Djibouti has seen a rapid spike in coronavirus cases with the Horn of Africa nation now recording the highest prevalence on the continent as the population largely ignores measures imposed by authorities.
The tiny but strategically important country that hosts major American and French military bases, recorded 985 positive cases - small on a global scale but the highest in East Africa. Two people have died.
The jump in cases is largely because of mass testing. Djibouti, with a population of about one million, has conducted more than 10,000 tests - a similar number to neighbouring Ethiopia, which has more than 100 million people.
More alarming than the soaring infection figure is the runaway rate of multiplication: In just two weeks, Djibouti has recorded a seven-fold increase in cases.
The Africa Centres for Disease Control and Prevention on Thursday said with 98.6 cases for every 100,000 people, Djibouti has the highest prevalence on the continent.
Authorities conceded the virus has not been successfully contained since a nationwide lockdown was imposed on March 23, when Djibouti had just two recorded cases of COVID-19, the disease caused by the novel coronavirus.
"The epidemic is getting worse," the health ministry said last week.
The inability to control the outbreak has irritated Djibouti's powerful President Ismail Omar Guelleh, who has ruled since succeeding his uncle in 1999, and is not bound by term limits.
"The confinement has not been respected by everyone, and unfortunately many of our compatriots still take this disease lightly," Guelleh said in a televised address to the nation this week.
"You continue to circulate, not observing minimum distances, not isolating yourselves, and spreading the disease."
Lockdown ignored
As the pandemic swept across the globe, Djibouti - which the democracy advocacy group Freedom House ranked "not free" on its 2020 index measuring political rights and civil liberties - ordered its citizens to remain home.
Only those working in essential industries were allowed outside, and public transport was banned to curtail movement.
The small nation - wedged between Somalia and Eritrea and landlocked Ethiopia's gateway to the coastline - also closed its borders as well as schools, places of worship, and all but the most necessary shops.
But crowds continue to throng the capital city and few wear masks or are stopped by police or soldiers on patrol.
No health measures were witnessed at busy markets selling fruit, vegetables and khat, a chewed narcotic leaf popular in the region.
"If behaviour doesn't change I will take even tougher measures," said Guelleh, who has crushed past rallies against his rule and curbed Djibouti's free press, civil society, and political opposition.
"This could go as far as a curfew, which would be the only way to stop the spread of this virus."
Djibouti's restrictions have been extended until April 28 but few can afford to hold out that long.
Three-quarters of Djiboutians live on less than $3 a day and unemployment sat at nearly 50 percent when measured in 2017.
Anger at authorities
Authorities came under fire for a debacle at the al-Rahma hospital in Balbala, where several patients were infected by two Egyptian doctors who had recently returned to Djibouti.
Some of those with COVID-19 were then transferred to another health facility in the country's south where more were infected.
The swift imposition of the lockdown without warning also bred resentment.
"We weren't ready at all. I wasn't prepared because from one day to the next, we were told the country was being confined," Ahmed, a rickshaw driver, told AFP news agency. "For people like me who live from daily work, it's difficult financially."
At the start of this month, Guelleh announced an emergency fund of one billion Djiboutian francs ($5.6m), promising 10 million francs ($56,200) from his own pocket.
The government said food distribution in poorer neighbourhoods reached thousands of families. But even this initiative was overshadowed by allegations of patronage and favouritism.
The United States military declared a public health emergency at its only permanent base in Africa as coronavirus cases in host country Djibouti climbed to nearly 1,000.
A statement said the precautionary measure affected all military personnel including contractors at Camp Lemonnier and Chabelley Airfield.
The emergency means any facility can be repurposed for the virus response and healthcare workers can be supplemented with volunteers. More than 4,000 US personnel are based in Djibouti.