FEARS that Africa would be the next Covid-19 hotspot have not materialised as the continent seems to have been affected only moderately.
There is reason for hope in its response to Covid-19, states new research from Oxford’s Leverhulme Centre for Demographic Science in collaboration with the African Research Network.
‘Many predicted a heavy toll of the pandemic on Africa. Its weakened health systems were harbingers of a terrible outcome. But the reality has been quite different, with Africa only moderately affected thus far,’ says their paper, published last week in Nature Medicine.
Local expertise gathered from previous outbreaks like Ebola and centralised public-health infrastructure with a clear action plan, together with a favourable demographic structure and climate ‘have put many countries in the continent in good standing to face this epidemic head on.’
Rapid and strict ‘effective lockdown measures’ have played a major role.
Up to June 3, Africa seems to have been affected ‘only moderately’ with around 156,000 cases and 4,391 deaths across all 54 countries. Egypt, Algeria, Morocco and South Africa were predicted to have the most immediate risk of circulating the causative coronavirus due to their having the greatest volume of imports and travel from China to their main cities.
‘Accordingly, they now have some of the largest numbers of confirmed cases and deaths throughout Africa.’
However, Nigeria, with an estimated 196 million citizens, had experienced just 407 deaths and the holiday destinations of Tanzania and Kenya had reported fewer than 200 deaths between them.
‘As of [June 15], Nigeria has experienced 53 deaths per million, compared to 41,000 in the UK and 17,000 in the US.’
When predicting the impact of Covid-19 on the continent, however, the number of reported cases does not tell the whole story, say the researchers.
‘Co-morbidity is of particular concern for Africa. Although infectious disease still is a heavy burden on health in Africa – in 2017, Aids caused 9.52 percent of all deaths in sub-Saharan Africa, followed by malaria at 7.27 percent and TB at 5.37 percent – with a slowly ageing population, urbanisation and an increase in life expectancy, Africa has seen a rise in non-communicable diseases.’
This double burden of disease is particularly of concern for the management of Covid-19 on the continent. The strategy of ‘flattening the curve’ may not be relevant in Africa and governments should tailor their approaches to their own countries.
‘Most African countries have over-burdened health-care systems and given the low socio-economic status in most of African cities, mass quarantines may mean people will starve, as many already struggle to find food on a daily basis
‘Even if the response of caring for the patients with severe Covid-19 were to be fully managed by the weak health systems, that would mean those patients would taking precedence over many other patients who could be left in the lurch. It is estimated that about 769,000 people could die from malaria alone if funding and campaigns are suspended due to this Covid-19 pandemic.’
Fortunately, so far, the four countries that have been most heavily hit have the highest GDPs among African countries and ‘the capacity to treat and monitor the spread of the disease more effectively than other African countries.’
Africa is well equipped to control the situation if countries are able to apply fast and thorough contract tracing and monitoring and ensure quarantine for potentially infectious contacts.