Eighty-three thousand to 190 000 people in Africa could die of COVID-19 and 29 million to 44 million could get infected in the first year of the pandemic if containment measures fail, a new study by the World Health Organisation (WHO) Regional Office for Africa finds. The research, which is based on prediction modelling, looks at 47 countries in the WHO African Region with a total population of one billion, and will appear as a peer-reviewed article in BMJ Global Health.
The new estimates are based on modifying the risk of transmission and disease severity by variables specific to each country in order to adjust for the unique nature of the region. The model predicts the observed slower rate of transmission, lower age of people with severe disease and lower mortality rates compared to what is seen in the most affected countries in the rest of the world. This is largely driven by social and environmental factors slowing the transmission, and a younger population that has benefitted from the control of communicable diseases such as HIV and tuberculosis to reduce possible vulnerabilities.
The lower rate of transmission, however, suggests a more prolonged outbreak over a few years, according to the study which also revealed that smaller African countries alongside Algeria, South Africa and Cameroon were at a high risk if containment measures are not prioritized.
Containment measures, which include contact tracing, isolation, improved personal hygiene practices and physical distancing aim to slow down the transmission of the virus so its effects happen at a rate manageable by the health system. Physical distancing is not about the confinement of people but rather avoiding unnecessary contacts as people live, work and socialize as a means to interrupt transmission.
“While COVID-19 likely won’t spread as exponentially in Africa as it has elsewhere in the world, it likely will smoulder in transmission hotspots,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa. “COVID-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region. We need to test, trace, isolate and treat.”
The predicted number of cases that would require hospitalization would overwhelm the available medical capacity in much of Africa. There would be an estimated 3.6 million–5.5 million COVID-19 hospitalizations, of which 82 000–167 000 would be severe cases requiring oxygen, and 52 000–107 000 would be critical cases requiring breathing support. Such a huge number of patients in hospitals would severely strain the health capacities of countries.
A survey of health services in the African region undertaken in March 2020 based on self-reports by 47 countries to WHO revealed that there were on average nine intensive care unit beds per one million people. These would be woefully inadequate. Additionally, the physical access to these services to the general population is very low, suggesting many people would not even have the chance to get to the needed care. Diseases that could be managed could easily become more complicated as a result.
The study recommends that countries across Africa need to expand the capacity particularly of primary hospitals and ensure that basic emergency care is included in primary health systems.
“The importance of promoting effective containment measures is ever more crucial, as sustained and widespread transmission of the virus could severely overwhelm our health systems,” said Dr Moeti. “Curbing a largescale outbreak is far costlier than the ongoing preventive measures governments are undertaking to contain the spread of the virus.”
All countries in the WHO African Region are using these results through the WHO country offices to inform their containment actions. The detailed methods and results are currently in press at the British Medical Journal-Global Health after extensive peer review and validation.
Two months after the first coronavirus case was reported in Africa, the dire warnings that the continent was destined to be ravaged by the virus appear to be ringing hollow. After all, the virus appears to be spreading far slower than COVID-19 hotspots around the world. So far, the confirmed case and death rates are significantly lower than most continents around the world. And with more than 21,000 recoveries, there are indications that Africa is more resistant to the deadly microbe than other continents.
The Africa Report questions whether this is simply because the disease arrived later on the continent and, as a South African study which projects the disease’s peak to come in September suggests, the worst is still ahead.
The Ivory Coast on Friday lifted many of its coronavirus containment measures, except in economic capital Abidjan, which has the vast majority of the country's cases. And a report on the News24 site notes that jubilant citizens feted the return of the country's vibrant nightlife.
The West African nation acted swiftly in enacting restrictions against the pandemic six weeks ago, and it has so far recorded only 20 deaths. “No positive case has been detected in the interior of the country since 21 April,” said President Alassane Ouattara who lifted all restrictions and curfews at schools, restaurants, bars and concert venues.
