In this Feb. 6, 2020, photo, a security guard stands outside of the Sino-Zambia Friendship Hospital in Kitwe, Zambia. The coronavirus that has spread through much of China has yet to be diagnosed in Africa, but global health authorities are increasingly worried about the threat as health workers on the ground warn they are not ready to handle an outbreak. (AP Photo/Emmanuel Mwiche)
In this Feb. 6, 2020, photo, a security guard stands outside of the Sino-Zambia Friendship Hospital in Kitwe, Zambia. The coronavirus that has spread through much of China has yet to be diagnosed in Africa, but global health authorities are increasingly worried about the threat as health workers on the ground warn they are not ready to handle an outbreak. (AP Photo/Emmanuel Mwiche) Credit: Emmanuel Mwiche

At a Chinese-run hospital in Zambia, some employees watched as people who recently returned from China showed up with coughs but were not placed in isolation. A doctor tending to those patients has stopped coming to work, and health workers have been ordered not to speak publicly about the new virus that has killed hundreds around the world.

The virus that has spread through much of China has yet to be confirmed in Africa, but global health authorities are increasingly worried about the threat to the continent where an estimated 1 million Chinese now live, as some health workers on the ground warn they are not ready to handle an outbreak.

Countries are racing to take precautions as hundreds of travelers arrive from China every day. Safeguards include stronger surveillance at ports of entry and improved quarantine and testing measures across Africa, home to 1.2 billion people and some of the worldโ€™s weakest systems for detecting and treating disease.

But the effort has been complicated by a critical shortage of testing kits and numerous illnesses that display symptoms similar to the flu-like virus.

โ€œThe problem is, even if itโ€™s mild, it can paralyze the whole community,โ€ said Dr. Michel Yao, emergency operations manager in Africa for the World Health Organization.

Those growing worried include employees at the Sino-Zambia Friendship Hospital in the mining city of Kitwe in northern Zambia, near the Congo border. Chinese companies operate mines on the outskirts of the city of more than half a million people. One company is headquartered in Wuhan, the city at the center of the virus outbreak. Hundreds of workers traveled between Zambia and China in recent weeks.

โ€œWeโ€™re definitely not prepared. If we had a couple of cases, it would spread very quickly,โ€ physiotherapist Fundi Sinkala said. โ€œWeโ€™re doing the best we can with what resources we have.โ€

The Sino-Zambia Friendship Hospital, or Sinozam, a low-slung facility near the cityโ€™s train station, has taken some precautions, including checking patient temperatures with infrared thermometers and establishing isolation areas. Employees wear masks. Gloves, disinfectant and oxygen inhalers have been stockpiled. Sinozam treats many Chinese in Kitwe and its precautions go further than other hospitals in the area.

But the employees and others familiar with the matter, some of whom spoke anonymously under the new rules, say some Chinese patients checked in with coughs and fevers but did not get placed in isolation.

Visiting Zambian health officials concluded the patients did not merit special treatment and did not take samples to test for the virus. After the people recovered, they were sent home with antibiotics, employees said.

On Wednesday, the hospital set up a new fever clinic, where people arriving with a high temperature are now taken to right away. Itโ€™s โ€œunfortunateโ€ the ward wasnโ€™t set up earlier, Sinkala said.

Two people familiar with the matter say a doctor tending to the sick has fallen ill. Dr. Yu Jianlan has not come to work in the past week and hospital administrators have not explained her absence, Sinkala said. The other person spoke on condition of anonymity for fear of retribution.

Hospital administrator Li Zhibing said there were no patients with a fever and said Yu had a urinary tract infection, not a fever. But a notice posted by the Zambia-China Cooperation Zone, which manages the hospital, quoted an employee as saying on Jan. 27 that the facility โ€œprobably sees 120 fever patients a day, and at least 70 of them are carrying germsโ€ of various diseases.

Earlier this week, a Zambian official acknowledged for the first time that his country was following up on an unspecified number of suspected cases. Zambia is one of 13 African countries identified by WHO as a high priority because of busy travel links with China.