Scientists puzzled and wary as Africa avoids COVID catastrophe
Harar At a crowded market in a poor town outside Harare this week, Nyasha Ndo kept his mask in his pocket as hundreds of people, mostly unmasked, flocked to buy and sell fruit and vegetables displayed on wooden tables and plastic sheets. As in most parts of Zimbabwe, here the coronavirus is quickly receding into the past, with political rallies, concerts and home gatherings returning.
“COVID-19 is gone, when did you last hear about anyone who died of COVID-19?” Nadu said. “The mask is to protect my pocket,” he said. “The police demand bribes so I lose money if I don’t move with a mask.” Earlier this week, Zimbabwe recorded 33 new cases of COVID-19 and zero deaths, in line with the recent decline in the disease across the continent, as WHO data shows infections have fallen since July.
When the coronavirus first emerged last year, health officials feared the epidemic could spread across Africa, killing millions. Although it remains unclear what the final outcome of COVID-19 will be, this catastrophic scenario has yet to materialize in Zimbabwe or in much of the continent.
Scientists stress that getting accurate COVID-19 data, especially in African countries with incomplete monitoring, is very difficult, and they warn that the coronavirus’ downward trends could easily be reversed.
Wafa Al-Sadr, chair of global health at Columbia University, said there is something “mysterious” going on in Africa that baffles scientists. “Africa doesn’t have the vaccines and resources available in Europe and the United States to fight COVID-19, but somehow they seem to work better,” she said.
Less than 6% of people in Africa are vaccinated. For months, the World Health Organization described Africa as “one of the least affected regions in the world” in its weekly reports on epidemics.
Some researchers say that the continent’s younger population – average age 20 versus about 43 in Western Europe – combined with lower rates of urbanization and their penchant for spending time outdoors, may have spared it the deadly effects of the virus so far. Several studies are looking into the possibility of other explanations, including genetic causes or exposure to other diseases.
Authorities are accustomed to curbing outbreaks even without vaccines, said Christian Happe, director of the African Center for Excellence in Infectious Disease Genomics at Redeemer University in Nigeria, crediting the extensive networks of community health workers.
“It’s not always about how much money you have or how advanced your hospitals are,” he said.
Devi Sridhar, head of global public health at the University of Edinburgh, said African leaders were not getting the credit they deserve for acting quickly, citing Mali’s decision to close its borders before COVID-19 arrived.
“I think there is a different cultural approach in Africa, these countries have treated COVID with a sense of humility because they have faced things like Ebola, polio and malaria,” Sridhar said.
In the past months, the coronavirus has hit South Africa and is estimated to have killed more than 89,000 people there, by far the highest death toll on the continent. But for now, African authorities, while acknowledging the potential for gaps, are not reporting huge numbers of unexpected deaths that may be linked to COVID. World Health Organization data shows that deaths in Africa make up only 3% of the global total. By comparison, deaths in the Americas and Europe account for 46% and 29%.
In Nigeria, Africa’s most populous country, the government has recorded nearly 3,000 deaths so far among its 200 million people. The United States records that many deaths every two or three days.
Those low numbers put Nigerians like Obemibo Ari, 23, in Abuja, at ease. “They said there would be bodies in the streets and all that, but nothing like that happened,” she said.
Owewell Tomori, a Nigerian virologist who sits on several WHO advisory groups, has suggested that Africa may not even need as many vaccines as the West. It’s an idea, though controversial, which he says is being seriously discussed among African scientists – and is reminiscent of a proposal made by British officials last March to allow COVID-19 to freely infect the population to build immunity.
But this does not mean that vaccines are not necessary in Africa.
“We need to vaccinate everything to prepare for the next wave,” said Salem Abdulkarim, an epidemiologist at the University of KwaZulu-Natal in South Africa, who has previously advised the South African government on COVID-19. “Given what’s happening in Europe, the likelihood of more cases spreading here is very high.”
The impact of the coronavirus has also been relatively mild in poor countries such as Afghanistan, where experts have predicted that an outbreak amid ongoing conflict would be catastrophic.
Hashmat Arifi, a 23-year-old student in Kabul, said he had not seen anyone wearing a mask in months, including at a recent wedding he attended with hundreds of guests. In his college classes, more than 20 students routinely sit unmasked in close quarters.
“I haven’t seen any cases of corona recently,” Al-Arifi said. So far, Afghanistan has recorded about 7,200 deaths among its 39 million people, although few tests have been conducted amid the conflict and the actual numbers of cases and deaths are unknown.
Back in Zimbabwe, doctors were grateful for the relief from COVID-19 – but feared it was only temporary.
“People must remain very vigilant,” warned Dr Johannes Marissa, president of the Zimbabwe Association of Physicians and Private Practitioners. He fears another wave of coronavirus will hit Zimbabwe next month. “Complacency is what’s going to destroy us because we might be surprised by that.”
Cheng reported from London. Rahim Faiz from Islamabad, Pakistan, and Shinido Asado in Lagos contributed to this report.
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