On a world map of the distribution of COVID-19 cases, the situation looks pretty optimistic for Africa. While parts of Europe, Asia and the United States are shaded by dark colors that implicate a higher infection rate, most African countries appear faint. This has created uncertainty over whether or not the impact of COVID-19 in Africa is as severe as other continents.

Lack of Testing

A closer look at the areas wearing light shades reveals that their situation is just as obscure as the faded shades that color them. Dark spots indicate more infections in places like the U.S. However, in Africa these are usually just cities and urban locations, often the only places where testing is available.

Although insufficient testing has been a problem for countries all over the world, testing numbers are much lower in Africa. The U.S carries out 205 per 100,000 people a day. Nigeria, the most populous country, carries one test per 100,000 people every day. While 8.87% of tests come back positive in the U.S, 15.69% are positive in Nigeria (as of Aug. 4, 2020). Nigeria was one of 10 countries that carried out 80% of the total number of tests in Africa.

As a continent that accounts for 1.2 billion of the world’s population, the impact of COVID-19 in Africa is even more difficult to measure without additional testing. To improve this, the African CDC has set a goal of increasing testing by 1% per month. Realizing the impossibility of reliable testing, countries like Uganda have managed to slow the spread by imposing strict lockdown measures. As a result, the percentage of positive cases in Uganda was only 0.82% (as of Aug. 4, 2020).

A Resistant Population

COVID-19 in Africa has had a lower fatality rate than any other continent. Fatality rates may even be lower than reported. Immunologists in Malawi found that 12% of asymptomatic healthcare workers were infected by the virus at some point. The researchers compared their data with other countries and estimated that death rates were eight times lower than expected.

The most likely reason for the low fatality rate is the young population. Only 3% of Africans are above 65 compared with 6% in South Asia and 17% in Europe. Researchers are investigating other explanations such as the possible immunity to variations of the SARS-CoV-2 virus as well as higher vitamin D in Africans with more sunlight exposure.

Weak Healthcare Systems

Despite these factors, the impact of COVID-19 in Africa is likely high. Under-reporting and under-equipped hospitals contribute to unreliable figures. Most hospitals are not prepared to handle a surge in cases. In South Sudan, there were only four ventilators and 24 ICU beds for a population of 12 million. Accounting for 23% of the world’s diseases and only 1% of global public health expenditure, Africa’s healthcare system was already strained.

Healthcare workers have the most risk of infection in every country. In Africa, the shortage of masks, equipment and capacity increases the infection rate further amongst healthcare workers. Africa also has the lowest physician to patient ratios in the world. As it can take weeks to recover from COVID-19, the recovery of healthcare workers means less are available to work.

Additionally, those that are at-risk and uninsured can rarely afford life-saving treatment in Africa. For example, a drug called remdesivir showed promising results in treating COVID-19. However, the cost of treatment with remdesivir is $3,120 – an unmanageable price for the majority of Africans. These factors will determine the severity of COVID-19 in Africa.

Economic and Psychological Factors

Strict lockdowns have helped some nations in controlling the spread of COVID-19 in Africa but at a very great price.

Lack of technology often means that all students stop learning and many lose their jobs. More than three million South Africans have become unemployed due to the lockdown. The lockdowns have also resulted in much higher rates of domestic violence, abuse and child marriage. Many such cases go unreported and mental health services for victims or those struggling through the pandemic are unavailable. In Kenya, the U.N. has appealed for $4 million to support those affected by gender-based violence.

The slow spread of COVID-19 in Africa has allowed the continent and leaders to prepare, and the young population will lessen the impact. Although there’s reason to be hopeful, there’s no doubt that there will be an impact on Africa’s economy and future. This calls for the need of foreign assistance – not only in controlling COVID-19 in Africa but in the recovery of the continent for years to come.

– Beti Sharew
Photo: Flickr