There has been a slight increase in Covid‐19 infections in Africa over the past month, according to the latest information from the Africa Centres for Disease Control and Prevention (Africa CDC). The number of new daily confirmed cases has started rising after declining since mid‐July, although in some countries cases are still on a downward trend.
Over the four weeks up to October 25th, there was a 6% average increase in new cases, according to the Africa CDC. This was across most regions except in west and central Africa – in Nigeria, there was a decline in new cases. Egypt, Democratic Republic of Congo, South Africa and Kenya recorded increases over this period, but in Ethiopia, there was a marginal decrease. And other countries which have experienced the decreases in new cases include Sierra Leone, the Gambia, Burkina Faso, eSwatini and Côte d’Ivoire.
The head of the Nigerian Centre for Disease Control says the low numbers recently could be attributed to a drop in testing caused by the curfew imposed in some states following anti‐police brutality protests. By contrast, Kenya has been experiencing a steep increase in new cases. Data from Africa CDC shows over the past month, cases increased by 45% on average.
The World Health Organisation (WHO)’s Matshidiso Moeti says of the increase in Kenya: “We expect that [increase] in some countries as the measures are eased. The most important [thing] is to contain them without the situation getting out of control,” she adds. Dr Moeti also feels people could be tiring of measures such as wearing masks, social distancing and hand hygiene.
As of late October, new deaths had been declining on the continent for two weeks after being on an upward trend. The Africa CDC said on October 25th there was a 15% decrease in news deaths the previous week compared to the week before.
Most Affected
South Africa has the highest recorded number of total cases and reported deaths in Africa so far. Daily reported numbers have been stable after falling for about three months, although there have been some spikes in some provinces. Health Minister Zwelini Mkhize has warned that the country could be experiencing another rise in positive cases in some provinces. The Western Cape province – where Cape Town is located – recorded a 42% increase in cases during the seven days ending October 21st, which some reports linked to a single event at a bar or club.
However, the reported death rate per capita on the continent has been low compared with other parts of the world, despite the poor health infrastructure in many African countries. The WHO says this could be partly because of the relatively young population in Africa – more than 60% under the age of 25. Covid‐19 is known to have a higher mortality rate for older age groups, and among people with health problems like obesity and type 2 diabetes which are also less common in Africa. Experts also say expertise in epidemic control from tackling other outbreaks, cross‐immunity from other coronaviruses, low travel and outdoor living could also be contributing to Africa coping better.
In terms of what proportion of people who get Covid‐19 go on to die, there were 12 African countries with rates comparable with or higher than the global average rate of 2.9% on October 15th.
Testing
The WHO says the testing level in Africa is still very low compared to other regions. “Most African countries are focused on testing travellers, patients or contacts, and we estimate that a significant number of cases are still missed.”
Ten countries account for about 75% of the total tests conducted – South Africa, Morocco, Ethiopia, Egypt, Kenya, Nigeria, Cameroon, Rwanda, Uganda and Ghana. There are wide variations in testing rates, with South Africa doing the most and Nigeria doing relatively few per capita, according to Our World in Data, a UK‐based project which collates Covid‐19 information.
About half of the countries on the continent have a ratio lower than the benchmark of doing at least 10 tests for every positive case recommended by the Africa CDC. And in some countries, there’s insufficient data available on testing to know how much is being done. (BBC News 30/10)
Paths out of the Pandemic
There is little consensus in Africa on what the next steps should be. There are credible arguments for a wide range of policy options.
The public health corridor initiative, launched with a flourish on October 5th, comes with a new app (www.africacdc.org/trusted-travel) that has so far been adopted by 36 countries. It details the often confusing requirements for travel to different countries, lists testing centres, and allows for test results from these approved centres to securely auto‐load onto a traveller’s app, thus becoming an individualised ‘Covid‐19 digital passport’. Standardising the format and authenticity of test results was an urgent requirement.
Currently 29 countries in Africa insist that passengers arrive with a negative PCR Covid‐19 test, taken within 72 hours of departure. Africa CDC continues to push for more harmonisation, and affordability.
‘Vaccine wars’ remain a problem. At his press conference in the week‐ending October 3rd, Africa CDC director John Nkengasong was frank about the failure of the international COVAX initiative, led by French President Emmanuel Macron, to attain the numbers of vaccines Africa will need to produce herd immunity. While praising the programme for “speaking to international solidarity”, he said that the 220m doses of vaccine falls well short of what is needed.
“We’ve always said”, he asserted, “that to build herd immunity, we are going to need to achieve somewhere between 40% and 60% of population coverage. This COVAX allocation might only be 10% if we find everyone needs two shots”. He says that they have no alternative but to work to find alternative additional supplies and commended Afreximbank for being willing to provide resources. Finding supplies might be more difficult than finding the money to buy them.
