Covid may have shaken Africa harder than statistics suggest
It’s one of the enduring mysteries of Covid-19: why didn’t the pandemic hit low-income African nations as hard as wealthy countries in North America and Europe?
There is no simple answer. But this week, two new studies added to our understanding.
One of the studies suggested that the number of Covid-19 cases may be vastly undercounted across the continent. The other study found good evidence that the number of deaths in at least one country could be significantly undercounted.
They could have a big impact on the debate about how and why African nations were forgotten by wealthy nations during the pandemic – especially as the European Union and the African Union are meeting at a joint summit in Brussels, and the World Health Organisation pushes for wealthy nations to back a South African facility that aims to share mRNA technology.
‘‘In Africa, 83 per cent of people still have not received a single dose,’’ WHO Director-General Tedros Adhanom Ghebreyesus said this week at a Vaccine Equity for Africa event in Germany. ‘‘This is not only a moral failure, it is also an epidemiological failure, which is creating the ideal conditions for new variants to emerge.’’
A report in December 2020 said Africa ‘‘appears to have bucked the doomsday predictions of global health experts’’. Even after the fastspreading Omicron variant was first identified in southern Africa late last year, that trend has largely held up.
One-fifth of the world’s population lives in Africa, but the continent has accounted for only a tiny sliver of confirmed Covid-19 cases.
According to Our World in Data, as of mid-February, 2.7 per cent of all confirmed cases were found in Africa. By comparison, North America saw 22 per cent of all global cases, and Europe more than a third.
But reliable public tracking of new daily Covid-19 cases rests on something important: easy access to coronavirus tests and the expensive infrastructure to administer and track their results. Throughout the pandemic, many African nations have had neither.
In a study released this week, a team of researchers with WHO backing tried to tackle that problem by looking at available data about people with Covid-19 antibodies across the continent.
These studies, known as seroprevalence surveys, use bloodwork to show who has some level of immunity to the coronavirus – whether through vaccinations or a previous infection.
The study found that levels of immunity in Africa appeared to be vastly higher than could be explained by official case numbers, even when combined with the continent’s paltry vaccination levels.
Every nation surveyed had far higher levels of immunity than official figures showed – Nigeria had a ratio of 958 to 1.
By September 2021, over 65 per cent of the continent had some form of immunity to Covid-19, the study estimates. This, the authors write, suggests there had not been 8.2 million cases across the continent by that time, but 800 million.
One possibility, raised by the WHO-backed study, is that many of the cases in Africa may have been asymptomatic – perhaps more than two-thirds.
Compared with Europe and North America, most African countries have relatively young populations that are less likely to see serious illness from the coronavirus.
The comparatively low number of deaths recorded from Covid-19 across the continent seems to support this idea. Just 4 per cent of deaths globally were recorded in Africa, according to Our World in Data.
Most African nations do not collect the data needed to estimate excess mortality. But a small and innovative study released by the World Bank this week used an unusual method to estimate pandemic deaths in Kenya: a popular obituary website. The conclusion was that since the start of the pandemic, there have been roughly 28,000 ‘‘excess deaths’’ during the pandemic period, compared with just 5520 recorded in official government figures.
When excess deaths are evaluated on a global scale, the vast majority of them may have been in the developing world. Africa wasn’t miraculously spared from the pandemic, and there’s little reason to think it could not be hit far harder next time.