While coronavirus has swept across the globe leaving devastating impacts, Africa has survived surprisingly well, having just hit 1.3 million confirmed cases and about 33,231 deaths. Healthcare experts and policymakers alike feared the worst for this continent, making these results especially puzzling. The community infrastructure and medical predispositions of African populations may clue in outside policymakers to their success.
The living conditions of Africa’s urban communities immediately concerned health experts during the initial global outbreak. With social distancing – highlighted as the best preventative measure against COVID-19 transmission – next to impossible in crowded housing and communal areas in Africa, massive outbreaks seemed inevitable. Countries in Africa also appeared unprepared for lockdown, with only 4 of the 34 surveyed countries partially ready to quarantine. Professor Shabir Madhi, the top virologist of South Africa, echoed the fears of quickly overwhelmed hospitals even in the continent’s most medically developed country.
But that was not the case.
Most African countries were able to flatten their curves, and the continent as a whole has avoided a peak in cases and deaths. In September, South Africa boasted a COVID-19 death rate at about a seventh of Great Britain’s. The rest of the continent appears to mirror South Africa’s flattened curve and low death rate.
Experts have a few possible explanations for the unusually low infection and death rates. The first is an overall lack of testing and death reporting. By the beginning of August, Nigeria had tested less than 1% of its population, following the rest of the continent in its failure to meet the global benchmark of 10%. The issues preventing adequate testing are twofold. The primary restraint is the sparsity of testing resources. At the beginning of the pandemic, only two labs in Senegal and South Africa were able to test for the novel virus. With minimal and distant resources, widespread testing has been inaccessible to the majority of the continent. The second barrier to testing is political dissent with state governments, such as Tanzania, refusing to release data that would undermine federal hegemony. However, of the 400 randomly tested individuals in Nairobi in April, only 3 tested positive. Grassroots groups hold this as evidence against suggestions of gross under testing, suggesting that Africa simply has far fewer cases than expected. While this is only one city, experts like Kennedy Odede believe its results are reflected across the continent. Additionally, African death statistics have remained within the norm, indicating few hidden deaths. It is highly unlikely that limited testing could be the sole cause of Africa’s appearance of success against COVID-19.
Another possible reason for Africa’s success against the virus is its young population. Developing countries frequently see fewer people survive into old age due to insufficient healthcare and poor living conditions. Considering the virus has proven to be far more deadly to elderly populations, other parts of the world would likely suffer far more fatalities while Africa’s numbers stay low. Poorer countries within Africa with younger populations offset their underdeveloped medical systems with far lower hospitalization rates than richer African countries, such as Egypt and South Africa. However, Professor Salim Karim of South Africa’s coronavirus response team challenges this theory arguing, “age is not such a big factor.” Instead, the quick and effective lockdowns implemented in many African countries may have averted disaster. Countries like Uganda implemented strict lockdowns quickly, giving the government and health systems time to prepare. Like the quick responses in Asia, African countries could promptly and effectively address outbreak threats due to their past experience with highly contagious diseases. Quick travel bans, closure of businesses, curfews, and bans on large gatherings became the rule in Uganda in time to prevent a massive spike in cases, unlike countries unprepared for life in a pandemic.
In the balancing of “lives versus livelihoods,” African countries like Uganda aggressively favored lives, sometimes through military enforcement. South Africa also deployed more than 70,000 troops to enforce the lockdowns. This domestic deployment is the largest in South Africa’s democratic history, and draws fears of the formation of a military state. These actions harm impoverished communities far more: both directly through harassment and brutality, and through the greater strain lockdown procedures place onto poor families. These steps are aggressive, and often value coronavirus protection over personal freedoms, but they appear to be effective against COVID-19. This approach, while extreme, may have allowed for a prompt return to regular life, while countries with marginal restrictions – like the United States – are stuck with increasing numbers of confirmed cases and rising death tolls.
An incredibly important aspect of Africa’s success is a community mindset. This value system is absent from many outside countries, where individual freedom is valued above public health or the common good. Instead, public prioritization allows for the effective implementation of protocols including lockdown, testing, and even mask-wearing.
While the low numbers of cases and deaths in Africa could be attributed to misinformed data and demographic differences, the quick implementation of strict shutdowns and the prioritization of public health has played a significant role in preventing catastrophe. While the extremity of these measures would see serious pushback in the United States, elements of African covid policies – including total lockdowns and increased prioritization of public health – could benefit the United States far beyond our current lackadaisical approach.
One reply on “Prepared for the Worst: The Surprising Sparsity of COVID-19 in Africa”
This is a fascinating article with good news. Natalie Brown considers carefully so many important factors, and is convincing that the community mindset / a willingness to prioritize public health has to be seen as pivotal. That may be traced to Africa’s historic Bantu tradition of community decision-making and shared resources. Certainly couldn’t hurt. Also, the people of Africa are more keenly aware of viruses’ threats due to the ongoing, devastating experience with HIV and recent Ebola epidemics.