The mystery behind low Covid-19 cases in Africa

Medics check temperatures of Kibera residents in Nairobi, Kenya. [AFP]

The first African coronavirus case was confirmed in Egypt. 11 days later, the first case in sub-Saharan Africa was recorded in Nigeria after an Italian man who had travelled to the West African country tested positive.

Since then, Africa’s curve of infections has exhibited an abnormal pattern compared to other countries such as the United States which had its first case on January 15 and by the beginning of March, only 70 cases had been reported with scanty testing being done at the time. More than 1,000 deaths have been reported in the global superpower with other days recording more than 2,000. The country now has the 644,188 confirmed cases and 28, 579 deaths, the highest in the world.

However, this is not the picture painted in Africa which had its first case just one day before the United States and up to now has a total of 17,827 cases and 913 deaths from the virus. The figures show an average of 34 times less impact of the virus in Africa than the United States both in the number of infections and deaths.

African currently has a total of 17,827 Covid-19 cases (0.863 per cent of global deaths) and 913 deaths (0.66 per cent of global deaths) from the virus. South Africa topping the list of most affected in the continent with a total of 2,506 cases (14 per cent of the total cases in the continent) and 34 deaths from the time the first case was reported on March 5. However, Algeria- one of the first Saharan countries to report Covid-19 case has the highest number of deaths from the virus; 336 people, 37 per cent of the total deaths in the continent and only 0.24 per cent of the global deaths.

Even though the social-economic impacts of Covid-19 in Africa have far exceeded the harsher and more brutal strike of the virus witnessed in other places of the world, many experts see the continent as a ticking time bomb on the assumption that the number of infections are not a true reflection of the real situation.

Health experts also predict that the continent is also likely to be the hardest hit due to the poor healthcare infrastructure, high population density in crowded informal settlements, a population disproportionately affected by HIV/AIDs, tuberculosis and other infectious diseases which increase the likelihood of succumbing to covid-19.

Why the low numbers in Africa?

The short answer would be low testing numbers. The continent has had little capacity at the beginning of the pandemic and thus limited resources in terms of testing kits to aid in the testing. For a country like Kenya, the early days following March 13 when the first virus was reported saw samples being sent to South African for testing. Even though the countries currently have the capacity to test, that capacity is still limited.

At the moment, the unofficial number of tests done in African are below half a million in a continent of 1.3 billion people. South Africa has carried out 90,515 tests as of today followed by Ghana having done 50,719 tests, Egypt 25,000 tests, Tunisia 13,137 tests, Morocco 10,392 tests while the other countries fall under the ten thousand mark of testing.

The capacity difference in testing is visible when the numbers in Africa are contrasted with that of the United States which has carried out a total of 3,261,611; 7 times higher than the entire continent.

Speaking with CNN journalist Poppy Harlow on April 11, Mellissa Gates, wife of Microsoft CEO Bill Gates said that “part of the reason you’re seeing the case numbers still don’t look very bad is because they (Africa) don’t have access to very many tests.”

Even though the numbers are low, new evidence suggests that the virus is no longer coming from individuals travelling from abroad but is currently spreading among the local population. In Kenya, Health Cabinet Secretary Mutahi Kagwe reported on April 15 that the nine new coronavirus infections were transmitted locally.

“In the last 24 hours, we have tested 803 samples. All of the nine positive cases are Kenyan nationals. Five of the cases are from Nairobi and four are from Mombasa and they are aged between nine and 69 years,” Kagwe said during his daily briefing at Afya house in Nairobi.

It is the age factor that gives Africa a significant edge when it comes to surviving Covid-19. African has a median age of 20 compared to 47 of Italy. This means that half of Africa's population is under 20 years and the other half over the same. According to the United Nations Department of economic and social affairs, by 2015, there were 46 million people in Africa aged between 60 and above, a number that was only 3.89 per cent of the continent’s population at that time.

Though Covid-19 affects people of all ages, evidence has shown that those greatly affected and even die from the virus have underlying health conditions- a group mainly made up of the old population. Even though this is not entirely good news, this information shows the prospects that Africa may survive the lethal claws of death of Covid-19 in the event of a full-blown pandemic.

Quick response

Ten days after the first case was reported in South Africa, the country went into a nationwide lockdown. It is this quick response that has abruptly flattened the curve of infections leading to a steady number of infections about 70 new cases a day.

The same swift action was witnessed in Rwanda which put in place a nationwide lockdown 6 days after the first case was reported on March 14.

In Kenya, hand washing, social distancing and wearing of masks has been made mandatory from offices to public places and public vehicles. 33 days after the first case, the county has recorded only 225 cases and 10 deaths from Covid-19.

Such has been actions taken in most African countries immediately the first cases were reported. Africa has recorded 3,862 recoveries, a good sign that Health Cabinet Secretary Mutahi Kagwe has warned should not make people complacent in following the protective guidelines outlined by the authorities.

Even though the real reason for the low infection numbers in African is yet to be known, most of the counties want to keep it that way.

For a continent battling economic difficulty, poverty, a recent locust invasion in East Africa, resurrection of Ebola in the Congo, incessant conflict in Libya and a newly declared yellow fever outbreak in South Sudan, Africa is standing at a precipice with its fingers crossed.