The COVID-19 Crisis in Africa

The coronavirus pandemic swept across the world at an alarming pace in 2020. With modern cross-border air travel, what started as a frightening, highly transmissible virus in Wuhan, China, soon reached other parts of the globe. While cases and fatalities continue to spike in the Americas and Europe, it becomes surprising that the African continent, despite its relatively poor health infrastructure compared to the rest of the world, has a much lower fatality rate.

The African continent is home to 17 percent of the world’s total population, yet it only accounts for 4 percent of COVID-19 cases worldwide. (1) The case-fatality ratio (CFR) is also much lower than the global CFR, with 69,960 deaths among 2,929,778 cases as of January 6, 2021. (2) This unexpected outcome has sparked much interest among experts to understand why the impact of COVID-19 on Africa is not as great as predicted.

Some experts cite undercounting as a possible reason behind Africa’s relatively lower numbers. Dr Matshidiso Moeti from the World Health Organization remarked that the testing level in Africa is still comparatively lower than other continents. (3) Thus, it might be the case that there are missed cases due to the limited testing capabilities in Africa. However, Dr John Nkengasong, the head of Africa Centers for Disease Control and Prevention (Africa CDC), asserted that even though the number of diagnosed cases might be inaccurate, there is no clear indication that the number of COVID-19 related deaths are not accounted for. (4) This shows that statistical results of the number of COVID-19 deaths can be considered reliable, and there are other reasons that have led to Africa’s lower fatality rates.

One of these reasons include that of quick human intervention. When the first COVID-19 case was confirmed in Egypt in February last year, countries across Africa immediately took action. Public health measures such as social distancing and mask-wearing were imposed. The public closely adhered to the new rules, as shown from a survey conducted by PERC on 18 African countries. Approximately 85% of the survey respondents claimed to have been wearing masks in public, reflecting sufficient public support for government intervention to prevent the spread of COVID-19. (5)

In addition, Africa’s population is considerably young, with a median age of 19 years. (6) Scientific research has proven that severe COVID-19 affects the old more than the young, so mortality rates from COVID-19 are much higher in places in Europe and Asia where older people reside. Africa, as a result, with only 3% of its population over the age of 65, has lower fatality rates from COVID-19. (7) People with obesity or Type 2 diabetes are also more susceptible to having severe COVID-19, but such illnesses are less common in Africa. (8) These reasons thus account for Africa’s comparatively fewer deaths.

Despite the lower COVID-19 mortality rates in Africa, it is unwise for the continent to let down its guard. In South Africa, a second wave of infections was reported late last year. Those diagnosed are mostly between 15 and 19 years old. It is believed that the spike in numbers is due to large gatherings held to celebrate the end of exams. (9) In Nigeria, Egypt, Uganda and DR Congo, daily infections are also on the rise. (10) This shows that the pandemic is far from over, and more should be done to flatten the curve.

It is also concerning that there is a new variant strain that has emerged in South Africa. Similar to the one in the United Kingdom, this variant, named 501Y.V2, is more transmissible. The mutation to the spike protein that the virus uses to gain entry into cells in the South African strain might reduce the effect of antibody drugs. (11) Furthermore, while there is no evidence pointing to how the 501Y.V2 might reduce immunity provided by current COVID-19 vaccines, experts warn that further mutations to the coronavirus might pose a threat to the effectiveness of vaccines. (12)

There are a multitude of reasons behind Africa’s relatively better control of the COVID-19 pandemic. However, given that the virus continues to mutate and fatigue from adhering to lockdowns and other social distancing measures gradually increases, vigilance remains necessary.