Covid-19: in Africa, a second wave more deadly than the first
A member of the medical team in a health center installed in the Steve Biko hospital in Pretoria, January 11, 2020. AFP - PHILL MAGAKOE
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6 min
According to the Africa CDC, the African Union's Center for Disease Control and Prevention, the death rate from the coronavirus pandemic in Africa now exceeds the global average.
Twenty-one countries are particularly affected.
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According to the CDC, 70% of Covid-19 patients in Africa are identified in five countries.
South Africa, with 41% of cases, is far ahead.
Morocco, Tunisia, Egypt and finally Ethiopia follow.
But "
the great concern
" of the CDC, according to its director John Nkengasong, is now fixed on the death rate of patients.
This mortality rate amounts to 2.5% of recorded cases, for a world average of 2.2%.
The director of the Africa CDC sees a turning point compared
to the first wave
, since this rate was then below the world average.
Among the countries concerned, the CDC cites Sudan with a death rate of 6.2% of the cases detected, Egypt (5.5%) and Liberia (4.4%).
Clogging of health systems
For the Center for Disease Control and Prevention, this increase is linked to an acceleration in the number of coronavirus cases detected.
In the past month, that number has increased by 14% every week in Africa.
This increase can overwhelm
the health systems of some countries
, due to a limited quantity of beds and equipment in particular.
“
When we see an increase in daily deaths, it means that health systems are starting to enter a phase of stress
,” explains John Nkengasong.
It also means that we are reaching a point where nurses and doctors are seeing their ability to care for patients diminish.
Because of this, care is starting to fall short, since there are fewer beds and less equipment available.
"
The Africa CDC director insists: “
Africa needs a significant supply of oxygen, just to assist with existing cases on the continent.
This excess mortality is not necessarily due to new variants of the disease, it is just that our health systems are starting to be overwhelmed.
I heard the director of the CDC in Nigeria say that some hospitals have had to start sorting out who will be treated and who will not.
So the crisis is here, the second wave is here, violently, and our healthcare systems are starting to be overwhelmed.
"
An average
But an epidemiologist working in Africa warns against too much dramatization: among other factors, according to him, the CDC figures mainly illustrate an increase in "
recruitment
", according to the term.
That is to say that there are for example more people who are being hospitalized today compared to the first wave.
Which mechanically increases all the statistical data.
Dr Matshidiso Moeti, Director of WHO in Africa, also recalls that this is only an average, which does not apply to all countries.
Even if we must ensure that these countries can mobilize enough caregivers and have enough supplies.
“
On average we don't think the death rate is much worse than elsewhere.
But we must ensure that basic and quality care is provided, that there is enough oxygen - which is also starting to be a problem in some places - and also ensure that patients have access to care on time.
"
What about the variants on the continent?
But experts are also concerned about
the circulation of the South African variant
on the continent.
A mutant SARS-Cov-2 that does not appear to be more dangerous but spreads 1.5 times more easily than the coronavirus, according to preliminary studies.
So far, Botswana, Zambia and The Gambia have confirmed the presence of the South African variant in their populations, the WHO says.
But the organization believes that it could circulate in other countries of the continent.
The difficulty is to be able to detect this virus.
For this, it is necessary to be able to sequence its genome, that is to say to read its genetic code.
And sequencing remains a challenge in many countries of the continent as recalled by the director of the WHO in Africa, Matshidiso Moeti.
“
What we are doing at WHO is working with several countries in Africa that have laboratories that have the capacity to sequence genomes and we have offered to other countries to send their samples to these laboratories to establish if this is the variant and whether or not this virus is circulating on their soil.
At the same time, we are also helping them develop their own sequencing capabilities.
Which will become more and more important for monitoring the virus.
"
The question is whether this variant, like those detected in England or Brazil, are susceptible to vaccines.
Studies are underway, but Dr Richard Mihigo, head of emergencies and vaccines at WHO Africa is optimistic: "
The first indications clearly show that the existing vaccines will be as effective against some of these variants
".
The WHO goal remains to see 20% of
the African population vaccinated
by the end of the year.
To date, the continent remains officially one of the continents least affected by the Covid with just over 3 million cases detected, and nearly 82,000 deaths.
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