The coronavirus outbreak could affect a third of the 440 million formal and informal jobs in Africa as lockdowns across the continent deprive people in the world’s poorest continent of the means to make a living, according to McKinsey & Co.

Between 9 million and 18 million of the continent’s 140 million formal jobs could be lost as a result of the crisis, McKinsey said in its Finding Africa’s Path report.

A further 30 million to 35 million could see a reduction in wages and working hours. One hundred million of the 300 million informal jobs on the continent are at risk, it said.

In major sectors such as manufacturing, retail and wholesale, tourism, and construction, the jobs of more than half the workforce could be affected, McKinsey said.

While the epidemic has been slow to take off in Africa, the fallout from the disease has decimated the economies of the continent. Shutdowns across many countries have curbing activity while the snarling of global supply chains has depressed the prices of the commodities many countries export.

The World Bank now projects the region will have its first recession in 25 years.

There are also concerns that limited testing is suppressing the real number of infections, with the disease apparently yet to take hold in many African countries, and a rapid rise in numbers is expected.

Africa is ill-equipped to fund a medical response and needs to spend $5 billion on health over the next 100 days, McKinsey said.

“The entire continent may have just 20,000 beds in intensive care units, equivalent to 1.7 ICU beds per 100,000 people,” the consultancy firm said. “By comparison, China has an estimated 3.6 ICU beds per 100,000 people, while the U.S. has 29.4.”

In sub-Saharan Africa outside of South Africa, there may be as few as 3,500 ventilators, McKinsey said. The U.S. has 160,000.