Why Africa is showing signs of becoming the next covid-19 epicenter
With healthcare systems on the brink of collapse,an unprecedented humanitarian crisis may be unfolding on the continent.
There is currently an estimated total number of covid-19 cases on the African continent that is slightly more than the US state of California (as of 27 January 2021). Data from the Johns Hopkins University however shows that, if the situation is left unchanged, Africa is on a gradual but steady path of becoming the pandemic’s next epicenter.
Steep increases in cases
Six African countries - Egypt, Lesotho, Malawi, Nigeria, Uganda and Tanzania - have witnessed steep increases in active cases since the start of the year, prompting - in the case of Nigeria - the head of the Nigerian CDC to observe that the country was reaching a “critical level” that threatens to overwhelm the capacity of hospitals in the country.
Testing
Testing is the window to understanding the spread of the pandemic. Unfortunately, the data shows that testing rates on the continent are very low. Of the 20 African countries that the Johns Hopkins University has testing data on; the countries testing the most (South Africa, Namibia and Zambia) are only testing 2 people per thousand.
The rest are testing even less. For example, Ghana, Ivory Coast, Malawi and Senegal are testing an estimated 1 person per 7,000 while countries like DRC and Madagascar are estimated to be doing even worse - testing an estimated 1 person per 100,000.
Importantly, while the WHO recommends a positive rate - the share of covid-19 tests that are positive - of 5% or lower for at least 14 days as an indicator that a country has the pandemic under control, only 2 (Kenya and South Sudan) of the 20 African countries have positive rates lower than that threshold.
The rest all have positive rates over 10 percent, with Malawi registering the highest (34 percent). Put simply, the actual number of confirmed cases across the continent is significantly higher than suggested by the number of confirmed cases.
Mortality rates
Covid-19 mortality rates, among other indicators, reflect the burden of the virus on society. Thirty-eight percent (or 19 countries) of the 50 countries with the highest covid-19 crude mortality rates are from Africa with five countries (Sudan, Egypt, Liberia, Mali and Tanzania) registering mortality rates over 4 percent (See Table below).
The burden of death due to the virus on a country can be extrapolated by examining the time it takes for death numbers to double. The quicker it takes for deaths to double, the harsher the negative effects of the virus on a country.
According to Johns Hopkins University data, it took less than 21 days for covid-19 deaths to double in 5 African countries - Malawi, Botswana, Comoros Islands, Lesotho and Zimbabwe placing them among the top 5 countries globally where covid-19 deaths doubled the quickest.
Where are the hot-spots?
John Hopkins University data suggests that because of their high positive rates (See Map 1 above); DRC, Madagascar, Malawi, Mozambique, Namibia, Nigeria, Senegal, South Africa, Zambia and Zimbabwe are the hot-spots. Overall, the data strongly suggests that countries closest to South Africa are most vulnerable to the spread of the virus.
Malawi the most vulnerable
Among these countries, Malawi seems the most vulnerable. Registering an average of 548 new cases a day since the start of the new year, Malawi had one of the steepest increases in confirmed cases since the start of the year.
Additionally, the country has the highest positive rate on the continent and the third highest positive rate worldwide — only Mexico (39%) and Bolivia (36%) have higher positive rates.
What makes Malawi particularly vulnerable is the pace at which covid-19 deaths are happening. Covid-19 deaths are estimated to have taken just 11 days to double in Malawi making it the country where deaths doubled fastest globally.
A combination of rapidly increasing confirmed cases, the 3rd highest positive rate globally and the fastest rate of doubling of deaths globally; have thus conspired leaving Malawi well placed to be the next covid-19 epicenter.
Worsening the situation is the state of healthcare in the country. With an estimated 53,000 people per healthcare worker, the WHO ranks Malawi as having one of the ‘severest’ healthcare worker shortage in Sub-Saharan Africa. This means that the successful delivery of healthcare services in the country was already grossly compromised well before the start of the pandemic. Unfortunately the pandemic has further exacerbated the situation as it has led to an estimated 900 healthcare workers in the country being quarantined.
An urgent call for action
Without urgent intervention, Southern African countries face the prospect of becoming the next epicenter of a covid-19 induced humanitarian and socioeconomic crisis that threatens to unwind decades of human development in less than 6 months.
Countries like DRC, Malawi, Mozambique, Zambia and Zimbabwe urgently require substantial upscaling of testing and surveillance and strengthening of their healthcare systems to ensure they are not overwhelmed. The current pace at which the virus is spreading also strong suggests the need of at least, well implemented localized restrictions in movements to break the cycle.
It goes without saying that the governments of these countries will not be able to achieve this without assistance from a range of partners that include development partners, the private sector, the diaspora as well as private citizens.
PS: Please consider contributing to the fight to avoid overwhelming Malawi’s healthcare system by donating to a fund established to support Malawi’s healthcare system. No donation is too small. To donate, please visit: https://www.gofundme.com/f/70p2cpk
