Covid-19: Africa hit by a second, deadlier wave

The indicators are red. Africa, spared by the first wave of the coronavirus, is facing a second, much stronger and deadlier wave. The continent’s mortality rate, 2.5%, now exceeds the world average of 2.2%, according to the Africa CDC. The number of cases on the continent rose by 14% per week in December.

South Africa is overwhelmed by the rapid spread of the variant virus. Its neighbours are also affected. The Maghreb is also facing a rise in cases. In West Africa, Nigeria, Mali, Mauritania, Burkina Faso, Senegal, the number of cases has risen rapidly since December. We are witnessing a reversal, » Judge John Nkengasong, Africa CDC director, told a press conference on 21 January. « The increase in the mortality rate marks a break with the first wave, during which Africa had remained below the world average, » he insists. He is extremely concerned, particularly by the circulation of the South African variant, and also admits, in an interview on France 24, that the number of cases reported on the continent is obviously underestimated.
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On the continent, 21 countries have mortality rates above the world average of 2.2%. In Sudan, the virus kills 6.2% of those infected, and 5.5% in Egypt. In West Africa, Liberia has a case-fatality rate of 4.4%, Mali 4.1%, Chad 3.6% and Niger 3.5%* (see list). The highest case-fatality rate, 11.8 per cent, is recorded in the Saharawi Arab Democratic Republic, a member state of the African Union.

This excess mortality is caused by the accelerating number of patients clogging up the continent’s health systems, explains Africa CDC. Africa remains, according to the figures, one of the least affected continents, with 3.5 million cases of Covid-19, or 3.5 per cent of the world’s cases and almost 87,900 deaths, according to the agency as of 27 January.

South African variant

Identified in October by South African researchers, Covid-19 strain 501Y.V2 is spreading across the continent and around the world. Its propensity to spread more rapidly is causing concern and alerting health authorities around the world. Since then, other variants, English and Brazilian, have been causing concern.

In South Africa, the situation has deteriorated considerably since the discovery of this new, more contagious variant of the virus, which now accounts for more than two-thirds of cases in the country. Although it is not more deadly, its higher contagiousness is contributing to overloading hospitals. By the end of January, the country had more than 40,000 deaths, almost half of the Covid-19-related deaths reported on the continent.

This variant has also been identified in six other African countries: Botswana, Comoros, Gambia, Ghana, Kenya and Zambia. It is probably present in many African countries, but it has been little detected due to the low capacity of countries to sequence the virus’ genomes. In France, two outbreaks of people infected with this South African variant were identified after a religious trip to Mozambique last December. Around twenty countries in the world, in Asia, Europe, North America and Australia, have already reported it. Measures are being taken to prevent its spread in the overseas territories, in Mayotte and Reunion Island, and in French Guiana for the Brazilian variant, where border controls have been strengthened.

During the third week of January, 173,556 new cases of Covid-19 were reported in Africa, a 17 per cent decrease in the number of new cases reported compared to the previous week. This decrease is largely due to the recent drop in the number of new cases reported in South Africa. « Some member states have tightened restrictions on social measures, which has influenced the decline in reported cases, » CDC Africa also notes.

Patient management

Now, in many countries, the dynamics of the epidemic « are overwhelming the capacity of nurses and doctors to care for patients, » Nkengasong said. Supplies of equipment, including the need for oxygen to treat severe forms of Covid-19, are becoming « critical ».

With hospitals overwhelmed, people are turning to the vaccine. A handful of countries are launching their vaccination campaigns, based on bilateral contracts (Morocco, Seychelles, Egypt and Guinea). In the coming weeks, 1.5 million vaccines are expected in South Africa. This order is part of negotiations between the government and the AstraZeneca-Oxford alliance. South Africa will pay 2.5 times more for its doses than the European Union. Taking advantage of the virtual Davos summit, the South African president shared his anger: « The rich countries of the world are monopolising these vaccines. We call on them to make available the surplus doses ordered and hoarded, » he said via a video message. The European Union is hiding behind the fact that it, for its part, has helped fund research into the vaccine.

For its part, the African Union has ordered 270 million vaccines for the continent, in addition to those planned through the Covax scheme, an initiative of the World Health Organisation (WHO) and private partners for equitable access to vaccines. This WHO scheme should make it possible to vaccinate 10% of the African continent’s population.

Vaccines are still missing

« It is not vaccines alone that will help us to end this pandemic, it is vaccination, » said WHO Director General Tedros Adhanom Ghebreyesus. « The rapid and equitable distribution of vaccines is not only a moral imperative, but also a strategic and economic health security imperative, » he stressed.

• List of 21 countries reporting lethality rates above the global rate of 2.2%. These are the Saharawi Arab Democratic Republic (15.4%), Sudan (6.2%), Egypt (5.5%), Liberia (4.4%), Mali (4.1%), Chad (3.6%), Niger (3.5%), Eswatini (3.4%), Zimbabwe (3.4%), The Gambia (3, 2%), Tunisia (3.2%), Comoros (3.2%), Democratic Republic of Congo (3%), South Africa (2.9%), Somalia (2.7%), Algeria (2.7%), Malawi (2.6%), Mauritania (2.5%), Angola (2.4%), Sierra Leone (2.4%) and Senegal (2.3%).