For months, experts have warned of a potential nightmare scenario: After overwhelming health systems in some of the world’s wealthiest regions, the coronavirus gains a foothold in poor or war-torn countries ill-equipped to contain it and sweeps through the population.

  Now some of those fears are being realised.

In southern Yemen, health workers are leaving their posts en masse because of a lack of protective equipment, and some hospitals are turning away patients struggling to breathe.

 In Sudan’s war-ravaged Darfur region, where there is little testing capacity, a mysterious illness resembling COVID-19 is spreading through camps for the internally displaced.

Cases are soaring in India and Pakistan, together home to more than 1.5 billion people and where authorities say nationwide lockdowns are no longer an option because of high poverty.In Latin America, Brazil has a confirmed caseload and death count 2nd only to the US, and its leader is unwilling to take steps to stem the spread of the virus.

Alarming escalations are unfolding in Peru, Chile, Ecuador and Panama, even after they imposed early lockdowns.

The first reports of disarray are also emerging from hospitals in South Africa, which has its continent’s most developed economy. Sick patients are lying on beds in corridors as one hospital runs out of space.

At another, an emergency morgue was needed to hold more than 700 bodies.

“We are reaping the whirlwind now,” said Francois Venter, a South African health expert at the University of Witswatersrand in Johannesburg.Worldwide, there are 10.1 million confirmed cases and over 501,000 reported deaths, according to a tally by Johns Hopkins University of Government reports.Experts say both those numbers are serious undercounts of the true toll of the pandemic, due to limited testing and missed mild cases.

South Africa has more than a third of Africa’s confirmed cases of COVID-19 with 138,000 as of Monday.

 It’s ahead of other African countries in the pandemic timeline and approaching its peak.

 So far its facilities have managed to cope, but if they become overwhelmed, it will be a grim forewarning because South Africa’s health system is reputed to be the continent’s best.

Most poor countries took action early on. Some, like Uganda, which

already had a sophisticated detection system built up during its yearslong battle with viral hemorrhagic fever, have thus far been arguably more successful than the U.S. And other wealthy countries in battling coronavirus.

But since the beginning of the pandemic, poor and conflict-ravaged countries have been at a major disadvantage, and they remain so.

The global scramble for protective equipment sent prices soaring.

 Testing kits have also been hard to come by. Tracking and quarantining patients requires large numbers of health workers. "It's all a domino effect," said Kate White, head of emergencies for Doctors Without Borders.

 "Whenever you have countries that are economically not as well off as others, then they will be adversely affected." Global health experts say testing is key, but months into the pandemic, few developing countries can keep carrying out the tens of thousands of tests every week needed to detect and contain outbreaks. "The majority of the places that we work in are not able to have that level of testing capacity, and that's the level that you need to be able to get things really under control," White said.   South Africa leads Africa in testing, but an initially promising

program has now been overrun in Cape Town, which alone has more reported cases than any other African country except Egypt. Critical shortages of kits have forced city officials to abandon testing for anyone under 55 unless they have a serious health condition or are in a hospital.