Governments and health systems in wealthy nations are struggling to cope with the coronavirus pandemic, suggesting the poorest countries may be hit far harder if the virus gains a foothold there, a top U.N. official warned.

Mami Mizutori, head of the U.N. Office for Disaster Risk Reduction (UNDRR), said even in developed countries, health services were under stress and did not have enough equipment to treat people in need as the numbers infected rose rapidly.

“It is easily imaginable that if this becomes the case in a country where the health system is not as sophisticated, then that could lead to possibly higher mortality,”

A coronavirus tracker map from John Hopkins University showed there were more than 150,000 confirmed cases worldwide on Saturday, with the death toll topping 5,600.

East Asia, Iran and European countries have been the worst hit so far, but the map showed a small number of cases in about 20 African states, and more across Central and Latin America.

Even in wealthy parts of the world like Europe and the United States, the virus has exposed how risk affects everyone differently depending on their economic status, Mizutori noted.

People living in poverty and lacking health insurance or secure employment cannot afford to be sick or miss work, she said, pointing to the virus as an “equity issue”.

“We need to really make sure that the vulnerable people are protected,” she added.

Large numbers of office workers have been told or have opted to work from home but this is not an option for many people.

“The day that you can’t go to work may be the day you stop getting food for yourself and your family,” she said.

If coronavirus expanded in poor countries, the economic impact on individuals would likely be greater as economic losses would be a bigger share of gross domestic product, she added.

The slower spread of the virus to Africa, however, may have bought the continent valuable time to take preventive measures.

Some African countries, like Rwanda and Uganda, are implementing strict controls at airports as well as simple hygiene practices such as setting up public sinks to wash hands.

“Hopefully the lessons that are rapidly being learned in other countries where it has happened earlier will prevent that this becomes a serious situation in less-developed countries,” Mizutori said.

Malka Older, an affiliated researcher at the Sciences Po Center for the Sociology of Organizations, said there was an element of “elite panic” to the pandemic as leaders, politicians and top sports personalities contracted the virus.

“Part of the reason we have been seeing so much global attention … to this is that it affects the rich too – more than quite a lot of disasters do,” she said.

Mizutori urged all states to invest more in their health services, including medical staff and data collection, to boost resilience to health threats, as they agreed five years ago.

In 2015, after epidemics like Ebola, MERS and bird flu, most governments signed up to a disaster prevention roadmap, called the Sendai Framework, which gave higher priority to health threats alongside natural risks like earthquakes and floods.