So far, COVID-19 hasn’t hit Africa as hard as other regions, but a new study by the World Health Organization (WHO) predicts the worst of the pandemic is yet to come for the continent, and it may “smolder” for years.
The WHO shared the main findings of the study, which will be published in the British Medical Journal-Global Health, on Thursday. It lays out a worst-case scenario: If no containment measures are put in place – which fortunately, has not been the case so far – 29 million to 44 million people could be infected in the first year, and 83,000 to 190,000 could die in that same time frame. Based on prediction modeling of 47 countries that do not include Egypt, Libya, Tunisia, Morocco, Eritrea, Sudan, Somalia and Djibouti – the study also forecasts that the outbreak will peak within four weeks of widespread transmission, which about half of African countries have not yet experienced.
It also estimates that 3.6 million to 5.5 million people could be hospitalized due to COVID-19. As many as 167,000 of them would be severe cases that require oxygen support, and up to 107,000 would be critical cases requiring ventilators. This influx of patients would be a severe strain on health-care systems in the region, most of which already have a significant shortage of health-care workers, personal protective equipment and other necessary resources. In March, the WHO found that on average, health services in Africa have nine intensive care unit (ICU) beds per 1 million people, according to self-reports from 47 countries. And a huge portion of the population may not even be able to access necessary services, whether for coronavirus symptoms or other health needs. For example, the UN warned on Monday that deaths from AIDS-related illnesses in sub-Saharan Africa could double from the disruption of care during the coronavirus pandemic.
However, the disease seems to be spreading slower in Africa than in other regions, possibly because of social and environmental factors like less population movement. That’s why the study warns about a higher risk of exposure in geographically smaller countries and in countries where people can move around more easily due to better transportation infrastructure, like Algeria, South Africa and Cameroon. So far, the Africa Centres for Disease Control and Prevention has reported over 64,000 cases of COVID-19 and more than 2,000 deaths – compared to nearly 148,000 deaths in Europe and more than 80,000 deaths just in the U.S.
“While COVID-19 likely won’t spread as exponentially in Africa as it has elsewhere in the world, it likely will smoulder in transmission hotspots,” said Dr. Matshidiso Moeti, the WHO Regional Director for Africa in a virtual press conference on Thursday. “COVID-19 could become a fixture in our lives for the next several years unless a proactive approach is taken by many governments in the region. We need to test, trace, isolate and treat.”
Moeti specifically praised Namibia and Seychelles for their adherence to WHO guidance, and noted that those two countries have not reported any new cases in the last month. However, the WHO delivered its warnings just as several African countries, including Ghana, Nigeria and Botswana, have begun to ease their lockdowns due to the heavy economic toll. The economic impacts have been particularly harsh in Africa, where large portions of the population are daily wage earners in the informal sector, with little to no social safety nets or savings. Therefore, food security has become an even greater issue than it was before. While acknowledging the economic effects of current containment methods, Moeti said that opening up economies had to be progressive, starting with the most vital components of the economy – “not lockdown one day, and open up everything the next.”
In the meantime, the study recommends that countries across the continent, with the help of private partners and other governments, must urgently expand the capacity of primary hospitals and health systems to prepare for the peak that has not yet hit as well as if the disease lingers for years, as the model predicts.
Doing so, says Moeti, can actually leave Africa in a better place after the pandemic than now.
“When we came out of the devastating Ebola outbreak,” she said, “it left in those countries some determination to start up [their COVID-19 response] better. And we’ve seen how Liberia and Sierra Leone, for example, have been able to put in place measures to confront the epidemic that have been quite impressive. That painful learning really enabled them to start off at a different level [than other countries] with a different outlook on how to invest [in health systems].”
Still, she said, the severity of the situation cannot be overlooked, because, as the study suggests, this pandemic could devastate Africa – and may continue to do so long after other parts of the world have put this chapter behind them.