African countries are being urged by the World Health Organization to “urgently” expand their critical care capacity while Covid-19 cases are rising rapidly in several countries and vaccine shipments to the continent are almost at a standstill.

Efforts to augment critical care will help health facilities from becoming overwhelmed, Matshidiso Moeti, WHO Regional Director for Africa, said in a briefing Thursday.

“Many African hospitals and clinics are still far from ready for a surge in critically ill Covid-19 patients,” Moeti told reporters. To prepare for a resurgence of the virus, the WHO is lining up case management experts and essential equipment, including oxygen concentrators, that “can be deployed quickly when needed,” she said.

The continent had a 20% increase in cases in the past two weeks, with eight countries recording a rise of more than 30% in the past week. Still, a WHO survey last month showed most African countries have less than than one intensive care unit bed per 100,000 people, reflecting “long under investment in health systems among many other competing priorities,” Moeti said.

The risk of surges comes as only one in every 100 Africans has had a vaccine dose, compared to the global average of 23 doses per 100 people. In some high-income countries it’s almost triple that rate, at 62 doses per 100 people.

While 51 African countries, including Burkina Faso and Chad recently, have received their first deliveries of vaccines, many need help to get second doses in people’s arms, said Richard Mihigo, program area manager for immunization and vaccine development at the WHO’s regional office in Brazzaville, Republic of Congo. Eritrea, Burundi and Tanzania have not yet received vaccines.

“The threat of a third wave in Africa is real and rising,” Moeti said.