierra Leone, Liberia, and Burkina Faso each having reported less than 1,000 cases — experts fear a sharp increase in cases may be inevitable. The United Nations Economic Commission for Africa has warned that the wider African continent could see as many as 123 million cases and 300,000 deaths this year.

Authorities in both Liberia and Sierra Leone have responded quickly to the threat, but they know a large outbreak of coronavirus would bring them to their knees.

“If we get a large number of cases, we’re going to get overwhelmed and we may have to make some hard decisions. Some people will have to die,” Mosoka Fallah, head of Liberia’s Public Health Institute, told Business Insider Weekly.

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Locals are hoping the lessons they learned from Ebola will help them with the current pandemic.Experts warn the African continent could see as many as 123 million coronavirus cases and 300,000 deaths this year.

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People in the region hope the vital lessons they learned last time about the importance of early contact tracing and prevention can stave off the kind of disaster that is still fresh in their memories.

In Liberia, the coronavirus response has been much swifter than than it was for the pandemic six years ago.

The government ordered a nationwide lockdown on April 8, when there were only around 25 reported cases of the virus. Temperature controls, checkpoints, movement restrictions, and handwashing stations were put in place in an attempt to reduce the rate of transmission.

And for those with the virus, a system of contact tracing, again learned from Ebola, has kicked into action.

“We can either go the more aggressive way or we see people falling down and dying all around us before, like Ebola when the truth started to hit,” Fallah said. “It might get late, we might go in to help, but then there will be consequences. There will be the trauma, there will be the lives that we could have prevented.”

And in Sierra Leone, a state of emergency was declared even before the first registered case. Three-day lockdowns were then imposed to allow contact tracers to track down anyone who may have been exposed to infected people to keep the spread of the virus to a minimum. 

But the odds are still stacked against them.

Healthcare workers in West Africa know that if the coronavirus outbreak worsens, the results could be devastating. And for those with the virus, a system of contact-tracing, again learned from Ebola, has kicked into action.

Liberia only has around 200 doctors to go around — not to mention just 180 intensive-care hospital beds and a handful of ventilators, according to Reuters. If a large-scale outbreak hits the country, “we’re probably going to run out of PPEs within a matter of weeks,” one doctor, Heounohu Hessou, said.

In neighboring Sierra Leone, doctors face a similar challenge: a fragile healthcare system and high levels of poverty. According to Reuters, there are only 13 ventilators and around 150 doctors nationwide.

Liberia only has 200 doctors to go around, and Sierra Leone only has 150.

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Where some projections see the death toll from COVID-19 in Africa being lower than other continents — in part  because of large young populations who are more resilient to the virus — fear and hunger, coinciding with the peak of the malaria season, may see many children dying avoidable deaths.

“People get scared not to go to the different health centers,” said Mariatu Kamara, a nurse supervisor in Sierra Leone with Doctors Without Borders. “They maybe might not be suffering from the COVID itself — it might be malaria, it might be HIV, it might be tuberculosis— and sometimes you find out when they rush with the child to the hospital that sometimes it’s already late.”

“It’s really heartbreaking to see as a health worker, seeing children dying from conditions that are curable that can be managed in the hospital rather than coming with them half-dead and then maybe ending up dying in the health centre, it’s really heartbreaking.”

Medical teams know that prevention and education may be the only tools they really have.

“We are all scared,” Mamadu Baldeh, a doctor in Sierra Leone, told Business Insider Weekly. “Health workers in other parts of the world are scared equally, and we do not want to have a situation where we’re not considering prevention, we’re considering care — having to fight the disease.”

“I think the best shot we have is to prevent — prevent prevent prevent — that it doesn’t come.”

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