When Covid appeared in 2020, I feared that poorer countries that had widespread unsanitary living conditions and healthcare systems that lacked the capacity and technology to handle large increases in the number of seriously ill people would fare poorly compared to wealthy nations that benefit from vast resources, sophisticated healthcare systems, and cutting-edge therapeutics and technology. In Africa, and a few other places, it appears that the opposite is happening.
Two weeks ago I saw the map below in a newsletter titled “Covid State of Affairs: July 7”. The publication was written by Dr. Katelyn Jetelina, MPH PhD, an assistant professor of epidemiology and biostatistics. The alarming surge in Covid infections in many countries is being driven by a new SARS-CoV-2 strain called BA.4/5.
The latest Covid wave is not the part of the picture that was a bit shocking. On the whole, it appears that African nations continue to do much better with the virus than countries that are much wealthier and are better positioned to combat this disease.
Compare this chart from the Bloomberg Vaccine Tracker, a source I’ve used in prior posts, to the chart above.
Many African countries lag far behind more developed countries in vaccine distribution but are doing much better in Covid infections, illness and deaths. The number of reported infections could be substantially higher than the number of actual cases. That is true everywhere. One study said that a survey of blood donations in Malawi showed that 80% of the population had been infected.
But there is little doubt that Africa has escaped the catastrophe many feared. An ABC News article published in November 2021 states in part:
But there is something “mysterious” going on in Africa that is puzzling scientists, said Wafaa El-Sadr, chair of global health at Columbia University. “Africa doesn’t have the vaccines and the resources to fight COVID-19 that they have in Europe and the U.S., but somehow they seem to be doing better,” she said.
Fewer than 6% of people in Africa are vaccinated. For months, the WHO has described Africa as “one of the least affected regions in the world” in its weekly pandemic reports.
Some researchers say the continent’s younger population — the average age is 20 versus about 43 in Western Europe — in addition to their lower rates of urbanization and tendency to spend time outdoors, may have spared it the more lethal effects of the virus so far. Several studies are probing whether there might be other explanations, including genetic reasons or past infection with parasitic diseases.
Who would have thought that malaria might offer protection from Covid? There could be other cause, too. One article by Richard Wamai, associate professor of cultures, societies, and global studies at Northeastern University notes that while African countries lag wealthier countries as far as money spent on healthcare and widespread access to the latest technology and therapeutics, experience with previous pandemics such as HIV/Aids, Ebola led to mastering public health measures that have been used to deal with Covid-19, including isolating the infected, tracing their contacts and then getting them quarantined while they get tested.
Also there are few nursing or assisted living homes where Covid spread with deadly effect in the West, and African countries tended to take the Covid threat seriously from the outset.
When I was in Kenya in May 2022, except for a few places I visited such as some hotels and airports, it was almost impossible to tell the world was in the midst of a lethal pandemic. Almost no one wore masks. Another factor I’d point to as helping to reduce the spread of Covid is that in Kenya at least, almost all of the restaurants we ate at were open air even if they were covered.
I think the difference between the expected outcome and the reality needs further study. Are there any other reasons you can think of for Africa’s relatively successful results?