Africa — where lifesaving equipment like ventilators, oxygen and masks, and even basic necessities like water and soap, are in short supply — could become the next epicenter of the coronavirus pandemic, the World Health Organization has warned.

Michel Yao, the WHO’s emergency operations manager in Africa, said last Thursday that Africa could see more than 10 million severe cases of the virus in the next six months, based on provisional models.

A report by the United Nations Economic Commission for Africa said that in a worst-case scenario, where no interventions against the virus are taken, 3.3 million people in Africa could die from COVID-19 and 1.2 billion could be infected by the end of year.

Even under the best-case scenario, the report said, 300,000 people in Africa could perish from the virus.

To date, the continent has reported more than 20,000 cases of coronavirus and 1,000 deaths.

Africa, the U.N. report said, is “particularly susceptible” to COVID-19 because of widespread poverty, overcrowded living conditions and the highest prevalence among all the continents “of certain underlying conditions, like tuberculosis and HIV/AIDS.”

A lack of medical equipment and poor access to basic necessities like water and soap could further exacerbate COVID-19’s effects on African nations.

Public hospitals across 41 African countries have fewer than 2,000 working ventilators, The New York Times reported on Saturday, citing WHO data. The United States, in contrast, has 170,000.

Ten countries in Africa have no ventilators at all, according to the Times. Several nations, including South Sudan, Mali, the Central African Republic and the Democratic Republic of Congo, have five machines or fewer. Even if those numbers increase because of donations, the region lacks adequate trained personnel to use the equipment, the U.N. report noted. 

Other critical medical equipment, including masks and oxygen, are also scarce across the continent, and only 34 percent of African households have access to basic hand-washing facilities, the U.N. said. 

“We are now failing. Let me use that word deliberately,” epidemiologist Mahad Hassan, a member of the Somalian government’s coronavirus task force, told The Washington Post of the country’s COVID-19 response. “At our main treatment center, almost nothing is there. Last time I visited, beds, only beds.”

Somalia’s public health system reportedly does not have a single ventilator at its disposal. More than 100 confirmed cases have been reported in the country so far, though at least one health official told the Post that the number could “be even a million.”

Hassan told the Post he’s expecting “very, very painful weeks ahead.”