Six months on, Africa is one of the regions with the least deaths attributed to coronavirus in the world. World Health Organization experts explain why this might be.

First published in October 2020.

COVID-19 transmission in Africa has been marked by relatively fewer infections, which have been on the decline over the past two months, owing to a variety of socio-ecological factors as well as early and strong public health measures taken by governments across the region,” the World Health Organization (WHO) said, last week.

Since the first case was identified on the African continent, last February, some 1.4 million people have been infected with coronavirus. However, the pandemic has largely been in a younger age group (about 91% of infection in sub-Saharan Africa are among people below 60 years, and over 80% of cases are asymptomatic) and more pronounced in a few specific countries, suggesting country-specific aspects might be driving the pattern of disease and death in Africa. Indeed some of the most-affected countries include Algeria, Cameroon, Cote d’Ivoire, Ethiopia, Ghana, Kenya, Madagascar, Nigeria, Senegal and South Africa.

Africa has not witnessed an exponential spread of COVID-19 as many initially feared, said Dr Matshidiso Moeti, the WHO Regional Director for Africa, during a virtual press conference. “But the slower spread of infection in the region means we expect the pandemic to continue to smoulder for some time, with occasional flare-ups.”

Deaths attributed to COVID-19 have remained relatively low in the region. 35,864 people have now died of coronavirus in Africa, a figure similar to Italy alone (35,894).

Confirmed cases in Africa (as of 1 October 2020). | BBC News – Johns Hopkins University

The WHO explains the pattern of low infection and death rates seen in Africa by “a mix of socio-ecological factors such as low population density and mobility, hot and humid climate, lower age group, interacting to accentuate their individual effects.”

Dr Moeti explained that governments across the region have also taken “robust and decisive” public health measures that have helped curb the spread of the virus to limit further infections and deaths. They have made efforts to improve their COVID-19 testing and took drastic measures to limit people’s journeys and gatherings.

“In the African region, or in most African countries, we have about 3% of the population aged over 65 years.

Africa is less internationally connected than many other regions. If you look at most African countries, how many flights a day come in internationally?

And there are other factors, the ability to move around within countries, the road networks, the numbers of cars per capita. All of this makes a difference in terms of how intensely the virus is going to spread within countries.”

Comparing the situation in Western countries and in Africa, the WHO expert explained that the elderly tend to live at home in African societies, not in care homes – which were clusters where the virus hit hard the elderly and where many people died.

Professor Francisca Mutapi, a professor in Global Health Infection and Immunity and co-Director of the Global Health Academy at the University of Edinburgh, suggested that differences in culture and lifestyle could also play a role. “One of the factors about the virus is, it doesn’t transmit very well outdoors. Africa has a significant population that is rural and spends a lot of time outdoors. That is one of the factors that we have found from our own work.”

While some have raised the possibility that low numbers in the region could actually be the result of underreporting, the WHO has seen no evidence of miscalculation of death figures that would explain the low infection and death rates.

“That doesn’t fully explain it, because we would see healthcare systems being overwhelmed if there truly was an outbreak occurring,” Shaun Truelove, an assistant scientist and modelling expert at the Johns Hopkins Bloomberg School of Public Health, explained.

“We are learning every day,” Dr Moeti said in the briefing, as the WHO vows to continue to support countries to scale up their coronavirus public health response, particularly in high-risk locations.🔷

J.N. PAQUET, Editor of PMP Magazine, Author & Journalist.

[This piece was first published in PMP Magazine on 1 October 2020. | The author writes in a personal capacity.]

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