Hundreds of Lesotho citizens are making dangerous border crossings daily from South Africa to return home. All South African borders remain in line with level four COVID-19 regulations except for trade and medical travel.
A report on the EWN site notes that Lesotho has not started local testing, but a lockdown that was imposed in April has been partially lifted to allow all trade and government services for limited hours. Citizens who were stranded in South Africa walk through rivers or use inflatable mattresses.
Prime Minister Tom Thabane has beefed up army deployments on the borders to screen people for COVID-19.
Tanzanian President John Magufuli has addressed the country’s coronavirus testing protocols, citing possible interference by unnamed western powers. Magufuli last week revealed that he secretly commissioned the testing of random non-human samples and the results were inconclusive. The Health Ministry has formed a committee to investigate the conduct of the laboratory and will submit the results by 13 May.
CapitalFM reports that Magufuli downplayed the severity of the pandemic, saying it can be managed without disrupting the country’s economy. “Let’s continue working. Factories must continue to produce products. I have said it before and I will repeat it…. I will not place Dar es Salaam under lockdown,” he asserted. Tanzania’s approach to fighting coronavirus has been heavily criticised.
In Nigeria, the authorities have demolished two hotels in Rivers State for allegedly flouting COVID-19 restrictions. Governor Nyesom Wike recently issued an order banning hotels from opening their doors. The Premium Times reports that the Prudent Hotel and Etemeteh Hotel were gutted.
“Government has no alternative but to apply the executive order which I signed before the lockdown,” Wilke said. He explained why the state government is focusing on hotels in its fight against the coronavirus. “Look at the rate of infections…most of these people are found in hotels,” he said.
Sex workers in Zambia are helping to trace people who have contracted coronavirus after a surge in new infections at the border town of Nakonde. Health Minister Chitalu Chilufya said 76 of 85 reported new cases in the northern town were either sex workers or truck drivers.
“Sex workers have been very co-operative and they are giving us all the leads we want,” Chilufya said. BBC News reports that Zambia has confirmed 267 COVID-19 infections, with seven deaths.
President Edgar Lungu has announced the reopening of restaurants, casinos and gyms after a month-long shutdown to enforce social distancing measures.
Burundi has told the East African Community (EAC) that any observers sent to monitor its general elections will have to be quarantined for 14 days on arrival. The elections are only nine days away and the order effectively bars observers from scrutinising the voting process.
BBC News reports that the government has proposed that EAC staff who are already in the country take up the role of observers. The country has also declined to allow UN and civil society observers to monitor the elections.
[link url="https://www.afro.who.int/news/new-who-estimates-190-000-people-could-die-covid-19-africa-if-not-controlled"]Full WHO statement[/link]
[link url="https://www.theafricareport.com/27470/coronavirus-unpacking-the-theories-behind-africas-low-infection-rate/"]Full article in The Africa Report[/link]
[link url="https://africanarguments.org/2020/05/13/coronavirus-in-africa-tracker-how-many-cases-and-where-latest/"]Coronavirus in Africa Tracker[/link]
[link url="https://www.news24.com/Africa/News/ivorians-ready-to-rock-as-virus-measures-lifted-20200508"]Full report on the News24 site[/link]
[link url="https://ewn.co.za/2020/05/10/lesotho-citizens-stuck-in-sa-resort-to-dangerous-border-crossings-to-get-home"]Full report on the EWN site[/link]
[link url="https://www.capitalfm.co.ke/news/2020/05/magufuli-orders-probe-on-tanzanias-influenza-laboratory-citing-questionable-covid-19-results/"]Full CapitalFM report[/link]
[link url="https://allafrica.com/stories/202005110071.html"]Full Premium Times report[/link]
[link url="https://www.bbc.com/news/world-africa-52604961"]Full BBC News report[/link]
[link url="https://www.bbc.com/news/live/world-africa-47639452"]Full BBC News report[/link]