Why Has Africa Been Somewhat Spared by the Pandemic?

On the 14th of February 2020, the first case was reported in Egypt. To date, the ‘wave’ has still not arrived. How can this relative protection be explained?

Coronavirus Risk Africa

Coronavirus Risk Africa Courtesy of INSERM

Experts have been predicting a frightening scenario since the first case of coronavirus in Egypt. They predicted that Africa would quickly be hit by the COVID-19 pandemic, which would lead to a health disaster on a poor continent with a failing health system. The World Health Organization (WHO) calls on the continent almost daily to “prepare for the worst”. Weeks later, the tsunami has still not happened. This, notwithstanding the devastation in Europe, the United States, and the rest of the world.

Africa: The Continent Least Affected by the COVID-19 Pandemic

With 40,575 cases and 1,692 deaths as of May 2nd,  Africa is the continent least affected by the pandemic. Egypt is the country with the most deaths (406), ahead of Algeria, Morocco, and South Africa. In comparison, the US with a population of 365 million inhabitants has more than 65,000 Covid-19 deaths. So why does Africa, with a population of 1.2 billion, seem to be relatively spared?

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Of course, the number of cases may undoubtedly largely be underestimated. The head of the African Center for Disease Control and Prevention, John Nkengasong, admits that the statistics are not perfect due to a lack of testing. He, however, rejects the idea that cases are purposefully unreported. “Hospitals would be flooded with sick people, which is not true,” the doctor confirms. But other factors can also provide an explanation.

One Step Ahead

The epidemic reached Africa a few weeks after Europe and enabled its leaders to take preventive measures well in advance. “Even before the first cases of coronavirus were detected on Rwandan soil, we took very early hygienic measures that were applied throughout the country,” said Dr. Sabin Nsanzimana, Director General of the Rwandan Biomedical Center. South Africa, Tunisia, Morocco, and Algeria introduced restrictions and curfews before the epidemic spread.

Low Population Density

With 43 inhabitants per square km, compared with 181 in Western Europe and 154 in South East Asia, Africa remains a sparsely populated continent in most regions. The population is concentrated in the capitals and most were closed very early. In Ivory Coast, Abidjan has been officially isolated from the rest of the country since 30 March. The same applies to Nigeria, where the inhabitants of the two mega-cities Abuja and Lagos were not allowed to leave the city. This low density considerably reduces contact and thus the transmission of the virus is halted.

A Lower Influx of People

In contrast to most Western countries, many parts of Africa are still somewhat isolated and live in virtual self-sufficiency. As a result, the virus circulates only very rarely in the population. In comparison to Europe and the USA, most regions of Africa have less tourist movement. Of the 50 busiest airports in the world, only one is in Africa (Johannesburg). Furthermore, the number of Africans in the diaspora returning home during the Pandemic was less compared to places like China or India, who had to contend with the return of many foreign students. Also, there are fewer major population movements in sub-Saharan Africa.

A Younger Age Distribution

About 60 percent of the African population is under the age of 25. However, the coronavirus mainly affects older people: More than 72% of people who die from Covid-19 are over 65 years old. Northern Italy, the most affected region in the world, also has a very large population of older people. “On the African continent, there are no more elderly people to kill,” the Ivorian writer Gauz sarcastically said in an op-ed on the Jeune Afrique website. Africa also has a low obesity rate in comparison to the rest of the world, which is a major mortality risk factor for Covid-19.

Existing Immunity?

A preliminary study by the NHS (National Health Service) and King’s College shows a negative correlation between countries affected by malaria and countries affected by Covid-19, which can be explained by the possible protective effect of preventive malaria treatments such as chloroquine. According to another study, it is the systematic BCG vaccination used in Africa that could explain the immunization of the population. Countries without a universal BCG vaccination policy, such as Italy and the United States, are most affected by Covid-19, the authors note. However, these correlations do not provide any evidence of cause and effect.

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