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Less COVID-19 in Africa? We don’t know

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For now, most of the African continent seems to have avoided the catastrophic scenario the experts feared last spring. The Rumour Detector wondered if COVID-19 had really caused less damage, or if the epidemic was flying under the radar. 

For now, most of the African continent seems to have avoided the catastrophic scenario the experts feared last spring. The Rumour Detector wondered if COVID-19 had really caused less damage, or if the epidemic was flying under the radar. 

At the end of May, the World Health Organization (WHO) declared that Africa was the region least affected worldwide, with 1.5% of reported cases and 0.1% of deaths. At the end of June, an acceleration of cases was reported, but the continent still defied the predictions and models. In mid-September, according to a New Scientist assessment of the first eight months of the pandemic, Africa continued to report fewer cases and deaths than had been predicted. 

Protective factors ? 

Observers acknowledge that the African continent is vast and diverse, but they point out that certain demographic factors may be part of the explanation. The youthful population (median age of 18.9 years) could give reason to expect that the cases would be less severe. The low preponderance of obesity and diabetes, which increase the risk of complications, is also a possible cause. According to another hypothesis, some sub-Saharan African populations have been more exposed to other coronaviruses, which would offer them better immune protection.  

However, the potential interaction of the virus with other risk factors is unknown. These factors include malnutrition or other infectious diseases, such as malaria. 

Better preparation may also have helped: the African countries, already scalded by Ebola, were ready to declare war on the coronavirus, despite fewer health resources. Airport surveillance was implemented in January in Côte d’Ivoire and elsewhere. Rwanda and Morocco quickly closed their borders when they only had a handful of cases, and several countries imposed lockdowns. Traffic between cities is lower than in the rest of the world, slowing community transmission. Finally, the virus arrived a little later than in Europe, particularly because of the lower volume of international travellers. 

Or is it a smouldering fire? 

But what if a silent crisis is brewing beneath the apparent calm? Even before the pandemic, only eight African countries accounted for deaths efficiently, according to a survey by the Reuters news agency — that means they reported at least three cases out of four.  

Antibody tests in midsummer revealed that there were many more cases then announced in at least two countries, and in the metropolitan areas of a third. And then there is South Africa, which officially reported over 7,000 coronavirus deaths at the beginning of August. The statistics show about 28,000 excess deaths in three months. That means the number of deaths from all causes combined exceeds the average for the same quarters of the previous years. 

Certainly, the testing capacity of many African countries remains low, and some governments make it difficult to access their statistics. South Africa, which conducted the greatest number of tests per capita, is being criticized for its delays in disseminating the results. In Tanzania, the government stopped publishing figures at the end of April, claiming that the coronavirus had been eradicated “by the grace of God”. Finally, in some countries, fear of hospitals, or simply the difficulty of access to them, imposes a limit on statistics.  

Nonetheless, although antibody tests revealed that these coronavirus cases flew under the radar in Kenya, Malawi and Mozambique, they don’t seem to have translated into higher hospitalization levels or an increase in the number of deaths. Here again, the main factor mentioned is the population’s average age, which would make it less vulnerable: 20 years in Kenya, 18 years in Malawi. 

In mid-September, the Worldometers site counted nearly 1.4 million cases and over 33,000 deaths in Africa, half of them in South Africa alone. In comparison, South America counted 7.4 million cases and 230,000 deaths (more than half of them in Brazil) for a population three times smaller. 


This article was originally published on the website of L'Agence Science-Presse (French only).


 

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