There are other obstacles with signs that the anti‐vaxxers have been making headway on social media across the continent. According to the Johns Hopkins Covid‐19 Portal, many Africans say that they won’t accept a vaccination. In fact, vaccination scepticism in Africa is the worst of all the WHO’s six regions, with an average of 30% saying they won’t have a jab. An astonishing 67% of Cameroonians surveyed said they would refuse to receive a Covid‐19 vaccination. Côte d’Ivoire and Ghana also registered over 50% refusals, with Angola, Mozambique and Tanzania all returning results around the 40% bracket.
It is a serious challenge, encouraged through disinformation campaigns put out on social media. Many organisations are now working to counter the rumour merchants but after the billions of dollars invested in research, the vaccine roll‐out could be jeopardised by rumours that go viral. No wonder health chiefs are calling it an Infodemic. (Africa Confidential 8/10)
Ebola: In DR Congo 53 people have lost their lives since June in what has been the 11th outbreak of Ebola in the vast central African country since 1976. The latest Ebola epidemic there is now under control, the man leading the fight against the disease said on October 17th. “We are on the 16th day without new cases,” Professor Jean‐Jacques Muyembe wrote on Twitter, adding that the situation in the affected northwest province of Equateur was “under control”.
He said the treatment centres no longer had any Ebola patients and just one of 13 affected zones remains under surveillance. His comments were echoed by WHO. The latest epidemic was declared at the beginning of June in the northeast. Since then, a total of 128 cases of the haemorrhagic fever have been recorded (119 confirmed and nine probable) with 53 deaths, according to the authorities. The previous epidemic, which broke out in the east in August 2018, was the deadliest in the country with 2,277 deaths. (© AFP 17/10 2020)
Madagascar: An opposition figure in Madagascar was sentenced to jail for three years on October 15th for a protest over a herbal drink touted by President Andry Rajoelina as a coronavirus treatment and cure.
Harry Laurent Rahajason, a former communications minister, was sentenced to 44 months in prison for disrupting public order and inciting hatred, his lawyer Eric Rafidison told AFP.
The infusion’s effects have not been scientifically tested and the World Health Organisation (WHO) has issued several warnings against its use and distribution.
On July 13th, two youths put up a banner on a busy road in the capital Antananarivo seeking the release of the leader of their student group who had been detained in June for criticising the potion on Facebook.
They were arrested and questioned and said they were instigated by Rahajason, who was arrested three days later and placed under house arrest.
The former minister, visibly weakened, denied the accusations in court, saying: “I do not know these protesters, I have no links with them” or their leader.
Rajoelina had boasted about Madagascar’s natural resources and expertise that could “change history”.
More than a quarter of Madagascar’s 26m inhabitants have so far taken the drink, according to government figures, and there are still nine million bottles in stock.
But the Indian Ocean island nation has still recorded more than 16,400 coronavirus cases and at least 232 deaths, although the spread of infection has slowed in recent weeks. (©AFP 15/10 2020)
Malaria: Malaria cases in northern Mali have spiked, according to medical workers. The Ministry of Health said at the beginning of October that 59 people had died of malaria in the north since the start of 2020, almost double the number of deaths over the same period in 2019. Medical workers in the north registered 13,000 malaria cases between September 21st and 27th, marking an 88% increase on the previous week. Twenty‐three people also died over that period, the Ministry said.
“At the moment, the health system is really overwhelmed,” said Cheick Ag Oufene, a health centre administrator in Kidal, who called the situation “very alarming”. Mahamadou Sangare, a doctor in the northern town of Aguelhok, said malaria had been wreaking havoc since the arrival of the rainy season.
Treating severe cases is difficult in the remote north, he added, raising the likelihood of fatalities.
Rudy Lukamba, a Red Cross doctor in Mali, said Covid‐19 “has absorbed a lot of attention and redirected some of the funds, which has caused delays in prevention activities”.
“Cleaning up wetlands, clearing brushwood, drying up puddles, distributing mosquito nets and raising public awareness requires resources,” he added. (© AFP 3/10 2020)
Sudan: Health Minister Osama Ahmed Abdel Rahimhas said his ministry was committed to finding a solution to the severe shortage of life‐saving medicines in the country.
In early October Sudan’s Central Pharmacists’ Committee denounced an almost complete lack of essential medicines across the country. (SUNA 13/10)
Meanwhile residents in Western Darfur State capital, el Gineina, are calling for help decrying the “catastrophic” situation at the main hospital, where doctors are unable to cope with the steeply rising cases of chikungunya fever and the lack of facilities and medicines in general, the Darfur 24 website reported.
West Darfur State governor Mohamed El Doma has announced a state of health emergency in the state after confirming that 41 people had been infected with chikungunya fever.
Sudan’s health care system deteriorated under the Bashir regime; health services suffered from chronic underfunding and government corruption, as well as the privatisation of many public hospitals. Increasing costs of and lack of essential medical supplies have also arisen due to the country’s ailing economy. (Facebook 14/10) Coronavirus report p.22891A; Ebola on the rise in DR Congo p.22857A
