What is the research about?
When the COVID-19 pandemic started in early 2020, there were many theories circulating about why Africa seemed to have fewer cases than the rest of the world, including climate and increased sunlight, younger populations and natural immunity. However there has been little cross-continent analysis of the pandemic in a region that has more than 1.3 billion people. Understanding the variation of disease and response capacity across the continent is important to understand how resources should be allocated and how a region-wide crisis could be addressed better in future.
The researchers suggest that the relaxing of public health measures such as distancing and intermittent lockdowns – driven by economic necessity and pandemic fatigue – probably contributed to higher death tolls during the second wave.
What did the researchers do?
In a study published this week in The Lancet, researchers analysed trends in the COVID-19 pandemic between 14 February and 31 December 2020. They looked at how testing rates, as well as public health and social measures to mitigate the crisis, affected the numbers of cases and deaths. Previous studies have focused on predictions of how the pandemic would play out across the continent, but this research is one of the first to review actual patterns of disease and risk factors in Africa.
What did they find?
The research shows that the second wave of COVID-19 was around 30% worse than the first wave, and that there was significant regional variation. By the end of last year, Africa had nearly 3 million COVID-19 cases and just over 65,000 deaths. This was a small fraction (3%) of the global total. However, the second wave in December saw nearly 24,000 daily infections compared with just over 18,000 infections in July. A handful of countries, including Morocco and South Africa, accounted for most of the cases.
What does this mean?
The researchers suggest that the relaxing of public health measures such as distancing and intermittent lockdowns – driven by economic necessity and pandemic fatigue – probably contributed to higher death tolls during the second wave. Insufficient testing capacity probably also explains lower numbers than the rest of the world – in the first wave, only 25% of African countries could meet the demand for testing, and even by the second wave, this proportion had only risen to 33%. Data collection also needs to be improved – not all countries were gathering data daily or with sufficient information. “As African countries continue to face the COVID-19 pandemic, innovative and homegrown solutions, including local production of vaccine and rapid diagnostic tests, stronger involvement of community workers in disease surveillance, and telemedicine, have never been more important,” say researchers in a linked Commentary.